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Doctors say it’s generally fine for people who have had a previous coronavirus infection to get the vaccine, assuming they don’t have symptoms or an active infection.
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A CDC advisory committee has suggested that individuals wait 90 days after their infection, as re-infection is unlikely during this time.
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But for patients with long-term coronavirus symptoms, it is not known whether the vaccine might worsen an existing inflammatory response.
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For this reason, doctors say that it is best for these people to hold back.
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People who previously had COVID-19 are low on the priority list when it comes to U.S. vaccinations.
Emerging research suggests immunity to the virus could last from months to years, so U.S. officials remain focused on getting those who may become ill for the first time vaccinated.
“We want to be interested in vaccinating patients who have not been infected with COVID and who are susceptible,” Todd Ellerin, director of infectious diseases at South Shore Health in Massachusetts, told Business Insider. “Post-COVID patients will not be your first, second, third or fourth level of groups that you are going to look at for wanting to vaccinate.”
Still, people who have had infections in the past are not prohibited from getting vaccinated if they are part of a priority group such as healthcare workers or residents of nursing homes.
Advanced clinical trials from Pfizer and Moderna suggest the vaccines are safe for people with a history of coronavirus infections – and are likely just as effective in this group as in healthy individuals.
There are some exceptions, however. The Centers for Disease Control and Prevention recommends that people with an active infection wait until their symptoms have resolved – and the standard 10-day isolation period – before getting vaccinated. This includes people who have already received the first dose of the two-dose regimen of the vaccine.
“The recommendations for receiving any dose of the vaccine are not to get it if you are frankly ill at the time,” Dr Sandra Sulsky, epidemiologist and director at Ramboll, a global company told Business Insider. health science consultancy.
In December, a CDC advisory committee said people with access to a vaccine can wait 90 days after their initial infection for the first vaccine if they choose, as re-infection is unlikely during that time.
“In terms of whether the vaccine is needed to prevent re-infection, in general I am of the opinion that it cannot hurt and that it might help,” Dr Steven Deeks, professor of medicine at the ‘University of California at San Francisco. , told Business Insider. “So for the general population who have done well after COVID, [if] it’s been three months, get vaccinated. “
But for people who continue to experience long-term symptoms, the CDC has yet to offer a recommendation. This is because researchers still don’t know what is causing these persistent ailments.
For now, doctors suggest these patients are delaying getting vaccinated.
What clinical trials tell us so far
Pfizer did not screen participants for evidence of a previous coronavirus infection during its advanced stage clinical trial. It turned out that 3% of the participants had already been infected. The data indicated that the vaccine was equally effective in this group, but a Food and Drug Administration review said there was not enough evidence to know whether the vaccine prevented reinfection.
In Moderna’s trial, 2.2% of participants had already been infected.
“They were small numbers, so their stats weren’t particularly robust and you can’t really rely on them,” Sulsky said.
Still, if a person is no longer symptomatic, doctors say there is little risk of an adverse reaction based solely on a history of coronavirus infection.
Read more: What’s the next step for COVID-19 vaccines? Here is the latest of 11 major programs.
Instead, it is the ‘long haul’ – coronavirus patients whose symptoms last three weeks or more – who continue to mystify doctors.
“It would be difficult to engage a long haul in [a vaccine] study if they have ongoing health problems, “Natalie Lambert, associate professor of medicine at Indiana University, told Business Insider.” Ethically there would be big problems getting them vaccinated .
Deeks said it is likely that some long haul will be vaccinated anyway, whether as part of clinical trials or as part of general vaccinations in the United States. So, ultimately, scientists can acquire enough data to know if the shots are safe for this group.
Long-haul should wait
The FDA said there was “insufficient data” to assess whether coronavirus vaccines are safe for people with weakened immune systems. It is possible that long haul would fall into this category.
This makes it difficult for physicians to give individual advice on whether to vaccinate long-haul patients.
“It would certainly make sense to see your primary care provider, but since no one knows what to do, you’re not really going to get the advice of an informed expert,” Deek said.
At the moment, he said, there are two dominant theories as to why some people develop long-term symptoms.
The most plausible explanation, Deeks said, is that the long-term symptoms of the coronavirus are linked to an inflammatory response initiated by the virus. In this case, he added, the vaccine could worsen the inflammatory response.
“It’s easier to say it would cause more harm than good,” Deeks said. “With no data and no rush to get the vaccine, I would wait.”
The other idea, he said, is “a theoretical argument that persistent infection is causing symptoms and that if you improve your immune response to infection with a vaccine, you will get rid of it. infection and you will get better. “
But the theory, he added, “seems highly improbable.”
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