At the start of the pandemic, recovery from coronavirus infection was perhaps cause for cautious optimism: if you were lucky enough to bounce back from Covid-19, you had some level of immunity. Over time, research confirmed this, although it also showed that immunity wanes, so recovering from the virus was not a one-off affair. So how should vaccinated people think about their immunity after recovering from a breakthrough infection?
After an outbreak of omicron that infected hundreds of thousands of people a day in the United States – including many people who had breakthrough cases – some wonder if the combination of vaccination and infection, known under the name of hybrid immunity, will offer a kind of long-lasting protection. Is this contact with the virus sufficient to justify relief and a return to life without pandemic precautions? Vox spoke to experts to help advise new recoveries.
What does a Covid-19 infection do for my immunity?
Immunity is defined as your body’s ability to protect you from disease when you are exposed to bacteria, viruses, parasites, or fungi. immunity can help protect you from infection in the first place, and if you are infected, it can prevent you from feeling sick or protect you from serious symptoms. Depending on the type of infection, this type of protection can last for months, years or even a lifetime. For example, once a person has recovered from measles, they are immune for life and will not get it again. But most illnesses are not one and finite. Immunity to Covid-19 can last for months, but it weakens over time and the exact duration is still under investigation.
Everyone’s body and immune system react differently to the viruses they encounter. Unlike vaccines, which deliver a standard size and formula to large populations, “having a Covid infection is a very non-standardized thing,” says Theodore Bailey, chief of the division of infectious diseases at Greater Baltimore Medical Center. (Even though everyone’s immune system reacts differently to the same dose of vaccine — someone might have severe side effects and others might have none — the shots themselves are standardized.)
If you’ve tested positive for Covid-19, it’s unclear how much of the virus you’ve been exposed to, how well it’s managed to reproduce in your body, and how committed your immune system is to fighting it. . It is therefore difficult to know to what extent you will also be protected. “One person’s infection is not someone else’s infection,” Bailey says.
Studies show that before omicron arrived, recovering from Covid-19 infections made people much less likely to get infected again – at least for several months. But omicron seemed to behave differently: a non-peer-reviewed study conducted during the omicron wave in England found that omicron has the potential to evade immunity from past infection or two doses of vaccine. Similarly, another non-peer-reviewed Danish study found that omicron was able to evade immune responses in both vaccinated and unvaccinated people (although a small South African study showed that infection with omicron could protect against delta, which now includes a small minority of cases in the United States).
For vaccinated people who get sick, breakthrough infections boost immunity, according to a December study. “People who have had both the disease and the vaccination have much higher antibody levels than people who have just recovered and have not been vaccinated,” says William Schaffner, professor of infectious diseases at Vanderbilt. University Medical Center. “And higher antibody levels are associated with longer duration of protection.” If you have recently recovered from Covid-19 and are not vaccinated, Schaffner advises getting vaccinated to take advantage of this protective combination.
Is it safe to go to restaurants and bars after a Covid-19 infection?
It’s extremely unlikely that you’ll be re-infected with the same variant within a month or two of recovering from Covid-19, Bailey says. A scientific review of published research on immunity to Covid-19 has suggested antibody levels begin to decline three months after a previous infection. However, when you gain immunity to one variant, you don’t necessarily gain immunity to the others: it’s possible to be quickly reinfected by omicron after recovering from the delta. So a breakthrough infection is not permission to live like it’s 2019.
Because there will always be a risk of reinfection, Bailey suggests thinking about immunity in the weeks following recovery much like airbags in a car. Airbags protect drivers from serious injury, but risky behavior like texting, speeding or reckless driving negates the benefits of the airbag. Something similar is true for post-infection immunity: Antibodies offer protection, but persistent high-risk activities — like unmasking in a crowded bar — increase the risk of reinfection.
That’s not to say recently recovered people don’t have any leeway. They just have to decide how much risk they are willing to tolerate. In the first few months after infection, most healthy vaccinated people who aren’t immunocompromised have a low risk of serious reinfection, Bailey says, meaning they can move around the world knowing that a visit to the gym won’t kill them.
“They have a similar level of risk to other things we tolerate,” like highway driving, Bailey says. “So doing things like going to restaurants, potentially traveling, becomes something safer, and it’s even safer if you wear masks as much as you can and you’re not really going to do things. at very high density like a rave or a mosh pit.These things will further increase your risk.
What other fun activities can I do safely now, and what precautions are needed?
If you’re planning on getting on a plane or attending an indoor sporting event, Bailey says to make sure you always take precautions, such as masking up and avoiding crowds as best you can. “Even though I have my airbag, I’m still going to put on my seatbelt, I’m still going to pay attention to traffic,” he says. “As I take on this additional level of risk, I consider what else I can do in my immediate environment to limit the unnecessary elevation of risk.”
Schaffner agrees that recently recovered people should always be wary of crowds and should continue to mask up indoors. “It’s not recommended that they be reckless and say, ‘Okay, I got a release card, I can do whatever I want,'” he says. If you decide to go on vacation after illness, be sure to continue testing and masking, especially if you’re visiting an elderly grandparent or immunocompromised friend during or after your trip, advises Schaffner.
Although Schaffner says it’s unlikely in the short term that you’ll pick up an infection and spread it, it’s still possible. The more time passes after you recover, the more likely it is that you can be reinfected and spread the virus. The CDC continues to recommend that anyone who tests positive self-isolate, even if they are asymptomatic.
The risk of future variants should make people a bit more cautious about post-infection behavior, Schaffner says. When a new variant emerges, the world may face another round of wait-and-see uncertainty about how well vaccination, protection from previous infection, and hybrid immunity hold up against the mutated virus.
Ultimately, the activities you decide to participate in after recovering from Covid-19, Schaffner says, comes down to the level of risk you’re willing to bear. “If you are 72 and have diabetes, everything is at risk. That’s what I would tell all my patients,” he says. “If you’re 28 and otherwise perfectly healthy and have recovered, the first thing I would ask you is, ‘Are you vaccinated? These people can go out. But because nothing is “safe” or comes without risk, he recommends everyone wear masks in indoor environments.
As cases go down, the overall risk will also go down: less virus in the community means less chance of catching it and spreading it. On top of that, you can probably breathe a sigh of relief for a few weeks after infection, as long as you continue to avoid unnecessary risks, like crowded dance floors, and mask up around your vulnerable loved ones and anyone outside your household.