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While some groundbreaking cases among those who are fully vaccinated against Covid-19 are inevitable, they are unlikely to result in hospitalization or death. But an important question about the breakthrough infection that remains unanswered is: Can the vaccinated develop what is called the long Covid?
Long Covid refers to a set of symptoms – such as severe fatigue, brain fog, headaches, muscle pain, and problems sleeping – that can persist for weeks or months after the end of the treatment. active infection. The syndrome is poorly understood, but studies suggest that between 10 and 30 percent of adults who catch the virus can suffer from a long Covid, including those who have only experienced mild illness or no symptoms.
But the vast majority of data collected over the long Covid has been collected from the unvaccinated population. The risk of developing a long Covid for fully vaccinated people who become infected after vaccination has not been studied.
While preliminary research suggests that it’s actually possible that a breakthrough case could result in symptoms that can linger for weeks or even months, there are still more questions than answers. What percentage of breakthrough cases result in persistent symptoms? How many of these people are recovering? Are the symptoms that persist after a breakthrough infection as severe as those that occur in the unvaccinated?
“I just don’t think there is enough data,” said Dr Zijian Chen, medical director of the Center for Post-Covid Care at Mount Sinai Health System in New York City. ” It is too early to tell. The population of people who get sick after vaccination is not that high at the moment, and there is no good follow-up mechanism for these patients. “
A recent study of Israeli healthcare workers published in the New England Journal of Medicine offers insight into the long-lasting risk of Covid after a breakthrough infection. Of the 1,497 fully vaccinated health workers, 39 of them – about 2.6 percent – developed breakthrough infections. (All workers were thought to be infected after contact with an unvaccinated person, and the study was conducted before the Delta variant became dominant.)
While most breakthrough cases were mild or asymptomatic, seven of 36 workers followed at six weeks (19%) still had persistent symptoms. These long symptoms of Covid included a mixture of prolonged loss of smell, persistent cough, fatigue, weakness, labored breathing, or muscle pain.
But the study’s authors caution against drawing too many conclusions from the research. The sample size – only seven patients – is small. And the research was designed to study antibody levels in infected people, said Dr Gili Regev-Yochay, director of the infectious disease epidemiology unit at Sheba Medical Center. It was not designed to study the risk of Covid long after a breakthrough infection.
“That was not the scope of this article,” said Dr Regev-Yochay. “I don’t think we have an answer for that.
Even so, the fact that one in five healthcare workers who have had breakthrough infections still have persistent symptoms after six weeks appears to be the first indication from a peer-reviewed study that a long Covid is possible after a breakthrough infection.
“People said to me, ‘You are fully vaccinated. Why are you so careful? ‘ Said Dr. Robert M. Wachter, professor and director of the Department of Medicine at the University of California at San Francisco. “I’m still on the side of I don’t want to have the Covid. I don’t want to get a breakthrough infection.
Dr Wachter said that despite the many limitations of the Israeli study, the data offers more evidence that those vaccinated should continue to take reasonable precautions to avoid the virus.
“I’m going to take it at face value that one in five people, six weeks after a breakthrough case, continued to feel lousy,” Dr Wachter said. “It’s enough to make me want to wear two masks when I go to the grocery store, which isn’t that heavy anyway.”
Understanding the state of vaccine and mask mandates in the United States
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- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of their immunization status, wear masks in indoor public places in areas affected by epidemics, a reversal of guidelines it offered in May. . See where the CDC guidelines would apply and where states have instituted their own mask policies. The battle for masks has become controversial in some states, with some local leaders defying state bans.
- Vaccination rules. . . and bfactories. Private companies are increasingly imposing coronavirus vaccines on their employees, with different approaches. Such warrants are authorized by law and have been confirmed in court challenges.
- College and universities. More than 400 colleges and universities require students to be vaccinated against Covid-19. Almost all of them are in states that voted for President Biden.
- Schools. On August 11, California announced that it would require teachers and staff in public and private schools to be vaccinated or tested regularly, the first state in the country to do so. A survey released in August found that many American parents of school-aged children are opposed to mandatory vaccines for students, but were more in favor of mask mandates for students, teachers and staff who don’t. don’t have their vaccines.
- Hospitals and medical centers. Many hospitals and large healthcare systems are requiring their employees to be vaccinated against Covid-19, citing an increase in the number of cases fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their hand -work.
- new York. On August 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required from workers and customers for indoor meals, gyms, shows and other indoor situations, becoming the first city America to require vaccines for a wide range of activities. . Employees of the city’s hospitals must also get vaccinated or undergo weekly tests. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon has announced it will seek to make coronavirus vaccination mandatory for the nation’s 1.3 million active-duty soldiers “no later than” mid-September. President Biden announced that all civilian federal employees should be vaccinated against the coronavirus or undergo regular testing, social distancing, mask requirements and restrictions on most travel.
The fact that the United States Centers for Disease Control and Prevention only monitors post-vaccine infections that lead to hospitalization or death complicates the study of peak infections. Although the CDC continues to study breakthrough infections in several large cohorts, the lack of data on all breakthrough cases remains a source of frustration among scientists and patient advocacy groups.
“It’s very frustrating not to have data at this point in the pandemic to know what happens to revolutionary cases,” said Akiko Iwasaki, immunologist at the Yale School of Medicine who conducts studies on the long Covid . “If a mild breakthrough infection turns into a long Covid, we have no idea what number is. “
Diana Berrent, founder of Survivor Corps, a Facebook group for those affected by Covid-19 that has around 171,000 members, conducted an informal survey and found 24 people who said they had persistent symptoms after a breakthrough infection. This is not a scientific sample and the cases have not been validated, but the poll shows the need for more data on groundbreaking cases, Ms Berrent said.
“You can’t extrapolate it to the general population, but it’s a very strong signal that the CDC must demand the reporting of every revolutionary case,” Ms. Berrent said. “We cannot know what we are not counting.”
But some experts predict that the wave of new cases caused by the spread of the Delta variant will unfortunately lead to more groundbreaking cases in the months to come. Dr Chen of Mount Sinai said it will be several months before patients with Covid long from a breakthrough infection are enrolled in studies.
“We are waiting for these patients to come to our doors,” said Dr. Chen.
Despite the lack of data, one thing is clear: getting the vaccine will reduce the risk of getting infected and becoming long Covid, said Athena Akrami, a neuroscientist at University College London who has collected and published data from nearly 4 000 Long Covid Patients After Developing Long Covid. herself after a March 2020 fight with Covid-19
“These are simple calculations,” said Dr. Akrami. “If you reduce infections, the likelihood of a long Covid will automatically drop. “
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