Do vaccinations protect against the long debilitating symptoms of COVID? Early studies offer clues

It’s common knowledge: vaccines help protect against COVID-19, especially serious illness and death.

But can vaccines also protect against the long COVID? Thousands of people infected with the coronavirus before the arrival of vaccines last spring have had symptoms for weeks or months beyond the initial illness. In many cases, the puzzling sequels never went away. Scary, often life-changing conditions include chronic fatigue, shortness of breath, loss of sense of smell, muscle weakness, brain fog, and even psychosis.

Now, with the highly infectious omicron variant sweeping the Bay Area and COVID cases continuing to rise in some places, understanding whether the vaccine can stop lingering symptoms is critical.

“If everyone is at risk for COVID in the long term, we’re going to be in trouble,” said Dr. Steven Deeks, head of the ongoing UCSF study of people with such symptoms. “It’s going to be a huge medical and public health problem.”

The National Institutes of Health has already called the long COVID a “public health priority” and estimates that up to a third of those infected have long-term symptoms. The agency is spending $1.15 billion to find out why.

Early research suggests that vaccination is not a surefire way to prevent long COVID. But it seems to help.

A preliminary study of more than 240,000 patients also suggests that when people get vaccinated can influence whether they win or lose the long running COVID lottery. Being inoculated before catching the coronavirus or soon after appears to reduce the likelihood of developing long COVID.

But nine months after vaccines became widely available, peer-reviewed data from high-quality, double-blind research studies on their impact on long COVID is still scarce.

“Am I worried about Long Covid? A little. Literature is a mess,” UCSF Chief of Medicine Dr. Bob Wachter tweeted this month. “It seems that the vax decreases the risk. So that’s a concern, but there’s not much we can do but wait and see.

Yet as researchers lay the groundwork for larger studies destined to go through the pipeline, a peer-reviewed analysis published in September found that being fully vaccinated cut the risk of long COVID by half compared to unvaccinated people. .

“We found that the odds of having symptoms for 28 days or more after infection post-vaccination were approximately halved by having two doses of vaccine,” the researchers concluded in the study published in September in the Lancet Infectious Diseases.

The study relied on self-reported information, seen as limiting, by 1.2 million adults who took part in the UK COVID Symptoms Study. They reported symptoms and vaccination status on a cellphone app.

The researchers found that 31 of the 592 fully vaccinated participants with breakthrough infections, or 5.2%, had symptoms for at least a month. By contrast, among unvaccinated people with COVID, about twice that rate — 55 of 482, or 11.4% — had symptoms that lasted just as long.

Dr. Lisa Geng, co-director of Stanford Health Care’s long-running COVID clinic, called the results “very encouraging.”

Still, the study’s lead author, Dr Claire Steves of King’s College London, noted that the vaccine does not reduce long COVID to zero. So, “when large numbers of people are affected, there will always be large numbers that will unfortunately have long COVID effects,” she told The Chronicle.

Dr. PJ Utz, an immunologist helping lead a Stanford Long COVID study, said the fully vaccinated medical students he works with who have had breakthrough infections have all come out of the disease without lasting problems.

“So that makes me think the vast majority will be perfectly fine,” he said. “But at least a subset of people with a breakthrough may have an immune system that is not normal,” leaving open the possibility of a long COVID.

Medical equipment at the home of longtime COVID patient Charlie McCone Thursday, Jan. 20, 2022 in San Francisco.

Medical equipment at the home of longtime COVID patient Charlie McCone Thursday, Jan. 20, 2022 in San Francisco.

Santiago Mejia/The Chronicle

A Stanford patient who asked not to be identified is one of them. Fully vaccinated in March, she had a breakthrough case in September when her child, too young to be vaccinated, was infected at school.

Four months later, the 47-year-old healthcare worker still cannot smell or taste. His heart is pounding. She has trouble sleeping. His moods rise and fall. A competitive swimmer before her illness, she cannot ride an exercise bike without getting exhausted. She has difficulty hearing in one ear and her vision is blurry. She also suffers from shortness of breath, chronic headaches and frequent abdominal pain. She now works from home.

“My pure, raw feeling is anger,” she said. “We followed the rules, wearing N95 masks” – and getting vaccinated. “You feel helpless because your body is beyond your control. And when you’re a previously healthy person, that’s a big pill to swallow.

Possible explanations for the bizarre array of seemingly unrelated symptoms plaguing thousands of people include microscopic blood clots, systemic inflammation and even the body attacking itself with an immune response gone awry – known as the name of autoimmune disease.

Researchers are studying all of these, as well as the potential role of vaccination in reducing the problem in the first place.

In November, researchers published a study claiming that the risk of long COVID is lowest in people who get vaccinated before they are infected — and decreases the sooner they get vaccinated after catching the virus.

The study of medical records of 240,648 people was published in MedRxiv, a health sciences journal for preliminary research, and was not peer-reviewed.

The authors found that people who received their first dose of vaccine before contracting COVID were 8.8 times less likely than unvaccinated people to have symptoms for three to five months.

People injected within one month of infection were 5.3 times less likely to have persistent symptoms, 3.2 times less likely if they injected within two months, and 2.2 times less likely if they waited until the third month.

Terry Lee (left), a nurse, administers intravenous therapy to Charlie McCone at his home, Thursday, Jan. 20, 2022, in San Francisco.  McCone tested positive for the novel coronavirus in March 2020 and has since exhibited severe symptoms.  Intravenous fluids help treat his dizziness, chest pain, and other symptoms.

Terry Lee (left), a nurse, administers intravenous therapy to Charlie McCone at his home, Thursday, Jan. 20, 2022, in San Francisco. McCone tested positive for the novel coronavirus in March 2020 and has since exhibited severe symptoms. Intravenous fluids help treat his dizziness, chest pain, and other symptoms.

Santiago Mejia/The Chronicle

Yale immunologist Akiko Iwasaki called the results striking.

“This study supports the vaccination of people who acquired SARS-CoV-2 within the first four weeks to reduce the risk of long COVID,” she said. said on Twitter.

If approved by experts, the results “would recommend immediate vaccination for all newly symptomatic unvaccinated individuals,” said Dr. Rich Parker, study author and chief medical officer of Arcadia.io, a company of health data in Boston. “It would represent a huge and significant shift in clinical practice.”

The United States Centers for Disease Control and Prevention is currently urging people with COVID or who test positive without symptoms to delay vaccination until their quarantine period is over.

UCSF’s Deeks called the study important, but said the data would be more reliable if there was a consistent and widely accepted definition of long COVID. For example, symptoms accepted by the study included not only altered mental status and chest pain, but also headache and sore throat.

“If you look in the general population of people who have not contracted (the virus), you will find a number who also have headaches, fatigue, hair loss,” he said. declared.

To understand the mysteries of the long crippling symptoms of COVID — who gets them and why — the National Institutes of Health created RECOVER, a nationwide research consortium involving thousands of patients, hundreds of scientists, and dozens of institutions, including the UCSF and Stanford.

Meanwhile, thousands of patients have gathered in online support groups. Many are frustrated with the slow pace of research and its lack of focus on treatment.

“It’s maddening,” said Charlie McCone of San Francisco, who contracted COVID in March 2020, long before the vaccines, and is still so ill he’s on disability from his job at a nonprofit organization. non-profit. At 31, he remains extremely tired, struggling to breathe and suffering from muscle twitching and weakness in his left side. He also has fluctuating blood pressure and an elevated heart rate.

McCone had a second case of COVID in September. His vaccination last spring did not alleviate his symptoms and he still has to lie down most of the time.

Nurse Terry Lee (left) at the home of Charlie McCone on Thursday, Jan. 20, 2022, in San Francisco.  McCone tested positive for the novel coronavirus in March 2020 and has since exhibited severe symptoms.

Nurse Terry Lee (left) at the home of Charlie McCone on Thursday, Jan. 20, 2022, in San Francisco. McCone tested positive for the novel coronavirus in March 2020 and has since exhibited severe symptoms.

Santiago Mejia/The Chronicle

He is enrolled in a RECOVER clinical trial but says, reluctantly, the trial is intended to observe participants rather than develop treatments for them.

“Many of us understand that we are now looking at the possibility of lifelong disability,” he said. “So if you’re talking about COVID but not long COVID, you’re just not telling the whole story.”

Nanette Asimov is an editor for the San Francisco Chronicle. Email: [email protected]: @NanetteAsimov

About Terry Gongora

Check Also

India and the United States have common goals and challenges that bind them, says Minister Jitendra Singh

India and the United States have common goals and challenges that bind the two nations, …