Have you had COVID? You may need a single dose of the vaccine, the study suggests

In late March, Shannon Romano, a molecular biologist, fell into bed with COVID about a week after she and her colleagues closed their lab at Mount Sinai Hospital. He suffered first from debilitating headaches, then from rising fever, then excruciating body aches. “I couldn’t sleep. I couldn’t move,” said Romano. “All my joints hurt inside.”

He didn’t want to go through the same thing again … never. So when he recently became a candidate for the COVID-19 vaccine, he took the shot.

Two days after she was vaccinated, symptoms appeared that were very familiar to her. “The way my head and body hurt was the same as when I had COVID,” said Romano. She recovered in no time, but her body’s intense response to the cock took her by surprise.

A new study could explain why Romano and many other people who have had COVID have these reactions of unexpected intensity to the first dose of a vaccine. In a study published online Monday, researchers revealed that people already infected with the virus were more likely to report fatigue, headaches, chills, fever, and muscle and joint pain after the first injection than those who had never been infected. COVID survivors also had much higher antibody levels after receiving the first and second doses of the vaccine.

Based on these results, people who have had COVID-19 may only need one dose, the researchers said.

“I think one vaccination would be enough,” said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai Hospital and one of the study authors. “This would also avoid unnecessary pain when getting the second dose and make more doses of the vaccine available.”

While some scientists agree with this logic, others are more cautious. E. John Wherry, director of the Institute of Immunology at the University of Pennsylvania, said that before proposing a policy change, he would like to see more data on the ability of those antibodies to stop the virus’s replication. “Just because an antibody attaches to part of the virus doesn’t mean it protects you from infection,” he said.

It can also be difficult to identify people who are already infected, Wherry noted. “Documenting that is going to be a very complicated public health problem,” he said.

Side effects after vaccination are expected. These show that the immune system is organizing a response and will be better prepared to fight an infection if the body comes into contact with the virus. The Pfizer and Moderna vaccines are particularly good at eliciting a robust response. Most participants in the companies’ clinical studies reported injection site pain, and more than half reported fatigue and headaches.

It is also not surprising that individuals who were infected may have experienced more intense reactions. Both doses contain bits of genetic material that trigger the body to produce spike proteins, the bumps on the surface of the coronavirus. People who are already infected with the virus have immune cells that recognize these proteins very well. Therefore, when proteins appear after vaccination, some of those immune cells attack and this makes people feel bad.

Susan Malinowski, a Michigan ophthalmologist who had COVID-19 in March, no doubt felt that her body was under attack after she received the Moderna vaccine. The first dose was injected before lunch on New Year’s Eve. By dinner he started to feel bad. He spent the next two days in bed feeling bad.

“I have a fever. I had chills. I had night sweats. My whole body ached,” he recalled. “In fact, I felt worse after the vaccine than when I had COVID.”

On Jan. 27, a meeting of a committee of experts advising the Centers for Disease Control and Prevention (CDC) raised questions about the most serious reactions to the vaccine in people who have already had COVID.

Pablo J. Sanchez, a committee member and research institute at Children’s National Hospital in Columbus, Ohio, noted that he had heard of people responding worse to the vaccine than in their previous experience with COVID-19. Sánchez suggested adding a question about previous illness to the information the CDC requests from those who receive vaccines. “That question is not being asked,” said Sánchez. “It is very important to me”.

The CDC’s Tom Shimabukuro, who presented security data to the committee, said the agency was investigating the matter. “At the moment there is limited data on the subject, but we are looking for ways to obtain better information,” he clarified.

People who have had COVID “seem to respond to the first dose as if it were a second dose,” said Akiko Iwasaki, an immunologist at Yale University School of Medicine. So one dose may be “more than enough,” he said.

A recently published study found that surviving a natural infection for five months offered 83 percent protection against a new infection. “If we give two more doses in addition, it could be an exaggeration,” added Iwasaki.