Do COVID Survivors Have Stronger Reactions To Vaccines?

Two new studies have found a link between having strong response to the vaccine.

One study suggests those recovered from COVID may get 10 times the antibodies to fight off infection once they are vaccinated. Dr. Andrew Jameson, an infectious disease expert with Mercy Health Saint Mercy says they may also have more side effects, “People that have had been vaccinated or that have had COVID previously, are having a pretty strong reaction to the vaccine. And so, you know, it’s basically your immune system, getting that that wake up call. And so I think people just need to be ready for some of those side effects to be there. But knowing that that’s their immune system getting ready for the next time.”

Those side effects and range from mild to strong and may include fatigue, nausea, body aches and fever. People who’ve already had COVID-19 are believed to have protective natural immunity and memory that may last for months, and vaccination further boosts this response. Still, to this point, the CDC recommends that people receive both doses of Pfizer or Moderna “to get the most protection,” regardless of personal history. That’s a lot of second shots. With more than 110 million total COVID infections in the U.S. and a global shortage of vaccine, the doses saved via a one-shot vaccination strategy could be redirected to countries like India, Brazil, and Mexico, where the need is desperate. And patients in these countries could be “fully vaccinated” much quicker—in two weeks—and spared the side effects that often accompany the second dose.

Here’s the theory behind two doses being recommended: In two-dose regimens, the first dose essentially exposes an uninfected person to the virus’s spike protein, generating a muted immune response. The second dose is intended to boost antibody and T cell response.

But for those who’ve had COVID-19, the infection itself may have done the work of the first vaccine. In April, Cedars-Sinai researchers reported that in a study involving more than 260 health care workers, a single dose of the Pfizer vaccine given to those previously infected with COVID generated an antibody response similar to that of uninfected individuals who took the two-dose regimen. A study by University of Pennsylvania researchers, meanwhile, found that a single mRNA vaccine dose provided a “robust antibody response” and strong memory B cell responses in patients who had recovered from COVID-19—but that little benefit followed a second dose. Senior author John Wherry, director of the Penn Institute for Immunology, said in an email that the Penn data “are consistent with the idea that people who experienced natural infection do not benefit immunologically from two doses of mRNA vaccine,” though one dose may be useful in that regard.

And in a letter published in the New England Journal of Medicine, researchers said they had found that individuals who previously tested positive for COVID-19 developed a quick immune response (within days) of their first mRNA vaccine dose—at a rate 10 to 20 times higher than those who were never infected.

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