Vast majority of ICU patients with COVID-19 are unvaccinated, ABC News survey finds

July 29, 2021

Georgiy Datsenko/iStock

(NEW YORK) — With the country in the midst of a new nationwide resurgence of coronavirus infections and hospitalizations, misinformation about the effectiveness of the vaccines has been proliferating on social media, with increased attention falling on the rare number of vaccinated people ending up in the intensive care unit (ICU). However, according to dozens of hospitals across the nation surveyed by ABC News, very few fully vaccinated people are actually ending up severely ill and in the ICU with COVID-19.

And experts say that those that do, tend to be frail or have conditions that interfere with the vaccine’s effectiveness at producing protection.

ABC News contacted 50 hospitals in 17 states, and asked them to share data on their ICU wards’ current COVID-19 patients, including their vaccination status. In the surveyed hospitals, ABC News found that the overwhelming majority of COVID-19 patients currently being treated in ICUs were unvaccinated.

Of the 271 total COVID patients in the surveyed ICUs, 255 patients, or approximately 94%, were unvaccinated against COVID-19 in ABC News’ snapshot in time.

Further, of the 16 vaccinated individuals receiving care in the ICU, almost all suffered from comorbidities and other health problems, such as cancer or weakened immune systems. ABC News only heard of one otherwise healthy and fully vaccinated individual, with no reported underlying conditions, who was in the ICU.

According to the CDC, “vaccine breakthrough cases are expected,” and, as a result, “there will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19.” But data about ICU patients’ vaccination status is not regularly reported or readily available on the federal or state level.

“The current surge of COVID-19 is driven by those who have elected not to be immunized. We will continue to see the lopsided impact of COVID among the unvaccinated, as they represent the vast majority of severe illnesses, hospitalizations and deaths,” said ABC News contributor Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital.

The hospital sampling also appears to be reflective of a national trend. According to the White House COVID-19 Task Force, severe breakthrough infections remain uncommon, and nearly all of the patients who are currently hospitalized with COVID-19 — 97% — are unvaccinated.

Dr. Lew Kaplan, past president of the Society of Critical Care Medicine and professor of surgery at the University of Pennsylvania’s Perelman School of Medicine, said that the ABC News survey data “provides crystal clear guidance regarding the SARS-CoV-2 delta variant — that vaccines work.”

Furthermore, said Kaplan, the very fact that “the overwhelming majority of hospitalized critically ill patients with this viral variant are unvaccinated, should drive our nation to relentlessly pursue vaccination of every eligible individual.”

“It is our duty and our privilege to save lives,” Kaplan said. “The COVID-19 vaccine is staggeringly effective in helping us keep people at home and alive.”

Front-line workers support the numbers

ABC News’ findings are also supported by local data. In Springfield, Missouri, county health officials reported this week that since vaccines became available, 96.5% of those who have died of COVID in the community were not fully vaccinated.

Mercy Hospital nurse Emily McMichael said the county’s findings are supported by what she’s been seeing.

“These patients are a lot sicker and a lot younger than what we saw the last go around, so it’s just really sad to see,” McMichael said. “And a lot of the population is unvaccinated.”

In Alabama, which has the lowest vaccination rate in the country, 94% of current COVID-19 hospitalized patients are unvaccinated according to state statistics — and hospital admissions are six times higher than they were just a month ago, as health care workers report an influx of COVID-positive patients in need of care.

The University of Alabama at Birmingham Hospital has seen “an explosion of cases,” with the number increasing tenfold in the last three weeks, according to Dr. Kierstin Kennedy, chief of hospital medicine.

The patients who are currently hospitalized, Kennedy said, are younger than those who were hospitalized during the last surge — but unfortunately, they are just as sick. The vast majority of those patients are unvaccinated, she said.

Similarly, in Florida, state statistics show virus-related hospitalizations are nearly at their highest point since the onset of the pandemic, with more than 1,200 COVID-19 patients being admitted to the hospital every day.

“This is heartbreaking because all this could have been avoided; this is unnecessary human suffering that we are witnessing right now,” said Dr. Seetha Lakshmi, medical director of the Global Emerging Diseases Institute at Tampa General Hospital, where she said “almost all” patients are currently unvaccinated.

Another Florida physician said he believes low vaccination rates are one of the driving factors behind the state’s significant increase in COVID-19 patients.

“The vaccine is really protective in terms of being hospitalized or in terms of dying, and the people we’re seeing that are sick, ending up on ventilators and ending up hospitalized, are unvaccinated patients,” Dr. David Wein, emergency room physician at Tampa General, told ABC News.

Few severe hospitalizations for fully vaccinated individuals

Just a month ago, 37-year-old Amanda Spencer, an unvaccinated mother of two from Ohio, became infected with the virus while on a family vacation in Florida. She spent 16 days in a Florida hospital, 11 of them in a medically induced coma.

“I never dreamed that I would go through what I did, and that I would be that close to leaving my family,” Spencer told ABC News.

Spencer said that prior to her illness, she had not necessarily been against getting the vaccine, but had found it difficult to make time to get the shot — and to some extent had been afraid of the side effects.

However, her illness has shifted her perspective.

“Having gone through what I’ve gone through, I would have much rather gotten the vaccine, and maybe had a couple of side effects,” said Spencer, adding she now plans to get the vaccine as soon as she is able. “Everybody has a right to decide what’s best for them, but my advice is that if you have an underlying condition, whether it be asthma or any type of respiratory issue, I would definitely consider getting the vaccine.”

Although patients with underlying conditions are typically at higher risk, Dr. Kennedy said that from what she has seen, “the patients that have comorbidities and are vaccinated are not getting sick enough to require intubation.”

And several hospitals contacted by ABC News reported that often, vaccinated COVID-19 patients in the ICU are being hospitalized for reasons other than COVID-19.

“You may see COVID-vaccinated patients in the ICU, but many of them are not in the ICU for severe COVID,” Dr. Jennifer Leonard, an ICU physician at Missouri’s Barnes Jewish Hospital, told ABC News. “They have mild or asymptomatic COVID and they require an ICU bed for another disease or indication.”

Overall, Kaplan said the ABC News survey data demonstrates that “even if you are vaccinated you can still become ill, but it is so much less common that the benefit of being vaccinated is vast. It is incredibly protective and it protects you, the people you love, and the people with whom you work.”

Although the vaccine may not prevent 100% of illness, it lessens the impact for most, Kaplan said.

“Fully vaccinated individuals are less likely to become severely ill because they’ve prepared their immune system,” he said.

Kennedy said that she combats vaccine hesitation by explaining to patients that, at this point, there are millions of people around the world who have received the vaccines, with minimal side effects. The long-term side effect of vaccination, she tells her patients, is that they are not dying from COVID-19.

And what about the commonly stated concern of people who are waiting to get the vaccine because they don’t want to be guinea pigs?

Kennedy said she tells her patients that “if you don’t want to be a guinea pig, then don’t get COVID.”

ABC News’ Sony Salzman, Eric Strauss, Dr. Alexis E. Carrington, Dr. Chidimma J. Acholonu, Dr. Odelia Lewis, Dr. Priscilla Hanudel, and Dr. Jay Bhatt contributed to this report.