Texas has seen nearly 9,000 COVID-19 deaths since February. All but 43 were unvaccinated people.

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Of the 8,787 people who have died in Texas due to COVID-19 since early February, at least 43 were fully vaccinated, the Texas Department of State Health Services said.

That means 99.5% of people who died due to COVID-19 in Texas from Feb. 8 to July 14 were unvaccinated, while 0.5% were the result of “breakthrough infections,” which DSHS defines as people who contracted the virus two weeks after being fully vaccinated.

The agency said nearly 75% of the 43 vaccinated people who died were fighting a serious underlying condition, such as diabetes, heart disease, high blood pressure, cancer or chronic lung disease.

Additionally, it said 95% of the 43 vaccinated people who died were 60 or older, and that a majority of them were white and a majority were men.

DSHS noted that these are preliminary numbers, which could change because each case must be confirmed through public health investigations. Statewide, more than 50,000 people have died of COVID-19 since March 2020, but the rate of deaths has slowed dramatically since vaccines became widely available in April.

Dr. David Lakey, the chief medical officer of the University of Texas System, said people succumbing to the coronavirus despite being vaccinated was “not unexpected.”

“No vaccine is 100%,” said Lakey, who is also a member of the Texas Medical Association’s COVID-19 task force. “And we’ve known for a long while that the vaccines aren’t 100%, but they’re really really good at preventing severe disease and hospitalizations. … There will always be some individuals that will succumb to the illness in the absence of full herd immunity.”

He added that 0.5% is “a very low number of individuals in a state of 30 million. … In the grand perspective of everything, that’s not a large number that would call into question at all the use of this vaccine.”

COVID-19 cases have been surging in Texas and nationally — mostly among unvaccinated people — as the highly contagious delta variant has become dominant. The Pfizer-BioNTech vaccine is 88% effective against symptomatic cases of the delta variant and 96% effective against hospitalizations, according to Yale Medicine. Researchers are still studying the efficacy of the Moderna vaccine against the delta variant but believe it may work similarly to Pfizer.

As of Monday, 42.8% of Texans have been fully vaccinated; the state continues to lag behind the national vaccination rate of 48.8%, according to the Mayo Clinic.

DSHS doesn’t track the number of COVID-19 hospitalizations among vaccinated people statewide because hospitals are not required to report that information to the state. Travis County’s health authority, Dr. Desmar Walkes, told county commissioners and Austin City Council members in a Tuesday meeting that almost all new COVID-19 cases and hospitalizations in the area have been among unvaccinated people.

“It’s not surprising that we have [increasing COVID-19] cases,” Lakey said. “This delta variant spreads very rapidly among individuals, and there’s only some of these individuals who have been vaccinated, and a small number of those will have severe disease. But the vast majority of the people that have severe disease will be the unvaccinated individuals.

To count deaths from the virus statewide, DSHS analyzes death certificates to find people whose cause of death was listed as COVID-19. Those records are then checked against immunization records to see if each person was vaccinated.

Disclosure: The Texas Medical Association and the University of Texas System have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.