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How effective do vaccines protect against long-term COVID?

August. Aug. 8, 2022 – New York City vet Erin Kulick used to be a weekend warrior. Only 2.5 years ago, the 38-year-old new mom was playing Ultimate Frisbee and rugby with friends. She often runs 30 minutes to relieve stress.

Now, Kulick is usually so tired that she can’t walk non-stop for 15 minutes. She recently tried to take her 4-year-old son Cooper for his first visit to the American Museum of Natural History, but ended up on a bench outside the museum, sobbing in the rain because she couldn’t even get past the first hurdle in the line. “I just want to be with my kids,” she said.

Kulik contracted COVID-19 at the start of the pandemic in March 2020, nine months before the first vaccine would be approved. Now, she is estimated to be one in five, or 19 percent, of those infected with symptoms that develop long-term COVID.

Kulick is now also vaccinated and boosted. If the vaccine was available sooner, would it protect her from long-term COVID?

there is evidence that it is very likely.

“The best way to avoid long-term Covid-19 infection is to not have Covid-19 at all,” said Leora Horwitz, MD, professor of population health and medicine at NYU Grossman School of Medicine . “If vaccination can completely prevent you from contracting COVID, then it can help reduce long-term COVID.”

Just as vaccines can reduce the risk of serious illness, hospitalization and death , they also appear to reduce the risk of long-term COVID-19 infection if people do get a breakthrough infection. People with more severe initial disease appear to be more likely to have long-term symptoms, but those with milder disease can certainly get it as well.

“You’re more likely to have long-term COVID-19, a more severe disease, and we have good evidence that vaccination reduces disease severity,” Horwitz said. “We also now have considerable evidence that vaccination does reduce your risk of long-term COVID–probably because it reduces your risk of severe disease.”

There is little consensus that vaccines can reduce long-term risk of illness -term COVID symptoms, but several studies suggest this number ranges from 15% to over 80%.

This may seem like a big change, but infectious disease experts don’t think trying to explain the gap is as important as noticing where all these studies are consistent: “Vaccines do provide There is some protection, but it’s incomplete,” said Ziyad Al-Aly, MD, director of research and development at the Department of Veterans Affairs. . St. Louis Healthcare System. Focusing on the fact that vaccines do offer some protection is a better public health message than focusing on varying degrees of risk, said Al-Aly, who has led several large studies on long-term COVID.

“Vaccines do an amazing job for what they were designed for,” Al-Aly said. “Vaccines are designed to reduce the risk of hospitalization… To that end, even with all the changes in the virus, the vaccine remains effective.”

Still, Elena Azzolini, MD, PhD, Humanitas Research Hospital Head of Vaccination Center Milan, Italy believes that, Some studies may have underestimated the level of long-term protection from COVID-19 vaccines due to limitations in research methods, such as not including enough women who are more affected by prolonged COVID-19. Her most recent study looked at 2,560 healthcare professionals working in nine Italian centres from March 2020 to April 2022, focusing on risk for healthy women and men in their 20s to 70s.

In the paper, published in July in The

Journal of the American Medical Association , Azzolini and her researchers report , two or three doses of the vaccine reduced the risk of hospitalization for COVID-19 by 42% to 16% or 17% in people who had never been vaccinated. In other words, they found that the unvaccinated people in the study were almost three times as likely to develop severe symptoms over a period of more than 4 weeks.

But Azzolini and Al-Aly still say that even for vaccinated people, masks are necessary as long as COVID is around. That’s because current vaccines aren’t doing enough to reduce transmission, Al-Aly said. “The only way to really help [stop] the spread is to cover our noses and mouths with masks,” he said.

) How the vaccine affects people who have been chronically infected with the new coronavirus

Some long-term coronavirus patients say they get better when they get a boost, Horwitz says, while some say they get better To make matters worse, he is also the Principal Investigator of the NIH’s flagship RECOVER program, a 4-year research project to study long-term COVID in the U.S. (The NIH is still recruiting volunteers for these studies, which also Open to people who have never had COVID.)

A study published in The

BMJ May Analysis A survey of more than 28,000 people infected with COVID in the UK found a 13% reduction in long-term symptoms after the first dose of the vaccine, although it was unclear from the data if there was continued improvement.

The second dose was associated with an additional 8% improvement over 2 months. “It is reassuring that we are seeing an average modest improvement in symptoms rather than an average worsening of symptoms,” said Daniel Ayoubkhani, chief statistician at the ONS and lead author of the study. Of course, he said, different people’s experiences will be different.

“It does not appear that vaccination is a panacea for long-term COVID-19 eradication,” but evidence from multiple studies suggests that vaccines may help long-term

Yale Dr. Akiko Iwasaki, an immunobiologist at the University School of Medicine, told a White House summit in July that one of the best ways to prevent long-term symptoms is COVID-19. Next-generation vaccines will be developed that also prevent milder cases by stopping transmission in the first place. .

Back in Queens, New York, Kulick is now on the triple vaccine. She’s due for a fourth dose soon, but admits she’s “feared every time” she’ll get worse.

In her Facebook long-term COVID support group, she read that people with long-term symptoms can handle it well. She also noticed that some of her symptoms eased after her first two doses of the vaccine.

Since being diagnosed, Kulick has learned that she has a genetic condition known as Ehlers-Danlos Syndrome, which affects the supporting skin, joints, organs and The connective tissue of the blood vessels, which her doctors say may have made her more susceptible to long-term COVID. She was also screened for autoimmune disease, but for now, the only relief she’s found has come from long-term COVID physical therapy, changes to her diet, and integrative medicine.

Kulick is still trying to figure out how she can get better while working as a veterinarian for so long – and her health benefits. She is grateful that her husband is a devoted carer of their son and a professional jazz musician whose schedule allows for some flexibility.

“But every week feels hard like I’ve run a marathon,” she said. “I barely made it through.”



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