Dallas County health officials report four people have died from COVID-19 after they were fully vaccinated.
The four vaccine breakthrough deaths all had underlying high-risk health conditions, and three of the four were immunocompromised or on immunosuppressant medication which lowers the efficacy of the vaccine.
Doctors say COVID-19 vaccines may not offer complete protection for people with compromised immune systems and while they should still get vaccinated, they should continue to take extra precautions after vaccination.
"We really don't know whether this group of patients developed good immune response," said Infectious Disease Specialist at Baylor University Medical Center, Dr. Mezgebe Berhe.
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People with compromised immune systems, like those living with cancer or HIV, or those who take immunosuppressants for a medical condition were excluded from vaccine clinical trials.
Even though the Pfizer and Moderna trials proved the shots can be up to 95% effective in healthy people, breakthrough cases have been reported.
132 people died.
Even so, doctors say having some protection is better than none.
"If you are compromised, make sure you're vaccinated because the safety profile is excellent. Make sure the people around you are vaccinated and continue to use masks and social distancing until we have full data that can show us how protected compromised people are after vaccination," Behre said.
Kyle Killough, of North Richland Hills, heeds the advice.
He's a double lung transplant recipient and takes immunosuppressants so his body doesn't reject his new lungs.
He's fully vaccinated but still takes no chances.
"It was a little nerve racking but I don't live in fear," said Killough.
Doctors say people should not stop taking any immunosuppressant medications before their COVID-19 shot, in an attempt to have a better immune response to the vaccine.
"Any individuals on immunosuppressant therapy medications to keep their immune system in check should not stop those medications with a plan to get a COVID-19 vaccine and have a more robust response. They should always check with their physicians because holding those medications may have serious life-threatening problems," said Dr. Mark Casanova with the Dallas County Medical Society.