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LOS ANGELES, CA — The Centers for Disease Control and Prevention released a study Tuesday of Los Angeles County breakthrough coronavirus cases that shows immunity from coronavirus vaccines increasingly wained. The study played a role in the agency's decision to recommend booster shots this fall.

The study looked at 43,000 Los Angeles County adults and found that 25 percent of COVID-19 cases between May and July were among vaccinated residents. However, hospitalizations among the vaccinated were minuscule compared to that of the vaccinated. The findings show that the more coronavirus spreads through the unvaccinated population, the more likely the outbreak is to spill over to the vaccinated community. But even as immunity among the vaccinated wanes, the vast majority of LA's vaccinated population remains uninfected altogether or unlikely to experience severe outcomes.

"The Los Angeles cohort study tells a very compelling story of the impact of vaccination in protecting very well against severe disease and in reducing infection," Leana Wen, an emergency physician and public health professor at George Washington University told Politico. "It also highlights why it matters to the vaccinated if others around them are unvaccinated — the infections among the unvaccinated are spilling over and increasing the likelihood of breakthrough infections among the vaccinated."

As breakthrough infections climbed over the summer, infections and hospitalizations among the unvaccinated climbed at much higher rates, according to the study.

"On July 25, the SARS-CoV-2 infection rate among unvaccinated persons was 4.9 times and the hospitalization rate was 29.2 times the rates among fully vaccinated persons," the CDC study noted.

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Meanwhile, businesses in Los Angeles are largely doing their part to combat the outbreak, Los Angeles County Public Health Department officials said Tuesday.

Businesses checked by Los Angeles County health inspectors largely continue to be in compliance with COVID-19 health requirements, although a handful of locations — primarily gyms — were cited for violations, health officials said Tuesday.

According to the county Department of Public Health, inspectors visited 1,874 businesses during the week that ended Friday, and the "majority" of them were in compliance with restrictions. Businesses in violation of rules are generally provided with information aimed at helping them achieve compliance, but "five citations were issued to gyms and an office site for noncompliance" with health orders, according to the county.

"We are glad the majority of businesses are following the Health Officer Order on masking and other common-sense, best practice recommendations," county Health Officer Dr. Muntu Davis said in a statement. "Getting people vaccinated as quickly as possible is essential, particularly in places where people are at the highest risk.

"Unfortunately, over the past 18 months of the pandemic, COVID-19 has been the leading cause of death, surpassing coronary heart disease, stroke, lung cancer, diabetes, Alzheimer's disease, and all other leading causes of death," he said. "We must continue to work on having multiple layers of protection across the entire county as we start to move into influenza season. By increasing COVID-19 vaccinations and wearing masks in indoor settings, at worksites, and in crowded spaces, we can slow the spread of the virus."

The county on Tuesday reported another 39 deaths due to COVID-19, raising the cumulative death toll from the virus to 25,114. Another 2,600 cases were also confirmed, giving the county an overall total since the pandemic began of 1,388,143.

After seeing an overall drop in hospitalizations over the past five days, the number of COVID-19 hospital patients rose Tuesday to 1,747, up from 1,724 on Monday, according to state figures. The number of patients being treated in intensive care units rose to 463, up from 454 on Monday.

The rolling average rate of people testing positive for the virus was 2.8 percent as of Tuesday, the same rate as Monday but down from 3.4 percent a week ago.

Over the weekend, county health officials released statistics aimed at encouraging people to get vaccinated against COVID-19. According to the county, as of Aug. 7, unvaccinated adults between 18 and 49 years old were 25 times more likely to be hospitalized with COVID-19 than vaccinated adults of the same age. Meanwhile, unvaccinated adults over age 50 were nearly a dozen times more likely to be hospitalized than their vaccinated counterparts, and 17 times more likely to die, according to the county.

On Monday, the U.S. Food and Drug Administration gave full authorization to the Pfizer vaccine. It was the first of the three U.S. vaccines to receive such approval. All three versions of the vaccine have been in circulation under an "emergency use" authorization from the FDA.

"The COVID-19 vaccine is safe and remains the most powerful tool we have to both lower our risk of infection and protect against serious illness and death from COVID-19 if infected," county Public Health Director Barbara Ferrer said in a statement Monday. "The other tools to help reduce and prevent transmission are wearing a mask, keeping your distance, avoiding crowds and poorly ventilated spaces, and washing your hands frequently.

"We are grateful to the many scientists and researchers who have worked tirelessly to develop and evaluate the vaccines during the most challenging public health crisis of our lifetime. We are also grateful to the FDA for their thoughtful analyses and review processes to ensure that we can have the highest confidence that the vaccine is safe and effective. I hope the milestone of this vaccine's full approval gives those that were waiting to get vaccinated the confidence to now take this important step."

The latest figures show that 73 percent of county residents age 12 and over have received at least one dose of vaccine, and 63 percent are fully vaccinated. Among residents age 65 and older, 90 percent have received at least one dose, and 80 percent are fully vaccinated.

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