Coronavirus FAQ: I Had COVID. Should I Get The Vaccine?

Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions." See an archive of our FAQs here.

I had COVID. Do I need to get the vaccine?

Yes! While natural infection does seem to provide some immunity, studies suggest that it is short term: Protection can wane 90 days post-infection, says Dr. Jill Weatherhead, assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine.

We also don't know enough yet about how well natural immunity protects you from variants of the virus, she says.

On the other hand, she says, "currently available vaccines in the United States [from Pfizer, Moderna and Johnson & Johnson] will provide a more robust immunity that lasts a minimum of six months — and vaccines to date have shown clinical efficacy against all variants of concern."

There's another compelling reason, says Charlotte Baker, assistant professor of epidemiology at Virginia Tech. "You can get COVID more than once," she says, although the phenomenon is rare. "And some people who early on got COVID and then got it again had much worse outcomes."

The scant research on reinfection has shown mixed outcomes, but a small study from March showed more severe cases among 33 Brazilian health care workers with recurrent COVID, including one fatality.

So, does it matter when I get the shot?

If you've had COVID, wait until you are symptom-free and have completed the 10-day isolation period recommended by the Centers for Disease Control and Prevention. Out of respect for the health care workers volunteering to give you your inoculation, it's important not to go while you have an active case of COVID, Baker says.

"If you currently have COVID, you can pass COVID to health workers or other people who are giving vaccines or are in the same space," she says. "That's the biggest concern."

But don't hesitate after that isolation period, Weatherhead and Baker advise.

To ensure there are no gaps in your immunity, schedule your appointment within 90 days of your illness, Weatherhead says. When vaccines were scarce at the beginning of the year, the CDC said it was OK for people who had been sick with COVID to wait up to 90 days to get the shot, since the risk of reinfection is very low during those three months post-illness. Now, with widespread availability of the vaccine, most people don't need to wait until the end of that period.

If you received monoclonal antibodies or convalescent plasma as a COVID treatment, however, the CDC currently recommends waiting 90 days before getting a COVID-19 vaccine, to reduce any risk of the treatments interfering with the vaccine.

The vaccine should give you the same protection that it offers to those who haven't had COVID, and cover you from variants you weren't infected with, Baker says — in addition to lasting longer. Natural immunity appears to only protect you from the version of COVID that you had.

The bottom line: "You getting COVID-19 may help protect a little for a little while, but the vaccine helps protect a lot for a longer time," Baker says.

I've heard that side effects from the shot can be worse for people who had COVID.

This may be true, though evidence is light so far. Baker has some personal experience with this:

"My brother had COVID really early on, and he and I got the vaccine the same day," she says. "My symptoms subsided in a day or so, but his lasted a week. But we've also seen some who got the vaccine after being sick and they were good to go."

Side effects might not be fun, but Baker says you can rest assured that they are a normal response (and usually subside quickly!). Data from clinical trials have shown that it is safe to receive the vaccine after natural infection, Weatherhead says.

And preliminary research has shown strong immune responses in people who have had COVID and the first dose of the Pfizer or Moderna vaccines. So there's a chance that bigger, future studies could show that people who had the disease need just one shot of an mRNA vaccine because their natural infection likely jump-started their immune response. But remember, since studies haven't yet confirmed that, for now you need to get both shots to ensure you have full protection.

Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She's written about COVID-19 for many publications, including Medscape, Kaiser Health News, Science News for Students and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia

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