Monday, May 23, 2022

When should a vaccinated person recovering from COVID-19 get a boost? this is complex

People who have received a COVID-19 vaccination but haven’t had a booster and become infected are faced with a difficult choice: when to get that extra dose.

While the Omicron variant is spreading across the US, more vaccinated people are becoming infected than at any previous point in the pandemic. After recovery, some people wonder what to do next.

The lack of official guidance from government health officials about when to get boosters has added to the confusion among these patients as to whether or not they should line up for a booster shot.

Physicians and vaccine experts say that because there is limited scientific data to determine the time interval for boosters, timing should be individualized based on risk. They say that usually most recovered people can wait a few weeks before taking a third dose.

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“If you’ve had a recent illness with COVID, there’s no reason to rush out and get that booster dose,” said Buddy Creech, an infectious-disease specialist at Vanderbilt University Medical Center. “You have at least a period of eight to 12 weeks when you’re going to be highly protected because of that recent infection, and so it may be some time before you get a booster dose.”

Physicians and researchers also say that waiting will ensure that additional doses boost the immune system properly.

The highly permeable nature of Omicron has added to the urgency of getting booster shots for some people.


Photo:

Name Y. Huh/Associated Press

The discussion about when people should get their booster shots has intensified as more people are faced with the more permeable Omicron variant.

As the number of cases rise during the omicron surge, so have the successes. Recent data from the US Centers for Disease Control and Prevention shows that the rate of people vaccinated testing positive in December more than tripled at Delta’s peak at the end of August—444 people per 100,000, compared with 444 people per 100,000. compared to 132.

Those who tested positive in December came in at 1,006 per 100,000, compared to 683 per 100,000 at the end of August.

The vaccines have been shown to be highly effective in preventing symptomatic disease in clinical trials, but the two-dose primary series has been found to be less effective against Omicron than the earlier variants.

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Boosters reduce the chance of infection. Roughly 305 people per 100,000 people had successfully contracted infections in the week ending December 25, according to another CDC data set, which pulled from fewer US locations but isolated a booster effect. The rate in that data set for people who were vaccinated, but without boosters, was 512 people per 100,000.

As people who have been vaccinated but without the boost become infected, they may face different recommendations.

The CDC tells physicians that people who have finished their primary series of shots and have recovered from COVID-19 can receive a booster once, when they are not in isolation or quarantining, but additional There is no minimum amount of time for how soon after receiving the dose.

“We don’t want you to wait in line at Walgreens if you tested positive that day because it could potentially put employees at risk,” CDC official Sarah Oliver said recently during a meeting with the agency’s external panel of vaccine experts. will put it in.” ,

Amid a surge in cases, some countries are offering other booster shots. In Israel, early data suggests that a fourth vaccine dose may increase antibodies against COVID-19, but is not sufficient to prevent infection with Omicron. WSJ explains. Photo Composite: Eve Hartley / WSJ

pharmacy, where the U.S. Many people in the U.S. getting vaccinated say they follow government guidelines, but they also say people take extra steps before getting a booster.

CVS Health Corporation,

asks if patients seeking a booster have not tested positive or experienced symptoms within two weeks, a spokesman said. Walgreens Boots Alliance Inc.

The company said that patients are asked to wait at least 10 days after they started experiencing symptoms or tested positive if asymptomatic, and if they experienced symptoms, at least Be symptom-free for 24 hours, the company said.

Doctors and researchers say the lack of time lag may not matter for people who are at higher risk of developing severe COVID-19 and should get a booster relatively soon after clearing the virus. “For someone who is elderly with a lot of comorbidities, I would make a mistake in giving that booster dose,” said Dr. Gregory Poland, director of the Mayo Clinic’s vaccine-research group.

For those who are not at high risk, physicians recommend that many of them wait at least a month, possibly up to three, before receiving a booster, depending on their individual risk. They say these individuals are likely to have strong protection against infection – perhaps up to three months – from antibodies and other immune weapons that would combine with what they had received from vaccination, resulting in immunity alone by experts. seen as more powerful.

David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said a booster given soon after infection means the body will not distinguish it from a recent infection, and will not provide the proper boost.

When should a vaccinated person recovering from COVID-19 get a boost? this is complex

A vaccination site in New York City in January.


Photo:

Spencer Platt / Getty Images

“It would be hard to tell the difference between that vaccine” [booster] And just some virus that was still sitting around,” Dr. Dowdy said.

Waiting can also reduce the intensity of any uncomfortable side effects of vaccination, such as chills, headache, and fever.

Another reason to wait is the uncertainty of the duration of vaccines and immunity to infections, the researchers say, pointing to limited data on long-term infection immunity and how the virus behaves differently in individuals.

A single infection has shown to provide at least three months of protection against re-infection, and subsequent boosters protect even longer, but Dr. Creech said it is still unclear if the risk of infection Whether or not the duration of total protection changes immediately after the booster is given.

Dr. Creech’s Vanderbilt Hospital system, which requires vaccinated healthcare workers to take boosters, allows them to receive a 90-day exemption from testing positive COVID-19.

,John Kamp contributed to this article.

Write to Jared S. Hopkins at jared.hopkins@wsj.com

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