Some people suffering from long COVID have found significant symptom relief after the first dose of their COVID-19 vaccine, though the jury's still out as to whether that's the case for the majority of so-called long-haulers.
Last week, New York Times editorial board member Mara Gay tweeted that she felt significantly better after her first vaccine dose.
She acknowledged that her report was both "anecdotal and early," but that many other long COVID survivors had described a similar experience.
Several commenters responded to Gay that they, too, had significant symptom relief after their first dose, including Sharon MacMillan, MD, an ob/gyn in Massachusetts, who said she's been symptom-free for 6 weeks after her vaccine.
There are no definitive data on what percentage of long COVID patients may experience such relief, how long it lasts, or even if the effect is real. But the scientific community has indeed taken an interest, and some have even suggested the possibility of prospective studies.
The Data
Hannah Davis, co-chief of Patient-Led Research for COVID-19, said her organization is currently working on a survey to study the phenomenon.
"While there have been anecdotes of this happening, they generally seem to be in the minority so far," Davis told MedPage Today.
She pointed to a video report by U.K. film producer and long COVID patient Gez Medinger on results of an informal survey of long COVID patients from various Facebook groups and the Body Politic Slack group, another organization that has been tracking COVID long-haulers.
Medinger's survey had 473 responses -- 80% from the U.K. and 15% from the U.S.; 86% women -- and he had the help of a statistician when analyzing his results. The majority of patients received Pfizer's vaccine (60%), followed by AstraZeneca (30%) and Moderna (9%).
One week after their first dose, 9% of patients said their long COVID symptoms had improved, and by 2 weeks, 16% said their symptoms were much better.
Among all people who had their vaccine 2 weeks ago or longer, 27% said their long COVID symptoms are slightly better, while just 14% said their symptoms were slightly worse. About 5% felt completely back to normal and only 3.8% felt much worse than previously.
"Taking the vaccine is more likely to completely resolve your symptoms than it is to make you feel much worse," Medinger said. "It's almost twice as likely to make you feel slightly better than slightly worse."
He cautioned that a limitation of the survey is that there's no comparison group, so it's impossible to say whether people may have started to feel better on their own, without the vaccine.
Experts have indeed proposed the idea of a prospective study to see the impact of the vaccine on long-haulers. Akiko Iwasaki, PhD, of Yale University, tweeted that such a trial may be difficult, but is worth considering, given that it could potentially confirm vaccination as a therapy for long COVID.
Iwasaki tweeted out Medinger's video, saying that "while the numbers are still small in some groups, there are encouraging signs," and presented hypotheses on how vaccines may improve long COVID.
The Immunology
In June, Iwasaki proposed three potential mechanisms for long COVID: a persistent viral reservoir; viral fragments or remnants that drive inflammation; or an autoimmune response induced by the infection. Many papers have since provided support for all three theories, she said, noting that they're not mutually exclusive.
It could be that vaccine-induced T-cell and antibody responses can eliminate the viral reservoir or the viral fragments/remnants, or that the vaccine somehow diverts autoimmune cells, she tweeted.
Vaccines could also help by stimulating the innate immune response, she said. That transient inflammation may divert leukocytes causing long COVID. But if that is indeed the case, she warned, any benefit from vaccines wouldn't be sustained long-term.
Other experts agreed that studying the impact of vaccines on this population would be worthwhile.
Elisa Perego, a research associate at University College London, who coined the phrase "long COVID," agreed that there's a need for "appropriate data collection and clinical trials."
"We also need to verify whether any improvement -- if such improvements are indeed recorded and linked to vaccination -- is permanent or not," Perego added. "Data on the effects of vaccination on long COVID ... could help [us] understand whether people living with long COVID should have fast access to vaccines, among other target groups like those with pre-existing conditions or the elderly."
"It's a fascinating observation," Stanley Weiss, MD, an infectious disease specialist and epidemiologist at Rutgers New Jersey Medical School, told MedPage Today. "The way you progress in science and medicine, is that you take observations from astute observers and pursue them with scientific rigor."
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March 05, 2021 at 12:00AM
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Do Vaccines Help COVID Long-Haulers? - MedPage Today
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