People who have already had a Covid-19 infection may only need one shot of vaccine instead of two, according to Dr. Dan Bell of ECHO Clinic, advice backed up by a recent blog from the director of the National Institute of Health (NIH).
“Israel has already decided that is their national policy,” Bell said. “People who have had Covid get only one shot initially. They wait three months, and then get a second shot to boost immunity.”
Bell, who has headed up efforts to vaccinate more than 1,200 people at the ECHO Clinic, thinks this is an issue people need to be talking about.
“The thing we have seen with some of our patients, those who have had Covid, is that when they get their first shot, they get a pretty marked reaction,” Bell said. “They feel sicker than people who have not had Covid. They’ve already got good immunity. You throw that vaccine in there, and they get a robust and nasty reaction that says they probably don’t need any more vaccine shots. The side effects are so bad people are saying, ‘I don’t want a second shot.’ At this stage of the game, we don’t need to give two vaccinations to people who have already had Covid.”
However, people can’t always be certain they have had Covid. Back when Covid started appearing in February and March 2020, some people got really sick and suspected they had Covid. Covid testing was not widely available then, and Bell says 85 percent of the viruses in early 2020 were likely not Covid.
“Last march, RSV [respiratory syncytial virus] was the more common virus,” Bell was. “That was giving people unusually long episodes of bronchitis. They thought they had Covid, but only 15 percent had Covid. We had so little of it this past March.”
People who are unsure could get an antibody test before taking the first vaccine. But Bell thinks that is unnecessary.
“Since everyone different, I wouldn’t do a blood test,” Bell said. “What I would do is just get the vaccine and see how it goes. If you have a minimal reaction, you probably didn’t have Covid earlier and ought to get two shots. Let your body tell you what you need. If you got a miserable reaction compared to average with the first shot, I wouldn’t take the second shot. Use common sense.”
A recent blog by NIH Director Francis S. Collins, M.D., Ph.D., states that people who’ve recovered from Covid-19 should definitely get vaccinated to maximize protection against possible re-infection. But, Collins asks, if people already have some natural immunity, would just one shot do the trick? Or do they still need two?
“A small, NIH-supported study, published as a pre-print on medRxiv, offers some early data on this important question,” Collins wrote. “The findings show that immune response to the first vaccine dose in a person who’s already had Covid-19 is equal to, or in some cases better, than the response to the second dose in a person who hasn’t had Covid-19. While much more research is needed—and I am definitely not suggesting a change in the current recommendations right now—the results raise the possibility that one dose might be enough for someone who’s been infected with SARS-CoV-2 and already generated antibodies against the virus.”
Collins points out that Covid-19 and the mRNA vaccines are still relatively new, so researchers haven’t yet been able to study how long these vaccines confer immunity to the disease, which has now claimed the lives of more than 500,000 Americans. But he said these findings do suggest that a single dose of the Pfizer or Moderna vaccines can produce a rapid and strong immune response in people who’ve already recovered from Covid-19.
“If other studies support these results, the U.S. Food and Drug Administration might decide to consider whether one dose is enough for people who’ve had a prior COVID-19 infection,” Collins wrote. “Such a policy is already under consideration in France and, if implemented, would help to extend vaccine supply and get more people vaccinated sooner. But any serious consideration of this option will require more data.”
The study found that those who’d never been infected by SARS-CoV-2 developed antibodies at low levels within 9 to 12 days of receiving their first dose of vaccine. But in 41 people who tested positive for SARS-CoV-2 antibodies prior to getting the first shot of either the Pfizer or Moderna vaccine, the immune response looked strikingly different.