Rockefeller effort seeks to improve breakthrough infection data

State-by-state grades highlight lack of consistency in data collection and release, and negative effects on forming national response.

The Rockefeller Foundation is hoping to improve state data reporting of COVID-19 breakthrough infections by highlighting shortcomings in efforts to report this crucial pandemic information.

The foundation, which has mounted several data efforts in relation to the pandemic, sees significant problems in how data on breakthrough infections are reported. Such data is increasingly important right now, because organizations and policymakers need accurate, clear information to effectively respond to surges related to the Omicron variant.

Overall, the pandemic has highlighted data exchange and collection issues that need to be resolved to help the nation and its healthcare organizations better respond to future virus threats, and anticipate and manage capacity surges.


The country is particularly hampered by poor reporting of breakthrough infection data, researchers report in the Rockefeller report.

“Covid-19 vaccine breakthrough infection data provided by U.S. jurisdictions is incomplete and unstandardized,” report writers indicate. “We are releasing a reporting scorecard evaluating state data with the goal of improving data transparency and interpretability.”

The scorecard assigns letter grades to states best on alignment with best practices that researchers identified, and the organization plans to update grades monthly “to monitor progress.” Researchers rate state on the completeness of data reporting (cumulative reporting of breakthrough cases, hospitalizations, deaths and vaccinations; percentages of the same data; and time series data); data presentation; the sources from which data is gathered; and the regularity with which data is reported. Grades do not reflect how well a state is responding to COVID-19 overall.

Only three states --- California, Colorado and Utah – received grades of A from the initiative. Nine states received a grade of F. They include Alabama, Arkansas and Oklahoma, which has only reported on breakthrough infections once; and Florida, Iowa, Kansas, Louisiana, New Hampshire and Nevada, which have never reported on breakthrough COVID infections.

“Our analysis of state reporting found that most states are now reporting breakthrough data — with 43 out of 52 jurisdictions now regularly sharing data, up from just over half that in the summer,” researchers noted. “Almost all of those states report important cumulative counts of cases, hospitalizations and deaths; 34 of them report at least one metric over time.”

State public health departments typically have performed heroically to gather data from diverse sources to combat the pandemic, researchers said. “State health departments have been chronically underfunded, resulting in out-of-date, badly-maintained data systems for infectious disease surveillance. Some do not have resources to compile regular updates.”

States’ variable performance with breakthrough infection data seriously affects the national response to the pandemic, the researchers write.

“We are launching this scorecard due to the lack of high-quality breakthrough data in the United States. While the CDC shares some helpful information on BI rates, the information is challenging to aggregate on a nationwide scale; as a result, it is updated infrequently and cannot be broken down by state,” researchers noted. “State-provided BI data is faster and more granular than federal data, but like with other state Covid-19 metrics, largely incomplete and unstandardized. The ability to see local, fast-updating data on vaccine breakthrough infections is critical to an effective pandemic response.”

Improving data capture and release helps build public confidence in the data, as well. “Vaccine breakthrough data has other urgent policy implications; it provides crucial early warning signals for possible changes in transmission, vaccine-conferred immunity, and disease dynamics. “To understand the risk that vaccinated individuals face from variants like Delta and Omicron—and to assess impact on vaccine effectiveness of any new variants that may emerge—we need access to timely and local vaccine breakthrough data that states can provide.”

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