INDIANAPOLIS — Stopping COVID-19 is proving exceedingly hard to do.

Whether gaining antibodies via a vaccine or from having caught the virus before, neither approach is a silver bullet against picking up the virus, or one of its newer variants, again.

Getting an immunity boost from either method, whether vaccine or natural, has been shown to make a person less likely to get infected again — or in the case of vaccinated individuals, for the first time — as well as decreases the likelihood of being hospitalized or dying from the virus.

Vaccination allows a person to get the immune boost without suffering a potential illness and the risks associated with it. While the vaccine can have side effects, most are mild and last a day or two while severe reactions are exceptionally rare and generally occur at rates less than the risk a person would face by getting COVID-19.

But both types of immunity can and do fail.

As of Jan. 21, Indiana had seen 45,478 reinfection cases. Reinfections are people who had COVID-19 once before and then contracted it a second time.

As for vaccine breakthroughs, 218,793 Hoosiers have suffered a breakthrough infection after vaccination.

While the number of breakthrough infections is larger, a few caveats with the numbers:

First, the state started recording breakthrough infections earlier than it did reinfection cases. Indiana’s reinfection numbers are only from Sept. 1, 2021, and forward, while breakthrough records started before that. Indiana had just over 5,300 breakthrough cases recorded as of Aug. 9, 2021.

Second, the number of vaccinated individuals is far larger than the number of people who had COVID-19 at least once before.

Indiana has about 3.63 million individuals who are fully vaccinated, as compared to about 1.5 million people who contracted COVID-19 and didn’t die from it.

On a percentage basis, to date, the reinfection rate has been about 3% of people who had COVID-19 once. Meanwhile, the breakthrough rate is about 6% of the total vaccinated population.

Indiana has seen an increasing rate of breakthroughs in recent months as the delta variant continued to rage in the latter half of 2021 and the new highly infectious omicron variant arrived.

Health officials have noted that breakthrough infections are likely to increase as immunity for the first course of vaccines wanes. Booster shots are recommended for anyone six months past their original two-shot dosage of Moderna or Pfizer vaccines, or two months after a Johnson & Johnson vaccine. Those boosters can help re-energize the immune response to the virus.

About 1.64 million Hoosiers have received a booster, representing about half of all fully vaccinated individuals to date, so there are thousands of individuals who are continuing day-to-day life past the recommendation shelf life of their first vaccine course, leaving them more susceptible to breakthrough cases.

A recent study looking at individuals in New York and California showed that people who had gained natural immunity from a previous infection were a bit more resilient against the delta variant of the virus than those who protected themselves via vaccination.

However, the downside remains that a person has to become infected in the first place to gain that natural immunity, while Indiana statistics have shown over the last six months that the delta variant led to increased hospitalizations and deaths in unvaccinated.

People who had COVID-19 before and then got vaccinated on top of it had the greatest overall protection, the study showed.

It is still possible to suffer a breakthrough reinfection — Indiana State Health Commissioner Dr. Kris Box was one of them after she had COVID-19 in October 2020 and then was vaccinated and boosted — although those cases appear much rarer than other types of reinfections and breakthroughs.

The Centers for Disease Control and Prevention has since the start of 2021 and continues to recommend individuals get vaccinated even if they had COVID-19 before, as doing so gives the body a large boost to its immune response for future encounters with the virus.

While natural immunity showed a bit more resilience than vaccination, the clear worst option was people who hadn’t contracted COVID-19 before and hadn’t received shots, the true unvaccinated.

Hospitalization rates for unvaccinated individuals are significantly higher than for those who have some type of immunity, while death rates are also higher, especially among younger individuals who are extremely well protected if they’re immunized.

Indiana has seen 1,367 breakthrough deaths, although the average age of death for those individuals is 79 years old, people who are very old and have trouble mounting a strong immune response regardless.

Those breakthrough deaths represent just 0.62% of all breakthrough cases, a rate that’s half of the state’s all-time known-case death rate of about 1.31%.

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