Physician assistant Becky DeCamillis, of Novant Health Infectious Disease Specialists – Winston Salem, gets asked all the time: Can I skip the vaccine if I already had the coronavirus? Doesn’t that make me immune? Her answers follow, along with further input from Dr. David Priest, Novant Health senior vice president and chief safety. Bottom line: Why roll the dice when vaccines are available? And just because COVID-19 is receding, doesn't mean the pandemic is over. It's not. People who were not fully vaccinated are still getting sick.
If I've already had COVID-19, why do I need the vaccine?
People who have had COVID-19 often have some immunity after recovering, but the level of protection varies from person to person and we don't know how long this protection lasts. Since immunity after infection is unreliable, we can't say for sure that having COVID-19 protects someone from passing it to others or getting infected again, although reinfection is uncommon within the first 90 days after testing positive.
Vaccination, on the other hand, provides consistent immunity with higher antibody levels than what is seen after COVID-19 infection.
What about an Israeli study that suggests natural immunity from having had COVID is stronger than the vaccine?
Priest weighs in here: "That's a good question. Studies from different parts of the world are coming to somewhat different conclusions at times. The struggle with natural immunity is everyone's different, right? How old you are, what other health problems you have, what medications you take, and frankly, how big a dose of COVID did you get when you were infected. And so some people will get infected and have very mild symptoms, and they tend to have milder immune responses and their protection probably doesn't last very long. And there's a study on the CDC website right now that looks into this and found that those individuals were much more likely to get COVID a second time. What we know about vaccination is that it gives you a more even and predictable immune response.
"And so we take the approach as the CDC does, that if you've had COVID, we encourage you to get vaccinated. It's very hard on an individual person to determine whether their COVID gave them enough protection to avoid getting infected again, and how long that protection lasts. So we do encourage individuals who've had COVID to go ahead and get vaccinated."
If I've had COVID-19, are there any scenarios in which I should NOT get vaccinated?
If diagnosed with COVID-19, you should isolate, according to Centers for Disease Control and Prevention guidelines. You are eligible for the vaccine once your isolation period is over, which is usually 10 days after symptom onset if your symptoms are improving. If you received convalescent plasma or monoclonal antibody therapy for your infection, you should wait 90 days prior to getting vaccinated.
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Do I still need both doses of the mRNA vaccine (Pfizer or Moderna) if I've had COVID-19 before?
Yes. We don't have strong data to say that only one dose of the mRNA vaccine provides lasting protection for this group.
I felt really bad when I had COVID-19 and don't want to go through those symptoms again. Will the vaccine make me sick?
Like everyone else, those who have had COVID-19 previously may have some side effects, also known as expected effects after receiving the vaccine, like sore arm, tiredness, body aches, malaise, headache or fever. Fortunately, these symptoms are short-lived and usually resolve within 48-72 hours. We don't have data to say that people with previous infection experience more severe expected effects than those without previous infection. It's also important to remember that none of the COVID-19 vaccines can give you the virus itself.
In a nutshell: There's little way to know if you are protected from reinfection after having COVID-19, or how long that immunity will last. Getting the vaccine is the best way to protect yourself. It will also protect you from passing the virus on to your family and friends.