Breakthrough Covid cases: At least 125,000 fully vaccinated Americans have tested positive

At least 125,000 fully vaccinated Americans have tested positive for Covid and 1,400 of those have died, according to data collected by NBC News.

The 125,682 "breakthrough" cases in 38 states found by NBC News represent less than .08 percent of the 164.2 million-plus people who have been fully vaccinated since January, or about one in every 1,300. The number of cases and deaths among the vaccinated is very small compared to the number among the unvaccinated. A former Biden adviser on Covid estimated that 98 to 99 percent of deaths are among the unvaccinated.

But the total number of breakthrough cases is likely higher than 125,683, since nine states, including Pennsylvania and Missouri, did not provide any information, while 11, like Covid hotspot Florida, did not provide death and hospitalization totals. Four states gave death and hospitalization numbers, but not the full tally of cases.

And vaccinated adults who have breakthrough cases but show no symptoms could be missing from the data altogether, say officials.

Health officials continue to caution that breakthrough cases were expected, extremely rare and not a sign of vaccine failure. For example, according to Erin McHenry, spokesperson for the Minnesota Department of Health, "Our most recent data shows that 99.9 percent of Minnesotans who are fully vaccinated have not contracted the virus. Even among those very rare breakthrough cases, we have seen very few illnesses serious enough to require hospitalization."

Some state officials said that they could not be sure the vaccinated individuals had died from Covid-19 or from other causes. But other states directly attribute the cause to Covid-19: 32 deaths in Louisiana, 52 in Washington state, 24 in Georgia, 49 in New Jersey, 169 in Illinois.

Breakthrough cases among the elderly were more likely to be serious, according to available data. In Washington state, 27 of the 52 people who died were known to be associated with long-term care facilities, according to state information. In Louisiana, the median age of those with severe outcomes was 73.

For other states that publish data like Utah, it's clear breakthrough cases have accelerated in the past two months. In Utah on June 2, 2021, just 27 or 8 percent of the 312 new cases in the state were breakthrough cases. As of July 26 there were 519 new cases and almost 20 percent or 94 were breakthroughs, according to state data.

In Virginia, total breakthrough cases resulting in death from Covid-19 went from 17 in mid-July to 42 on Friday.

In Oklahoma, where cases are up by 67 percent, state officials broke down the data to show that for residents who got Johnson & Johnson vaccine the incidents of breakthrough were greater at 160 per 100,000 people compared to 93 per 100,000 for Moderna.

NBC News contacted health agencies in 50 states and the District of Columbia to collect data in the absence of complete and current numbers from the Centers for Disease Control data on breakthrough cases.

CDC spokesperson Jasmine Reed told NBC News in an email that "state and local health departments continue to report breakthrough cases to CDC to identify and investigate patterns or trends among hospitalized or fatal vaccine breakthrough cases" but the agency stopped publicly releasing that data on May 1, saying it was focusing instead on cases resulting in hospitalization or death.

CDC's most recent published data on hospitalizations and deaths in breakthrough cases does not break out how many people have died, saying instead that as of July 19 that there have been 5,914 fully vaccinated Americans who have been hospitalized or died from Covid-19. Research by NBC News indicates that the number who have been hospitalized or died has already passed 7,300 in just the 30 states providing data.

Dr. Marcus Plescia, medical director for the Association of State and Territorial Health Officials, says federal and state officials are still trying to understand the breakthrough rate especially when people who take at-home tests are under no obligation to report the results to health departments. And he says while there are concerns that the percentage of breakthrough cases may be higher in the elderly and immuno-compromised than was once thought, the vaccines are still effective. "Seventy percent is still really good, it's better than most flu vaccines," he said.

While some states track breakthrough cases meticulously, others — like Missouri, where cases are surging — lack "quality statewide data," according to state officials. Other states are choosing to only release partial data.

For example, like Florida, New York is not releasing data on breakthrough deaths.

"We are continuing to investigate the number of fully vaccinated people who may have been hospitalized or passed away," said Abigail Barker, spokesperson for the New York State Department of Health.

Even among states that track cases closely, officials cautioned data is likely incomplete. Vaccinated people who are infected but asymptomatic are probably largely missing from statistics.

Robert Long, spokesperson for Maine Department of Health and Human Services, said, "Those who have been fully vaccinated and have a breakthrough case but are not symptomatic and not part of a regular testing protocol may never be captured in these numbers."

The CDC is now changing tactics amid new information showing that fully vaccinated people who get Covid can transmit the virus to others.

Critics of the agency like former FDA Commissioner Scott Gottlieb, said federal officials are failing to capture the overall scope of infection of Covid cases. Gottlieb told CNBC Friday, "I suspect probably one in 10 infections is actually getting reported."