By Dr. Max Gomez

NEW YORK (CBSNewYork) — There has been much talk about Colin Powell succumbing to COVID-19 complications, even though he was reportedly fully vaccinated.

But there are a number of medical considerations other than vaccine status that could’ve played into Powell’s death.

READ MORE: Gen. Colin Powell, Former Secretary Of State, Dies At 84 Due To Complications From COVID-19

As CBS2’s Dr. Max Gomez explains, first off, no vaccine, even with boosters and multiple doses, is 100% protective. COVID vaccine effectiveness is often cited to be in the high 80s and mid 90s against severe disease and death. That still means you could fall in the 10%, maybe 15% group that is unprotected.

Part of who lands in that group is the individual’s immune system. We know older people don’t respond as well to a vaccine. Powell was 84. We don’t know whether fully vaccinated means two shots and/or a booster, or how long it has been since his shots. Immunity tends to wane with time.

COVID VACCINE

Then, most importantly, what were his other health issues?

READ MORE: Reaction Pours In To The Death Of Gen. Colin Powell

“We don’t know if he had hypertension, or diabetes. We do know that he had multiple myeloma and was on treatment for it,” said Dr. Mangala Narasimhan, director of critical care services at Northwell Health.

That last condition, multiple myeloma, is critical, Narasimhan said.

“Multiple myeloma, which we know is a blood cancer, we know that it affects your ability to make white blood cells and red blood cells. It affects your immune system, and the treatment for it are immunosuppressive drugs to suppress your immune system, which may also have affected his ability to respond to the vaccine,” Narasimhan said.

CORONAVIRUS PANDEMIC

In fact, a new study from Mt. Sinai shows that multiple myeloma patients have a poor immune response to vaccines. Still, vaccines can and will protect you against COVID, but if you are older or have other underlying medical issues, you should still wear a mask, and socially distance for maximal protection.

MORE NEWS: PHOTOS: Colin Powell Through The Years

One thing that is often missed about Powell is his sense of humor. Gomez had written a book on prostate cancer some years ago, and at a speech he giving, Powell found Gomez and related a humorous and self-deprecating anecdote about how the doctors had suggested he learned how to do a minor medical procedure on himself after he had prostate cancer surgery. But it may have been the only time he pulled rank, and ordered his military doctors to stand down. They weren’t about to teach the four-star general how to do anything like that.

Dr. Max Gomez