As the COVID pandemic grinds on, the questions keep coming. Here's the latest from Novant Health medical experts.

If someone has had COVID-19 can they get it again?

Rebekah DeCamillis
Becky DeCamillis

Yes, someone can get COVID more than once, said Becky DeCamillis, a physician assistant at Novant Health Infectious Disease Specialists – Winston Salem.

"People who have had COVID 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 protects someone from passing it to others or getting infected again, although reinfection is uncommon within the first 90 days after testing positive," DeCamillis said.

It’s also much safer to get your antibodies from a vaccine than it is to get COVID, experts say, which comes with the risks of serious complications such as blood clots or lung failure.

'I have natural immunity. I don't need the vaccine.'

Correct Priest mug
Dr. David Priest
The struggle with “natural immunity” is that everyone is different, said Dr. David Priest, Novant Health senior vice president and chief safety, quality and epidemiology officer.
“How old you are, what other health problems you have, what medications you take, and frankly, how big a dose of COVID you got when you were infected. 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,” Priest added.
Vaccination, on the other hand, provides consistent immunity with higher antibody levels than what is seen after infection. The CDC has taken the same approach.
COVID vaccine waiting area

Still need the COVID vaccine or booster? We can help.

Your vaccine

Why do I hear about "breakthrough" cases if the vaccines are effective?

No vaccine is 100% effective, but the COVID vaccines protect the vast majority of people from getting severely ill.

While numbers vary by the day, more than 95 percent of hospitalized patients at Novant Health are unvaccinated. And nearly all deaths due to COVID occur among the unvaccinated.

Dr. Charles Bregier
Dr. Charles Bregier

Much has been made of the fact that those who got breakthrough cases can infect others. That’s true. “But if you get vaccinated, you are much less likely to become infected and infect others,” said Dr. Charles Bregier, Novant Health medical director of corporate health.

"So yes, there will be breakthrough cases, but getting the vaccine will greatly reduce your chance of becoming infected by someone who has a breakthrough infection. The biggest danger from breakthrough infections is to the unvaccinated," Bregier added.

One more key point: If you get vaccinated and have a breakthrough case, your chances of becoming seriously ill are greatly reduced compared to those who are unvaccinated.

Why do I need a COVID booster?

Boosters are needed because the potency of the vaccines wane over time. Decreasing antibodies isn't unique to the COVID vaccines, Priest said. Take the flu shot, for example, which people are encouraged to get each year.

"What a booster does is increase the amount of neutralizing antibodies, making it less likely that someone would have a serious illness that results in hospitalization – or worse," Priest said. Data shows people who are 65 and older need a booster more than any other group, he added.

“The small number of people who are vaccinated and have to be admitted to the hospital are generally over the age of 65. They were vaccinated early in the pandemic and often have other medical issues," Priest said.

People who are “profoundly immunosuppressed” are also strongly encouraged to get a booster. “If you’ve had an organ transplant, are receiving chemotherapy or living with uncontrolled HIV, the booster is even more important because you generally don’t respond to vaccines in the same way,” Priest said.

Here is the latest on who qualifies for a booster and how to get one.

What is mRNA technology?

The mRNA technology in the Pfizer and Moderna vaccines is very fragile and disintegrates in roughly 48 hours. It does not affect DNA at all, doctors said, so it has no long-term effects.

Instead, it simply helps the body make a protein that looks like a COVID-19 protein, so your immune system recognizes it. Learn more about the "spike protein" here.

What is the main difference between the Johnson & Johnson, Moderna and Pfizer vaccines?

The Johnson & Johnson one-dose vaccine uses traditional vaccine technology, while Pfizer and Moderna are mRNA vaccines. While the vaccines are new, doctors have reinforced that mRNA technology is not. It’s been in development for over a decade.

Government and independent scientists — all free from political influence — carefully researched and reviewed all the science and findings behind development of the vaccines before declaring them safe. And more than 8 billion doses have been administered worldwide.

Is one vaccine recommended over another?

All three vaccines are effective in preventing serious illness and hospitalization, though Novant Health is only administering Pfizer and Moderna vaccines after the CDC updated its guidance, which cited the risk of blood clots linked to J&J’s vaccine.

“I would emphasize that the adverse events the CDC includes in their latest report are incredibly rare and involve blood clotting. However, COVID itself creates much higher risk of blood clots than the vaccine does. Despite these changes, J&J has been important tool and protected millions of people around the world from getting COVID,” Priest said.

Individuals who prefer or are only eligible for the J&J vaccine are encouraged to check NCDHHS or a retail pharmacy for availability.