Can the Vaccinated Develop Lengthy Covid After a Breakthrough An infection?

Whereas some breakthrough circumstances amongst those that are totally vaccinated in opposition to Covid-19 are inevitable, they’re unlikely to lead to hospitalization or loss of life. However one vital query about breakthrough an infection that continues to be unanswered is: Can the vaccinated develop so-called lengthy Covid?

Lengthy Covid refers to a set of signs — resembling extreme fatigue, mind fog, headache, muscle ache and sleep issues — that may persist for weeks or months after the lively an infection has ended. The syndrome is poorly understood, however research counsel that between 10 and 30 % of adults who catch the virus might expertise lengthy Covid, together with those that skilled solely gentle sickness or no signs in any respect.

However the overwhelming majority of knowledge collected about lengthy Covid has been within the unvaccinated inhabitants. The chance of creating lengthy Covid for the totally vaccinated who get contaminated after vaccination hasn’t been studied.

Whereas preliminary analysis means that it’s, in actual fact, potential for a breakthrough case to result in signs that may persist for weeks to months, there are nonetheless extra questions than solutions. What % of breakthrough circumstances lead to lingering signs? What number of of these folks recuperate? Are the persistent signs after breakthrough an infection as extreme as people who happen within the unvaccinated?

“I simply don’t suppose there’s sufficient information,” mentioned Dr. Zijian Chen, medical director on the Center for Post-Covid Care at Mount Sinai Health System in New York. “It’s too early to tell. The population of people getting sick post vaccination isn’t that high right now, and there’s no good tracking mechanism for these patients.”

One recent study of Israeli health care workers published in the New England Journal of Medicine offers a glimpse of the risk of long Covid after a breakthrough infection. Among 1,497 fully vaccinated health care workers, 39 of them — about 2.6 percent — developed breakthrough infections. (All of the workers were believed to be infected after contact with an unvaccinated person, and the study was conducted before the Delta variant became dominant.)

While most of the breakthrough cases were mild or asymptomatic, seven out of 36 workers tracked at six weeks (19 percent) still had persistent symptoms. These long Covid symptoms included a mix of prolonged loss of smell, persistent cough, fatigue, weakness, labored breathing or muscle pain.

But the study’s authors caution against drawing too many conclusions from the research. The sample size — just seven patients — is small. And the research was designed to study antibody levels in the infected, said Dr. Gili Regev-Yochay, director of the infectious disease epidemiology unit at Sheba Medical Center. It was not designed to study the risk of long Covid after a breakthrough infection.

“It was not the scope of this paper,” Dr. Regev-Yochay said. “I don’t think we have an answer to that.”

Even so, the fact that one in five of the health care workers who had breakthrough infections still had lingering symptoms after six weeks appears to be the first indication from a peer-reviewed study that long Covid is possible after a breakthrough infection.

“People have said to me, ‘You’re fully vaccinated. Why are you being so careful?’” said Dr. Robert M. Wachter, professor and chair of the department of medicine at the University of California, San Francisco. “I’m still in the camp of I don’t want to get Covid. I don’t want to get a breakthrough infection.”

Dr. Wachter said that despite the many limitations of the Israeli study, the data offer more evidence that the vaccinated should keep taking reasonable precautions to avoid the virus.

“I’m going to take it at face value that one in five people, six weeks after a breakthrough case, continued to feel crummy,” Dr. Wachter said. “That’s enough to make me want to wear two masks when I go into the grocery store, which is not that burdensome anyway.”

Complicating the study of breakthrough infections is the fact that the U.S. Centers for Disease Control and Prevention only tracks post-vaccination infections that result in hospitalization or death. While the C.D.C. does continue to study breakthrough infections in several large cohorts, the lack of data on all breakthrough cases remains a source of frustration among scientists and patient advocacy groups.

“It’s very frustrating not to have data at this point in the pandemic to know what happens to breakthrough cases,” said Akiko Iwasaki, an immunologist at Yale School of Medicine who is conducting studies of long Covid. “If mild breakthrough infection is turning into long Covid, we don’t have a grasp of that number.”

Diana Berrent, founder of Survivor Corps, a Facebook group for people affected by Covid-19 that has about 171,000 members, took an informal poll and found 24 people who said they had lingering symptoms after a breakthrough infection. It’s not a scientific sample, and the cases haven’t been validated, but the poll shows the need for more data on breakthrough cases, Ms. Berrent said.

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