Throughout North America, healthcare workers are now rolling up their sleeves for COVID-19 vaccinations. I’ve paid close attention to infection rates in B.C. healthcare workers since the pandemic began. In the early stages of the pandemic here in B.C., healthcare workers – especially nurses and nursing home care aides – accounted for about a quarter of all cases. More recently, as community cases have surged, the proportion is about 10%.
Surprisingly, there is little or no official guidance on whether healthcare professionals should be vaccinated if they’ve already had COVID. The Centers for Disease Control and Prevention in the U.S. stated last week:
“There is not enough information currently available to say if or for how long after infection someone is protected from getting COVID-19 again; this is called natural immunity. Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this. Until we have a vaccine available and the Advisory Committee on Immunization Practices makes recommendations to CDC on how to best use COVID-19 vaccines, CDC cannot comment on whether people who had COVID-19 should get a COVID-19 vaccine.”
I asked the BC Centre for Disease Control what position it takes and the somewhat perplexing, ambiguous response today was:
“People who have had laboratory-confirmed COVID-19 can be immunized. If someone has had COVID-19 and is among the first group eligible to get the vaccine, we recommend they wait and get the vaccine with a later priority group.”
Hmmm, so you can be vaccinated but you shouldn’t for awhile.
I’m keen to hear from healthcare professionals about this matter. In the meantime, a guest post on this topic appears below.
GUEST POST BY JASON TETRO
Jason Tetro is an Edmonton-based science communicator/media personality specializing in microbiology. He’s the host of a podcast, The Super Awesome Science Show. He has written two books – The Germ Code and The Germ Files.
From the moment the World Health Organization declared the COVID-19, a pandemic, it was clear the world was in trouble.
It should come as no surprise, therefore, that as soon as SARS-CoV-2, the virus causing this disease, was discovered, the race to develop a vaccine was on. In just under a year, nearly 200 different varieties of vaccines have been developed.
Four of them have jumped to the head of the line and one has already been approved. As you read this, many thousands of vials of vaccine are circulating in the hopes of giving immune systems that memory to protect them from the virus.
Because the vaccine is being rolled incrementally (instead of by way of a mass campaign), priority lists have been developed; those who are at the greatest risk for severe infection are at the front of the line in this order: front line healthcare workers, long term care residents, those over 80 years of age, those who live in high-risk conditions including people living in shelters, the homeless, and people in remote and isolated Indigenous communities.
Certain individuals are unsure of their place on the priority list: those who have had COVID-19 and recovered. Over one percent of the Canadian population is in this category and the numbers are growing daily. As this website has reported, a hefty proportion of healthcare workers – the very group now getting vaccinated – have been infected. Yet, there has been no official guidance on whether these people should go to the end of the line or stay in their appropriate category.
In a recent interview, Dr. Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases, said he doubts previously infected individuals will be restricted from accessing the vaccines and he has no reason to believe that taking the vaccine will be of harm to those who have already had COVID-19.
“I don’t think that should be a concern at all,” Fauci said.
When your name is called, regardless of whether you have been infected previously, you should get the shot. When your demographic is called, you should be prepared to roll up your sleeve even if it comes at the end of the stretch.
This plan may sound a little odd, particularly if you know what happens when a person experiences an infection like measles or mumps. After recovery from these viruses, you have immunity for life against them and never need the vaccine. This might be the case with SARS-CoV-2 but we simply do not know. The virus hasn’t been around long enough for us to determine how long post-infection immune memory lasts. We have some indication that it’s over six months, which is good. But beyond that is unknown.
So, while we wait, the best approach is to ask everyone to get the vaccine. It helps to ensure our progression towards the elimination threshold (herd immunity) is consistent and effective.
On that note, there is one caveat. If for whatever reason, the supply chain of vaccine is interrupted, there may be a need to send those who have recovered from infection to the back of the overall line, not just the demographic one. For now, there appear to be no signs of trouble but contingency plans are a part of good planning and it’s better to know in advance than to be upset should this occur.
After all, we are past the halfway point of this pandemic and the end is getting closer. It’s up to us to ensure we all do our part in hygiene, prevention, and yes, vaccination, to get us to that moment when we can say the COVID-19 pandemic is officially behind us.