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Since the pandemic took hold, many scientists agreed that after getting COVID-19 you do gain immunity for a period of time. But how much immunity, and for how long, differs from person to person.
This has resulted in many online claiming they don’t need additional protection after getting COVID-19.
My office today wanted proof that I got a booster. I told them I recovered from an actual infection and that I'm not getting a booster. I don't care if it means I lose my job. We need to fight. This shit is ridiculous.
— Yossarian's Locker (@YossarianLocker) January 7, 2022
Recovering from COVID-19 does offer you immunity for a fixed period of time. But that doesn’t mean you should not get a booster shot, because you won’t be protected forever.
To clarify for this article, a person is considered to be fully vaccinated two weeks after receiving two doses of mRNA COVID vaccines (Moderna or Pfizer/BioNTech), or two weeks after a single Johnson & Johnson shot. A booster is a third shot that adds immunity, and timelines about when to administer it after already being infected by COVID-19 differ.
Presently, the Centers for Disease Control and Prevention (CDC) recommend that most adults get a booster five months after being full vaccinated. Teens 12-17 years old should get only a Pfizer-BioNTech COVID-19 vaccine booster.
Scientists agree that you should eventually get a booster shot some time after recovering from COVID-19.
The CDC advises people that getting vaccinated after getting infected reduces your chances of getting infected again:
Getting sick with COVID-19 offers some protection from future illness with COVID-19, sometimes called “natural immunity.” The level of protection people get from having COVID-19 may vary depending on how mild or severe their illness was, the time since their infection, and their age. No currently available test can reliably determine if a person is protected from infection.
All COVID-19 vaccines currently available in the United States are effective at preventing COVID-19. Getting a COVID-19 vaccine gives most people a high level of protection against COVID-19 even in people who have already been sick with COVID-19.
Emerging evidence shows that getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection to your immune system. One study showed that, for people who already had COVID-19, those who do not get vaccinated after their recovery are more than 2 times as likely to get COVID-19 again than those who get fully vaccinated after their recovery. [emphasis ours]
But when should you get your shot after contracting the disease?
Some doctors say that you should at least wait for your symptoms to go away before getting a booster shot. Chicago Department of Public Health Commissioner Dr. Allison Arwady told NBC Chicago that people should wait 10 days after getting a positive test result before getting the booster shot, partly because the CDC recommends isolating for five days, and going out when you are asymptomatic.
“You should wait at least the 10 days, okay? During the time that you could be infectious […] Certainly if you’ve had a recent COVID infection, you’ve had your antibodies go up, but my recommendation to my staff, to my family, to everybody is particularly with the surge right now I would still recommending getting the booster,” she added.
Dr. Angela Branche at the University of Rochester Medical Center said people are likely immunized after getting COVID-19 for around three to six months, and should get a booster then, or even two weeks after their symptoms are gone:
While vaccination remains effective, a small percentage of vaccinated people may experience breakthrough infections. These cases are largely mild and rarely require hospitalization. Vaccinated individuals who recover from a breakthrough infection are expected to have high levels of circulating antibodies that are likely to be broadly protective for several months. These individuals would therefore likely not require a booster for three to six months after they have recovered, though it would be safe to obtain a booster dose as early as two weeks after full resolution of symptoms.
In Canada, advice on this also differs. The province of Quebec official guidance suggests that people should get boosted after their symptoms go away. Meanwhile, Dr. Kieran Moore, chief medical officer of health in Ontario, said 30 days is “the typical recommendation” for how long people should wait to get boosted after an infection.
A CDC report found that vaccine-induced immunity was more effective in reducing hospitalizations than natural immunity from contracting the disease.
People with previous COVID-19 (natural immunity) were 5x more likely to be hospitalized with re-infection COVID, compared to vaxxed people. Dramatic finding. Most extensive data on this topic in an American population, & over a substantial period of time.https://t.co/2oluIJFxNM pic.twitter.com/CdRty9qdWk
— Prof. Shane Crotty (@profshanecrotty) November 1, 2021
According to WebMD, “It’s not yet known how long the COVID-19 vaccines remain protective. There’s some evidence that protection against symptomatic infections wanes a bit over time as antibody levels drop. But protection against severe illness, including hospitalization and death, has remained high so far, even without a booster.”
Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told Very Well Health, “Immunity after a breakthrough case is imperfect […] People who have been infected should wait until after they have gotten better—and they may want to wait even longer after that—but it is suggested that they get a booster, if they are recommended for it.”
Meanwhile, Dr. Albert Shaw, Yale Medicine infectious diseases specialist, told Very Well Health that it was difficult to compare immunity after infection with immunity after vaccination.
“Factors such as how much virus someone was exposed to and infected with, whether their course of COVID-19 was mild, moderate, or severe, as well as factors such as age and pre-existing medical conditions—which affect the function of the immune system—all play a role.”
The immune response from natural infection will not be the same across individuals, but with a vaccine dose, which is the same given to everyone, it reduces the variability in the immune response across individuals.
“[…] my feeling is that if you are in a group for which boosters have been recommended, I’d still get the booster. We don’t know how a breakthrough infection compares to a booster vaccine,” Shaw said.
Ultimately, these variable recommendations about when to get a booster shot—if you haven’t already received one—are meant to indicate when you can gain the most from being boosted after already getting some immunity after being infected. A recent study found that boosters increase the immune response by stimulating “production of cross-reactive antibodies, or antibodies that bind well to both omicron and earlier strains of the coronavirus.”
Dr. Erica N. Johnson, chair of the Infectious Disease Board for the American Board of Internal Medicine, told Live Science, “You want to be sure that you have the best response possible to the vaccine […] It’s not that it’s unsafe to administer an mRNA vaccine earlier than that. It’s just that you want to be sure that you had the most effective response.”
While timelines differ, most scientists agree that you should get boosted to reduce your chances of getting infected again. Being fully vaccinated, getting the booster, and continuing to follow health guidelines like masking and social distancing are the best ways to protect oneself from getting the disease.
“Booster Shots and Omicron: Side Effects, Eligibility and More.” NBC Chicago, 18 Jan. 2022. https://www.nbcchicago.com/news/coronavirus/booster-shots-and-omicron-side-effects-eligibility-and-more/2730524/. Accessed 20 Jan. 2022.
Bozio, Catherine H. “Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19–Like Illness with Infection-Induced or MRNA Vaccine-Induced SARS-CoV-2 Immunity — Nine States, January–September 2021.” MMWR. Morbidity and Mortality Weekly Report, vol. 70. CDC, 5 Nov. 2021, https://doi.org/10.15585/mmwr.mm7044e1. Accessed 19 Jan. 2022.
“COVID-19 Booster Shot.” Centers for Disease Control and Prevention, 19 Jan. 2022, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. Accessed 19 Jan. 2022.
“Frequently Asked Questions about COVID-19 Vaccination.” Centers for Disease Control and Prevention, 11 Jan. 2022, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html. Accessed 19 Jan. 2022.
Goodman, Brenda. “Infected, Vaccinated, or Both: How Protected Am I From COVID?” WebMD, 9 Nov. 2021, https://www.webmd.com/lung/news/20211110/how-covid-immunity-works. Accessed 19 Jan. 2022.
Jonas, Sabrina. “Quebec Recommends 3rd Dose for Those Who’ve Recently Had COVID-19.” CBC, 12 Jan. 2022, https://www.cbc.ca/news/canada/montreal/quebec-recommends-3rd-dose-people-recently-covid-19-1.6312266. Accessed 19 Jan. 2022.
“Omicron Variant: What You Need to Know.” Centers for Disease Control and Prevention, 20 Dec. 2021, https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html. Accessed 19 Jan. 2022.
Pelley, Lauren. “So You Got Infected with Omicron. When Should You Get a COVID-19 Booster Shot?” CBC, 13 Jan. 2022, https://www.cbc.ca/news/health/omicron-covid-vaccinated-booster-1.6312471. Accessed 19 Jan. 2022.
“Q&A: How Long before a Booster Takes Effect? What If You Get COVID before Your Jab?” OrilliaMatters.Com, 24 Dec. 2022, https://www.orilliamatters.com/local-news/qa-how-long-before-a-booster-takes-effect-what-if-you-get-covid-before-your-jab-4898053. Accessed 19 Jan. 2022.
“Should You Still Get a Booster Shot After a Breakthrough COVID Case?” Verywell Health, 27 Nov. 2021, https://www.verywellhealth.com/booster-dose-still-recommended-breakthrough-infection-5205002. Accessed 19 Jan. 2022.
Solis-Moreira, Jocelyn. “You Got Omicron. Should You Still Get a Booster?” Livescience.Com, 18 Jan. 2022, https://www.livescience.com/how-soon-booster-after-omicron-infection.
“With Omicron on the Rise, Experts Answer COVID Booster Questions.” URMC Newsroom, https://www.urmc.rochester.edu/news/story/boost-your-way-into-the-holidays-experts-answer-your-covid-booster-questions. Accessed 19 Jan. 2022.