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ST. LOUIS (AP) — Missouri has reported just 14 breakthrough COVID-19 cases among people who are fully vaccinated to federal health officials, even though 96 such cases have been detected in just the state's largest county.

The St. Louis Post-Dispatch reported the U.S. Centers for Disease Control and Prevention asked states at the start of this month to instruct local health departments and health systems to collect real-time information on "breakthrough infections."

States are to collect the data and enter it into a national database. But by mid-April, when the CDC announced its first tally of breakthrough infections, it caught a disease investigator for the St. Louis County Department of Public Health by surprise.

"I wasn't sure how they were following it," James Hinrichs said. "I am very confused as to how this is being collected and by whom."

The county, which has been tracking down breakthrough infections on its own, shared last week that it had come across 71 such infections out of about 226,000 fully vaccinated people. Twenty-five more breakthrough infections were added this week to bring the county's total to 96.

However, Missouri reported only 14 such cases out of about 1.6 million fully vaccinated people. Asked about the discrepancy, Missouri Department of Health and Senior Services spokeswoman Lisa Cox wrote in an email that the state is vetting information received from the county level.

"There are many more currently under review than the 14 confirmed," Cox said.

Illinois by comparison, with slightly more than double the population of Missouri, has reported 918 breakthrough infections to the CDC out of its 3.5 million fully vaccinated people, an Illinois Department of Public Health spokesperson said a week ago.

On April 20, the St. Louis Metropolitan Pandemic Task Force created a process to survey all 217 COVID-19 patients in the hospital that day and found seven had been fully vaccinated. The count serves as a baseline to track changes, said task force director Alex Garza.

The task force hospitals — which include BJC HealthCare, SSM Health, Mercy and St. Luke's hospitals — are finalizing a process to gather vaccination data on COVID-19 patients going forward, Garza said.

The state health department has not asked for breakthrough infection information from the health systems, he said.

Despite the hospitalizations discovered by the task force and St. Louis County, Cox told a reporter in an email Tuesday, "So far, none of these cases resulted in hospitalizations or deaths which is what CDC will be focusing on."

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