JOHNSON CITY, Tenn. (WJHL) – Mitch Miller thought he just had allergies when he first felt run down the weekend before Thanksgiving. The Johnson Citian was fully vaccinated, after all.

But with a family visit coming up that would include some older folks, the 38-year-old decided to get tested for COVID-19 after spending the Monday before the holiday feeling pretty cruddy. The day before Thanksgiving, he learned that he had a breakthrough case.

“I went and got tested and I was shocked,” Miller told News Channel 11. “I didn’t think I had it.”

In the last week, more than a fifth of new COVID-19 cases in Tennessee were among vaccinated people.

As it turns out, situations like Miller’s are more common than people might have expected them to be when COVID vaccines burst onto the scene early this year. A new data tool on the Tennessee Department of Health (TDH) website reveals vaccinated people account for almost one in four new COVID cases statewide since Nov. 1.

Another TDH report shows that figure was about one in six for a period from May through September, when vaccine effectiveness had had less time to wane.

And regional data show the area’s most vaccinated county — by a long shot — has Tennessee’s highest seven-day COVID case rate per 100,000 population and the third-highest 14-day rate.

Washington County’s seven-day rate of 443 new cases per 100,000 is well above Northeast Tennessee’s 340 and about 2.5 times Tennessee’s current rate of 183.

Even deaths among the vaccinated have occurred in numbers that may surprise some people, given the degree to which the vaccines’ ability to almost completely prevent severe illness has been touted.

Washington County has Tennessee’s highest current COVID case rate — and one of the state’s highest vaccination rates.

Public health experts, though, tell News Channel 11 the data aren’t unexpected — and they say comparative hospitalization and death data are much more important clues into the difference COVID vaccines make.

“We recognize the vaccines are not perfect in preventing mild disease or disease transmission,” Sullivan County Regional Health Department Medical Director Dr. Stephen May said Tuesday.

“While unvaccinated people are more likely to get COVID-19 than vaccinated people…some people who have been vaccinated do get COVID-19,” East Tennessee State University College of Public Health Dean Dr. Randy Wykoff added.

But the numbers also don’t shake their conviction that vaccination, and more of it, continues to be the key to turning the COVID pandemic into a manageable endemic.

“It’s the seriousness of the disease, the need for hospitalization, ventilation and death we are really concerned with,” May said. “There, the efficacy has actually held up very well.”

Miller said he has personal experience to back that up. By the time he tested positive, his symptoms were already quite mild.

“I do feel like it did help me in terms of recovering, helping my body be more prepared,” Miller said. He knows people who haven’t had that layer of protection and whose COVID cases have turned out much differently than his.

“I have friends who were unvaccinated who had major, major issues with it.”

A new tool for TDH — breakthrough data

The Tennessee Department of Health (TDH) debuted a “Breakthrough Cases” tool on its daily COVID data webpage Monday. The Virginia Department of Health (VDH) has reported on breakthrough cases comprehensively for months.

Tennessee’s data show that slightly less than a quarter of new COVID cases over the past six to eight weeks have been among vaccinated people. The tool does not separate data for partially vaccinated people and fully vaccinated.

Unvaccinated people have gotten infected at a rate around three to four times higher than unvaccinated people, generally.

For instance, the week ending Nov. 21 saw 28 out of 100,000 unvaccinated Tennesseans contract COVID. That was just over three times the rate for vaccinated Tennesseans — nine per 100,000.

ETSU’s Wykoff said the gap nationwide, at least according to U.S Centers for Disease Control (CDC) estimates, is even wider, with an estimated 5.8 times higher likelihood among unvaccinated people to contract COVID.

The numbers that matter most — analyze with caution

The new web tool provides an interactive graphic allowing users to compare those rates per 100,000 for cases, hospitalizations and deaths. It also shows the total percentage of each metric that unvaccinated and vaccinated people account for.

That same data has been available for some time in TDH’s weekly “critical indicators report,” Wykoff said.

The latest such report, released Friday, shows a total of 793 vaccinated Tennesseans have died from COVID and 1,882 have been hospitalized. A total of 77,423 breakthrough cases have occurred, meaning 1.07% of those cases have ended in death.

The report gives a five-month snapshot, from May to September, that allows for specific comparisons for hospitalization and death rates among vaccinated and unvaccinated Tennesseans.

Unvaccinated Tennesseans accounted for about six times as many cases as vaccinated folks — 360,029 to 62,492.

During the same period, there were 3,479 deaths among unvaccinated people and 578 among vaccinated people. That’s a rate of 0.97% among unvaccinated people and 0.92% among vaccinated people — not much of a difference.

Many factors can impact these numbers, though. The percentage of older people and people with underlying conditions who are vaccinated, for instance, is much higher than that of younger people.

Very low percentages of children 12 to 18 were vaccinated between May and September, and no children under 12. Cases among that age group also produce almost no deaths.

“Breakthrough cases do happen,” Wykoff said. “Serious breakthrough cases do happen, some deaths happen. The reality is, someone who is vaccinated is much, much safer when it comes to COVID than someone who isn’t.”

Wykoff said the CDC estimates unvaccinated people have a 14 times greater chance of dying from COVID than those who are vaccinated. May also said the data don’t create any doubt in him about the importance of vaccines.

“The most important numbers we look at are the percentage of those who are admitted to the hospital who are unvaccinated,” May said. “Right now for Ballad (the region’s hospital system) that’s about 91%.”

The best current path forward — more vaccinations and mitigation measures

Vaccines aren’t perfect, May said, but they’re “critical in fulfilling the mission of decreasing hospitalizations and mortality.”

Even among the vaccinated, “we still have to worry about disease transmission to those who are at high risk for complications — and those who are high risk and unvaccinated,” he added.

For now, with less than 50% of the region’s population fully vaccinated, May said social distancing, masking and other efforts to slow the spread of COVID are crucial.

“These mitigation strategies work,” May said, adding that people should get tested regularly if they have any symptoms in addition to distancing and masking in public.

“This is not a matter of politics or anything else,” he said. “This is a matter of consideration for your fellow man.”

For his part, Miller has gotten a booster vaccine dose and gotten even more stringent about what he said was already a pretty careful approach to public settings — which he is in often due to his job.

He said he doesn’t want to force vaccination on anyone but he isn’t hesitant to lay out his reasons for choosing it.

“I weighed all the things that were of value to me and it led to me making the decision to get vaccinated,” Miller said. “I at least feel better knowing (his COVID case) had a smaller impact that it could have had … (and) I feel like for me, I was doing my part to protect the people I love.”