Doctors, public health experts, and the Centers for Disease Control and Prevention are clear: Get the coronavirus vaccine even if you had covid-19.
Yes, people who had the disease produce antibodies that provide immunity from the coronavirus. But that immunity fades over time, and the body’s natural response may not be enough to prevent a repeat infection 90 days after the first one, the CDC says.
Reinfections, both mild and severe, have been well documented since the coronavirus emerged in late 2019. For example, a nursing intern in the Netherlands with no issues in her immune system contracted covid-19 in the spring and again in the summer of 2020, with stronger symptoms the second time. A nurse in Ohio got the disease twice, seven months apart. Hundreds more cases have been reported worldwide, although experts say they are widely undercounted.
In an interview last week, Johnson speculated that the “best immunity possible” probably comes from having had the disease, so he would not be getting the vaccine. None of the doctors or public health experts we consulted agreed with this statement.
Here is the science and what experts say.
About 30 million coronavirus cases have been recorded in the United States. In October, Johnson announced that he had tested positive for the virus and was feeling “fine.” He likely got the virus from his chief of staff, Tony Blando, Johnson said his doctor told him. We wondered what a doctor would say now to a patient like Johnson who recovered from covid and was wondering whether to get the vaccine.
“You can’t conclude that someone is bulletproof because they have one piece of armor,” said Stuart C. Ray, an infectious-disease expert at Johns Hopkins Medicine who said he would tell patients like Johnson to get the vaccine. “The immune system is a system of responses that have to be coordinated in a certain way to protect us from infection.”
The key word is “system,” which entails multiple parts. Natural immunity is one component. Vaccine immunity is another.
The CDC says: “Yes, you should be vaccinated regardless of whether you already had COVID-19.”
Although people may experience side effects, such as pain, redness, swelling at the location of the shot, tiredness, headache, muscle pain, chills, fever and nausea, those “are normal signs that your body is building protection” and “should go away in a few days,” the CDC says.
Getting COVID-19 may offer some natural protection, known as immunity. Current evidence suggests that reinfection with the virus that causes COVID-19 is uncommon in the 90 days after initial infection. However, experts don’t know for sure how long this protection lasts, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody (immune system) response without having to experience sickness.Both natural immunity and immunity produced by a vaccine are important parts of COVID-19 disease that experts are trying to learn more about, and CDC will keep the public informed as new evidence becomes available.
Benjamin D. Singer, a pulmonary and critical care specialist at Northwestern University Feinberg School of Medicine, said “vaccination provides better and more durable immunity than natural infection.” He pointed to research findings published in the New England Journal of Medicine this year.
An NEJM study from January found that the Moderna vaccine “has the potential to provide durable humoral immunity” whereas “natural infection produces variable antibody longevity.” A study published last week compared two groups of people taking the Pfizer and Moderna vaccines: some who previously had covid-19 and some who did not. The recovered patients generally had higher antibody counts at the start of the vaccination period, but not always, and by the end of the vaccination period both groups had similarly high antibody levels.
“The take-home message is that people who survive covid should receive the vaccine, but it is reasonable to wait a few months to do so while doses are scarce,” Singer said. “The rationale for this recommendation is that vaccination provides higher-level and likely longer-duration protection than natural infection. This statement appears to be true for people who had covid as well as for those who did not.”
The world is still learning about the coronavirus and the newly developed vaccines, Ray said. Questions that remain are how long vaccine immunity lasts and whether booster shots will be required down the road, as with some other vaccines.
Another question: Some new research findings suggest that a single dose of the vaccine, rather than two, may be enough protection for people who previously had covid-19. “I would like to see some outcomes data (rather than just antibody responses) suggesting that this is a safe strategy,” Singer said.
“It would reduce the amount of vaccination we would need to do,” Ray said. But more study is needed before a conclusion may be reached, and in the meantime, “we know that the people who had evidence of prior infection showed evidence of protection from vaccination, and they appear to be safe.”
“The danger of undervaccination would be that we would have a partial blow to the virus, and that would be the best way for it to evolve to avoid those vaccines,” Ray added.
In a tweet responding to (and recasting) his comments to CBS 58, Johnson wrote: “As I said in this interview, I could have gotten the vaccine in December but I decided to let others go before me who need it more than I do. That shouldn’t be controversial.”
The spokesman also sent an opinion article in The Washington Post by a Johns Hopkins doctor who argued that natural immunity was more long-lasting than most researchers theorized. That doctor, Marty Makary, also wrote that “the vaccine is safe and [I] strongly recommend that we vaccinate all Americans” and that “I side with the scientists who predict that vaccinated immunity will last longer than natural immunity.”
Johnson’s staff emphasized this line Makary wrote: “Given the scarcity of the lifesaving vaccine and the urgency for vulnerable Americans to get it quickly, people who had the infection should step aside and go to the back of the vaccine line.”
No one is disputing that.
Johnson told CBS 58 that he was not getting the vaccine because he had contracted the disease, which “probably provides me the best immunity possible.” That’s the scientifically unsupported claim we decided to fact-check.
When we asked where the senator got that belief, we couldn’t get an answer. Johnson spokesman Ben Voelkel said, “Until everyone who wants a vaccine can get a vaccine, Senator Johnson is happy to rely on the natural immunity he developed having tested positive for covid-19.”
As chairman of the Senate Homeland Security and Governmental Affairs Committee last year, Johnson invited a vaccine skeptic, Jane M. Orient, to testify as lead witness, along with doctors promoting unapproved coronavirus cures and a critic of masking and social distancing.
Johnson was criticized for bringing in fringe commentators promoting quack cures, including hydroxychloroquine, which the Food and Drug Administration now says can cause heart problems in covid-19 patients. At the time, Johnson claimed the hearing was a way to overcome “a blackout on good information in social media and media” because “people are being denied information to make intelligent choices themselves.”
The FDA has approved remdesivir as a treatment for covid-19, as well as the combination of casirivimab and imdevimab (monoclonal-antibody therapy). But some of the cures trumpeted at Johnson’s hearing have been dismissed by serious experts and are not approved by regulators. Masking, social distancing and vaccination remain the uniform guidance from the medical and scientific community.
“All of the usual measures like masking and distancing are what we need while rates are still high, and we should recognize we are still higher than we were last summer, and we don’t have evidence of herd immunity yet,” Ray said. “We need to keep our guard up.”
In the interview excerpt from December that Johnson’s staff sent us, he mentions “growing evidence” supporting the use of hydroxychloroquine, but that was months after the FDA had revoked its authorization as a treatment for covid-19 patients. Once again, it’s just not sound scientific guidance.
The Pinocchio Test
Johnson stated a belief, and we won’t be awarding Pinocchios, because we don’t fact-check opinions.
But let’s not mince words.
At a time when more than half a million people have died of covid-19 in the United States, Johnson’s comments are irresponsible and dismally uninformed.
Many Americans who had the disease are wondering whether they should get the vaccine. They may look to their elected officials for guidance. Imagine what could happen if vulnerable viewers took Johnson’s comments as advice and declined the shot.
Senators have staffs. They have access to the latest research and data, and to leading experts. They go to good doctors. They shouldn’t be making unscientific claims on television about coronavirus immunity.
The vaccine has proven to be effective and safe, both for people who had covid-19 and for those who have not. Doctors, public health experts and the CDC all recommend getting the shot to build immunity and prevent the spread of the disease, though they say people who had covid-19 should wait until a few months after their infection.
Johnson previously invited a vaccine skeptic to testify in the Senate, which is worth keeping in mind. We will be watching the senator closely and intend to fact-check any questionable claim he makes about vaccines in the future.
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