Table of contents:
- What doctors and other experts are saying
- Is it worth relying on the immunity that has developed after COVID-19
- What's wrong with coronavirus immunity
- Is it dangerous to be vaccinated with a high level of antibodies
- Does this mean that vaccination can and should be done by everyone who has been ill
2023 Author: Malcolm Clapton | [email protected]. Last modified: 2023-07-28 10:38
Lifehacker has collected all the available information on the topic. And I must admit that the situation is not entirely straightforward.
What doctors and other experts are saying
From a medical point of view, the history of your previous relationship with the coronavirus is not very important in this case.
For example, the American Centers for Disease Control and Prevention (CDC) categorically reports Frequently Asked Questions about COVID-19 Vaccination / Centers for Disease Control and Prevention: the vaccine should be given regardless of whether you have had COVID-19. The same is recommended by COVID-19 vaccines: Get the facts / Mayo Clinic experts from the major medical and research center Mayo Clinic.
WHO experts agree with them. They believe that vaccination can be offered to everyone who has no contraindications, including people who have already been ill. No tests - serological or virological - are needed before vaccination to find out whether the body has encountered a coronavirus infection before. This is explicitly stated in the Pfizer / BioNTech Vaccine Guidelines Temporary BNT162b2, COVID-19, Pfizer-BioNTech Vaccine Guidelines for Emergency Drugs / WHO and Moderna Moderna Preliminary Vaccine Guidelines mRNA-1273 COVID-19 / WHO.
But at the same time, WHO adds: people who have suffered a SARS ‑ CoV ‑ 2 infection confirmed by PCR research in the previous six months may postpone vaccination until almost the end of this period.
Approximately the same advice at the end of January 2021 was given by Vaccination and restrictions: what to do for those who had been ill and vaccinated / Vesti. Ru Russians Tatyana Golikova.
Tatyana Golikova Deputy Prime Minister of the Russian Federation for Social Development, Education, Health.
We do not yet recommend vaccinating those who have been ill, because our observations indicate that cases of repeated COVID-19 disease are rare.
In fact, like the WHO, Golikova proposes to postpone the vaccination due to the natural immunity that forms in those who have had a coronavirus infection. But there are still many questions around immunity.
Is it worth relying on the immunity that has developed after COVID-19
The situation is ambiguous. This can be judged from the quote from the "Temporary guidelines" Temporary guidelines. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19) / Ministry of Health of the Russian Federation Ministry of Health of the Russian Federation: “In preparation for vaccination against COVID-19, laboratory tests for the presence of immunoglobulins These are antibodies that the body produces in response to infection. Immunoglobulins M (IgM) are formed in the acute phase of the disease. IgG - a few weeks after infection. classes G and M for SARS ‑ CoV ‑ 2 virus is optional. At the same time, persons who have positive test results for the presence of immunoglobulins of classes G and M to the SARS ‑ CoV ‑ 2 virus, obtained outside the preparation for vaccination, are not vaccinated."
Based on this confusing thesis, this is what turns out. It is not necessary to check whether you were sick and whether you still have immunity to the coronavirus before vaccination. But if for some other reason you donated blood and found out that you have antibodies to infection, then the Ministry of Health does not see the point of vaccinating you. Apparently, it is assumed that you are already protected.
A similar ambiguity is found in guidelines issued by the national health services of other countries. For example, Canada's Recommendations on the use of COVID ‑ 19 vaccines / Canada.ca also do not need to be tested for previous SARS ‑ CoV ‑ 2 infection before vaccination. But those who have already been ill and reported this to the doctor are shifted back on the list of those wishing to receive the vaccine. Thus, while there are not enough drugs, they are trying first of all to vaccinate the less protected - those who have not yet met with the coronavirus.
At first glance, a strange situation is developing. On the one hand, experts admit: immunity to COVID-19 develops after an illness. And even protects against re-disease. On the other hand, representatives of evidence-based medicine do not see the point in checking the presence of this immunity and are ready to vaccinate everyone who has no direct contraindications. Why? The answer is really simple.
What's wrong with coronavirus immunity
The fact is that COVID-19 is a new and still poorly understood disease. Whether everyone develops immunity to it, how long it lasts and how reliable protection against re-infection it provides, scientists do not yet know for sure. The information collected at the moment is objectively not enough to draw any unambiguous conclusions.
So, there really is a study (albeit small, with the participation of only a couple of hundred people), which shows Jennifer M. Dan, Jose Mateus, Yu Kato, et al. / Immunological memory to SARS ‑ CoV ‑ 2 assessed for up to 8 months after infection / Science: antibodies and T ‑ cell immunity This is a type of immunity in which the body detects and attacks the infectious agent using a special type of white blood cells - T ‑ lymphocytes, which are produced after the transferred COVID-19 and protect against recurrence of the disease for up to 8 months. The authors of another, more extensive work (for which more than 12 thousand doctors were examined), suggest Sheila F. Lumley, Denise O'Donnell, Nicole E. Stoes, et al. / Antibody Status and Incidence of SARS ‑ CoV ‑ 2 Infection in Health Care Workers / The New England Journal of Medicine: People who develop antibodies after an illness are unlikely to get infected again for at least 6 months.
Sounds optimistic. The problem is that, according to researchers, there are just over 90% of such people.
That is, for every tenth sick person, antibodies simply do not appear.
There are also doubts about the immunity of those who have been ill, but with mild symptoms or without them at all. These people have antibodies, but fewer. Jeffrey Seow, Carl Graham, et al. / Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS ‑ CoV ‑ 2 infection in humans / Nature than in more severe COVID ‑ 19 survivors. This means that the immune defense may be weak and short-lived.
T-cell immunity is also not a panacea. Up to 7% of those who have recovered within 30 days after infection do not have Jennifer M. Dan, Jose Mateus, Yu Kato, et al. / Immunological memory to SARS ‑ CoV ‑ 2 assessed for up to 8 months after infection / Science of T ‑ lymphocytes capable of recognizing coronavirus and rapidly triggering an immune response to it.
But even if we assume that your body has developed both antibodies and T-cell immunity, scientists are not ready to predict how long this protection will last for you personally. Up to 5% Jennifer M. Dan, Jose Mateus, Yu Kato, et al. / Immunological memory to SARS ‑ CoV ‑ 2 assessed for up to 8 months after infection / Science people completely lose it in a couple of months and become vulnerable again Letícia Adrielle dos Santos, Pedro Germano de Góis Filho, Ana Maria Fantini Silva / Recurrent COVID ‑ 19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers / Journal of Infection before infection. Perhaps you will fall into this number.
Re-infection is rare but occurs. And sometimes people who have safely undergone the infection the first time even die the second time.
In general, since science does not yet give predictions and exact numbers, the safest way to treat those who have been ill is to assume that they can get infected again at any time. And not only get infected yourself, but also start spreading the infection.
However, the issue of immunity is not the only one that raises doubts about the need for vaccination after suffering COVID-19. There are other points as well.
Is it dangerous to be vaccinated with a high level of antibodies
Indeed, such a theoretical (this is important!) Danger has been discussed. It consists in the following. If a person who has recovered from antibodies is vaccinated, they may experience a so-called antibody-dependent intensification of infection (ASUI). That is, he runs the risk of getting sick again, but much more severe. This does not apply to all pathologies, but only to some. Science has already observed Wen Shi Lee, Adam K. Wheatley, Stephen J. Kent, Brandon J. DeKosky / Antibody ‑ dependent enhancement and SARS ‑ CoV ‑ 2 vaccines and therapies / Nature have similar effects - in particular, they have been associated with vaccination against dengue viruses and feline infectious peritonitis.
Should you rush to get a COVID-19 vaccination? One specialist in Japan says he won’t / Mainichi Japan lead immunologist at Osaka University (Japan) Masayuki Miyasaka, and she made a lot of noise. We also mentioned it here.
However, there is an important note: during clinical trials, it is impossible to find out whether a vaccine is capable of leading to ASUI. This can only be done after the mass vaccination begins.
People around the world began to vaccinate widely from December to January 2020-2021. Over the past few months, millions of people have been vaccinated. And although some scientists continue to express Darrell O. Ricke / Two Different Antibody ‑ Dependent Enhancement (ADE) Risks for SARS ‑ CoV ‑ 2 Antibodies / Frontiers concern about a possible AZUI, in practice, doctors have not yet recorded Why ADE Hasn't Been a Problem With COVID Vaccines / MedPage Today, not a single confirmed case of such a drug reaction. So the story about AZUI in this case is most likely just a horror story.
Does this mean that vaccination can and should be done by everyone who has been ill
The answer to this question is largely individual and depends on a number of factors.
So, the manufacturers of each specific vaccine prescribe in their recommendations the categories of people who are not recommended to be vaccinated - regardless of whether the person was sick before or not. These include, for example, pregnant women, children under 12 years of age, people with autoimmune diseases, and those who are currently suffering from an acute viral infection. Also, a direct contraindication is an allergy to any of the components of the vaccine.
It is probably not worth getting vaccinated for those who had had coronavirus less than 4 weeks ago. Such a period is indicated, in particular, by the Public Health Department of England. Experts believe that during this period, the person cannot yet be considered completely recovered.
And the Mayo Clinic specialists separately note COVID-19 vaccines: Get the facts / Mayo Clinic: if you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should be vaccinated no earlier than 90 days after the illness.
Based on all this, the answer to the question "Should I be vaccinated if I have already been ill?" it is best to seek with your supervising therapist. The specialist knows what specific vaccines are available in your area and what contraindications they have. He is aware of the characteristics of your body (for example, existing allergies) and the treatment that you have received or are undergoing.
In general, listen to your doctor's advice. This is the most effective way to stay healthy and protect yourself from infections - including COVID-19.
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