Surprising number of DOAs were vaccinated

Vaccines and boosters remain effective tools against severe disease, hospitalization, and death.


In the current suspected Omicron surge, 69% of dead-on-arrival (DOA) cases were vaccinated. “There’s [sic] been 21 deaths in January 2022,” said Dr. Ann Pubotsky, Guam’s Territorial Epidemiologist, “of which 13–two-thirds, almost–are dead-on-arrival.

“4 out 13 were boosted, and a total of 9, including those with boosters–so, 9 out of 13 were fully vaccinated.”

The statistic, however, does not suggest that the vaccines are ineffective; in fact, recent data from the Centers for Disease Control and Prevention (CDC) reaffirms their effectiveness. The statistic points to a more vaccinated public. The report, prepared by Dr. Ann Pubotsky et al., reveals that as of February 1st, 93.5% of Guam’s eligible population is fully vaccinated.

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In a press meeting Wednesday, Dr. Annette David, Senior Epidemiologist for the State Epidemiological Outcomes Work Group, stated, “That really goes back to the huge difference in the size of the populations of those who are vaccinated in Guam versus those who are eligible but not vaccinated.”

According to yesterday’s COVID report, 29 hospitalized COVID patients are vaccinated while there are only 17 COVID patients who are unvaccinated. But looking at the numbers alone creates a skewed understanding of what’s going on.

Size Difference

According to the Joint Information Center (JIC), approximately 133,000 people in Guam are vaccinated compared to approximately 8,000 unvaccinated people.

“This is why it’s important to keep the relative sizes of those two populations always in mind,” said Dr. David. “That’s the tether that will give us the context of the situation.”

That said, according to the JIC, 20 out of every 100,000 vaccinated people end up hospitalized. Meanwhile, 191 out of 100,000 unvaccinated people end up hospitalized.

Observing statistics from both yesterday’s and today’s COVID statistics, the unvaccinated are almost 10 times more likely to get hospitalized.

Factors to COVID fatalities among the vaccinated

Most of the DOA cases had comorbid conditions and many were elderly.

“We’re seeing the same pattern in people with chronic conditions,” said Dr. Pubotsky. “It puts people at risk whether or not they’ve been vaccinated.”

Data from the report also highlights two types of vulnerabilities to COVID that confer high-risk factors, said Dr. David. “One is a physiologic, or medical, vulnerability in those who are elderly with weakened immune systems, and those with non-communicable, with chronic diseases: diabetes, hypertension, and the like.

“But there’s a second type of vulnerability that Dr. Scott showed, and that is a socio-economic vulnerability. . . . In his second slide, he talked about how people who were DOA were more likely to have lower incomes and more likely to not have medical insurance.”

Furthermore, Dr. Pubotsky suspects the current wave is almost entirely Omicron cases. Though Guam had received a genomic sequencing machine before the end of the new year, it’s not operational and that we are still relying on Hawaii for genomic sequencing, said Pubotsky.

Nevertheless, the last samples sent to Hawaii came out all Omicron, which though less severe than Delta, has its own set of concerns.

Because it is highly transmissible, it can infect a larger population in a shorter time. It also has some immune escape, which in short, neutralized antibodies from the vaccine and negatively impacts some COVID therapeutics, such as some monoclonal antibodies (mAb) treatments.

Specifically, it is resistant to Regen-COV, but according to Dr. David, another mAb therapeutic has been proven effective against Omicron Sotrovimab. The Department of Public Health and Social Services (DPHSS) has also just announced that Sotrovimab clinics will be operational starting Friday.