Colin Powell: Vaccination to Protect the Immune-Compromised

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Colin Powell was the first African-American Secretary of State, the 16th U.S. national security advisor and a 4-star general who was the 12th chairman of the Joint Chiefs of Staff. He died from COVID-19 because he had multiple myeloma, a bone marrow cancer that prevented his immune system from functioning normally. He had received his second Pfizer vaccination in February 2021, and was scheduled to receive his booster injection when he suddenly became sick with COVID-19, was hospitalized and died at age 84 on October 18, 2021.

The death of Colin Powell sends a message to all unvaccinated people that not only are they themselves at increased risk for developing severe COVID-19, they also are more likely to spread the virus to others, increasing the risk of death for people who suffer from immune suppressive diseases.

Progression to Prominence
Powell was born in Harlem in New York City in 1937 of parents who immigrated to the United States from Jamaica. He was an average student at the New York City public schools and the City College of New York, where he majored in geology and participated in the ROTC, and then went into the U.S. Army. He served a tour in Vietnam from 1962-63, but was injured in a booby trap and spent a year recovering and learning to walk comfortably again. In 1968, he returned to Vietnam and served as assistant chief of staff of operations for the 23rd Infantry Division. During that tour, he was in a helicopter crash in which he rescued division commander Major General Charles M. Gettys.

He had a spectacular 35 year career in which he rose to become a four-star general. After the Vietnam War, he served as Ronald Reagan’s National Security Advisor and helped negotiate several treaties with the Soviet Union’s Mikhail Gorbachev. In 1989 he became the chairman of the Joint Chiefs of Staff. He retired from the Army and in 2001 at age 64, he was appointed U.S. Secretary of State. He was awarded the Presidential Medal of Freedom (twice), the Congressional Gold Medal, the Presidential Citizens Medal, and the Secretary’s Distinguished Service Award.

Multiple Myeloma and Death from COVID-19
For several years Powell had suffered from early-stage Parkinson’s disease and multiple myeloma, a blood cancer that suppressed his immune system. He was being treated with chemotherapy drugs that suppressed his immunity even more. Furthermore, he was 84 years old, so his age put him at high risk for serious COVID-19 disease. His wife was also infected with COVID-19, but she recovered with no serious problems.

Twenty-five percent of people who suffer from blood cancers produce no detectable antibodies after vaccination with the Pfizer-BioNTech or Moderna vaccines (Cancer Cell, Aug 9, 2021;39(8):1031-1033). Vaccines can help protect multiple myeloma patients as 45 percent can develop adequate antibody titers to the vaccines and 22 percent develop partial antibody titers (Leukemia, July 29, 2021).

Vaccines for COVID-19 are Highly Effective in Preventing Hospitalization and Death
The vast majority of people who are infected with COVID-19 do not suffer from serious disease. However, those who have suppressed immune systems are at significant risk for hospitalization, admission to intensive care units, intubation and death. People over 65 are at increased risk for serious disease because aging suppresses immunity. The CDC’s website has an extensive list of high-risk underlying conditions that can suppress immunity.

Unvaccinated people are almost 30 times more likely to be hospitalized with Covid-19 than those who are fully vaccinated (CDC Los Angeles study, August 24, 2021).

Unvaccinated People More Likely to Spread COVID-19
Vaccinated people appear to be less likely to spread the virus if they develop a breakthrough case of COVID-19. An indirect measure of how likely an infected person is to spread the virus to cause disease in others is the amount of virus in their nasal secretions. People who have been vaccinated and then become infected with COVID-19 have much lower concentrations of virus in their nasal secretions than those who are not vaccinated (medRxiv, preprint, Feb 8, 2021 and July 31, 2021), so getting a vaccination may help to protect others from COVID-19 infection and its serious consequences.

Lessons from the Death of Colin Powell
People who are older or suffer from conditions that can suppress their immune system should follow all the rules to help protect themselves from very serious COVID-19 disease. They should be vaccinated and get booster doses, have all their family members and friends vaccinated, avoid people who are not vaccinated, wear masks when around other people, avoid indoor places where people congregate, wash hands frequently, and follow all the other rules to help avoid infection.

I believe that healthy people and younger people who are at low risk for serious COVID-19 disease should also be vaccinated so that they may be less likely to spread the COVID-19 virus to older people and those who have suppressed immune systems, and thus are at high risk for hospitalization and death.

Colin Powell
April 5, 1937 – October 18, 2021