Editor’s Note: For the latest long-winded COVID-19 news and guidance, see Medscape’s article. Long COVID Resource Center.
The COVID-19 vaccine has been a game-changer for millions of people around the world in preventing death and disability from the virus. Research suggests they offer significant protection against long-term novel coronavirus.
Studies consistently find that these vaccines not only prevent new episodes of long-term 2019-nCoV, but also prevent relapses in people already infected with 2019-nCoV.
Some anti-vaccine groups have made false and unsubstantiated claims that the vaccine itself could cause long-lasting COVID-19 and be a barrier to vaccination.
To help you separate fact from falsehood, here’s a checklist for doctors about what scientific research has revealed about vaccination and prolonging COVID-19.
What Research Shows
New York Presbyterian/Infectious Diseases Specialist Dr. Lawrence Purpra, MPH, treating patients at Columbia University Irving Medical Center, says doctors working in long-term COVID-19 clinics have long been vaccinated against long-term COVID-19 outbreaks. He said he suspected it might help prevent it. His clinic had been infected with the new coronavirus for a long time.
Over the past year, several large and well-conducted studies have supported that theory, including the study below.
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In a RECOVER study published in the journal in May Nature Communications, researchers examined electronic health records of more than 5 million people diagnosed with COVID-19 and found that vaccination reduced the risk of developing long-term COVID-19. Researchers have not compared the effectiveness of boosters to the full vaccination without boosters, but experts believe that the full dose of recommended vaccine provides the greatest protection. suggests that it is possible. Study co-author and RTI International Researcher Daniel Brannock, M.D., said: “In my opinion, the more doses the better. And over time, the effectiveness of vaccination in preventing COVID-19 is increasing. “Other studies have provided compelling evidence of fading.” Triangle Park, North Carolina. “Of course, the same is true for long-lasting COVID-19.”
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Review published in February BMJmedicine They concluded that 10 studies showed a significant reduction in the long-term incidence of COVID-19 in vaccinated patients. Even a single dose of the vaccine was protective.
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A meta-analysis of six studies published last December. Antimicrobial management and medical epidemiology They found that one or more doses of the novel coronavirus disease (COVID-19) vaccine was 29% effective in preventing long-term COVID-19 symptoms.
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A meta-analysis published in June found that JAMA Internal Medicine Researchers analyzed more than 40 studies of 860,000 patients and found that two doses of the COVID-19 vaccine cut long-term COVID-19 risk by almost half. discovered.
message? COVID-19 vaccination is highly effective in reducing the risk of long-term infection with COVID-19.
“Many of the risk factors are [for long COVID] It cannot be changed, at least it cannot be changed easily, but vaccination is a decision that everyone can make,” said Dr Vasilios Basileu, a clinical professor of cardiology at Norwich Medical School, UK.wrote an article in JAMA Internal Medicine.
Why vaccines are protective
Aaron Friedberg, M.D., Ph.D., clinical co-leader of the COVID-19 Post-Covid-19 Recovery Program at The Ohio State University Wexner Medical Center, noted that the COVID-19 vaccine is effective in preventing serious illness from the virus. This may provide clues as to why vaccines may help prevent long-lasting COVID-19 symptoms.
“If you’ve been vaccinated and contracted Covid-19, it’s possible that the virus will stick to your nose and respiratory tract, but it’s unlikely that it will spread throughout your body,” he said. “It’s like a forest fire. When the ground is wet or it starts to rain, there’s less chance of a big fire. As a result, the body is less likely to experience inflammation and damage.” The lower it gets, the more likely it is that a fire will start.
Friedberg stresses the importance of getting vaccinated, even for patients infected with COVID-19, a message he consistently conveys to his patients.
“There is some protection from previous COVID-19, but for some people it’s not enough,” he said. “It’s true that after infection, the body produces antibodies to defend itself against the virus. But I explain to my patients that this is like old Velcro. It’s barely catchable, but it doesn’t last, and the vaccine is much more likely to provide a solid immune response.”
In addition, a second or third bout of COVID-19 can lead to long-lasting COVID-19 in patients, Friedberg added.
“In my clinic, we have patients who were fine after their first bout of COVID-19, but who experienced long-term, debilitating COVID-19 symptoms after they had another COVID-19 attack. There are several people,” he said. “Why leave it to chance?”
Vaccines and the “Long Vax”
Although the COVID-19 vaccine is considered to be very safe, it has been associated with very rare side effects such as blood clots and heart inflammation. There are also anecdotal reports of symptoms similar to Long coronavirus (a syndrome that has come to be known as “Long Vax”). This syndrome is a very rare condition that may or may not be associated with vaccination.
“At my clinic, I saw people who developed long-lasting symptoms suggestive of COVID-19, such as brain fog, fatigue, and heart palpitations, lasting for months, shortly after receiving the COVID-19 vaccine,” Shira said. . But he cautions that there are no published studies to suggest an association.
A study called LISTEN is being organized at Yale University to better understand the potential link between post-vaccination adverse events and long-term COVID-19.
talk to the patient
Parpra said discussions about vaccination with patients, including those with COVID-19 and long-term COVID-19, are often difficult and difficult.
“There’s a lot of anxiety about getting worse,” he explained. His conversations with patients mirror the conversations all doctors should have with their patients about COVID-19 vaccination, even if the duration of COVID-19 is short-lived. He stresses the importance of highlighting the following elements:
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Show compassion and empathy. “Many people have strong opinions, and it’s worth exploring why they feel the way they do,” says Friedberg.
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Let’s talk about side effects. “Many people fear vaccine side effects, especially if they have already had COVID-19 for a long time,” Shira explained. Such patients can be asked how they felt after their last vaccination. Herpes zoster again influenza shot. Next, we explain that the COVID-19 vaccines are not significantly different, and that temporary side effects such as fatigue may occur. headacheor a mild fever lasting 24 to 48 hours.
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I will explain the benefits. According to the Kaiser Family Foundation, 85% of people say their health care provider is a reliable source of information about the COVID-19 vaccine. This trust helps talk about the benefits of vaccines, including their ability to protect against COVID-19 over the long term.
Other ways to reduce the risk of prolonging COVID-19
Vaccines can reduce the likelihood that patients will develop long-term COVID-19. The same is true for the antiviral drug nilmatrelvir (Paxlovid). Findings published in March 2023 JAMA Internal Medicine More than 280,000 new coronavirus infections were included. Researchers found that vaccination reduced the risk of developing the disease by about 25%.
“I refer to that study to all longtime COVID-19 patients who have been reinfected with the virus,” Parpra said. “Not only does it appear to be protective against long-term COVID-19, but it also lowers the levels of circulating virus in the body, which may help prevent flare-ups of symptoms.”
Another treatment that may help is diabetes drugs metforminhe added.
Study results published in June 2023 lancet infection They found that the incidence of long-term COVID-19 was reduced by about 41% when metformin was administered within three days of symptom onset.
“We’re still trying to figure out the issue, but it’s thought it could help reduce the inflammation that causes long-term COVID-19,” Shira explained. . However, further research needs to be done before recommending its use.
source of information
Nature Communications: “Long-term COVID-19 risk and COVID-19 pre-vaccination studies in an EHR-based cohort study from the RECOVER program.” May 2023. Long-term COVID-19 risk and COVID-19 pre-vaccination studies in an EHR-based cohort study from the RECOVER program | Nature Communications
BMJ Medicine: “Impact of COVID-19 vaccination on long-term COVID-19: A systematic review.” February 2023. e000385.full.pdf (bmj.com)
Cambridge University Press: “Effectiveness of the coronavirus disease 2019 (COVID-19) vaccine in preventing post-coronavirus conditions: a systematic literature review and meta-analysis.” December 2022. Efficacy of the coronavirus disease 2019 (COVID-19) vaccine in preventing post-coronavirus disease (COVID-19) conditions: a systematic literature review and meta-analysis | Antimicrobial management and medical epidemiology | Cambridge Core
JAMA Internal Medicine: “Risk Factors Associated with Post-COVID-19 Conditions: A Systematic Review and Meta-Analysis.” June 2023. Risk Factors Associated with Post-COVID-19 Conditions: A Systematic Review and Meta-Analysis – PubMed (nih.gov)
medRxiv: “Neuropathic Symptoms Due to SARS-CoV-2 Vaccination,” May 2022. Neuropathic symptoms due to SARS-CoV-2 vaccination – PubMed (nih.gov)
JAMA Internal Medicine: “Association of treatment with nirmatrelvir and risk of post-COVID-19 conditions.” March 2023. Association between treatment with nilmatrelvir and risk of post-COVID-19 conditions | Clinical Pharmacy and Pharmacology | JAMA Internal Medicine | JAMA Network
LANCET Infectious Diseases: “10-Month Outpatient Treatment of COVID-19 and Incidence of Post-COVID-19 Symptoms (COVID-19): A Multicenter, Randomized, Quadruple-blind, A parallel-group, phase 3 trial”. June 8, 2023. Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-19): multicenter, randomized. , quadruple-blind, parallel-group, phase 3 study – The Lancet infection
