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Studies Describe Vaccine Efficacy Against Long COVID

Two new large studies, one based on outcomes among US children and teens and the other on adults in Japan, show COVID-19 vaccines are protective against long COVID. Both studies were conducted when the Omicron strain of the virus was dominant, with the first also assessing the Delta variant. 

In the first study, published in eClinicalMedicine, researchers measured the real-world efficacy of the Pfizer-BioNTech (BNT162b2) vaccine against long COVID in children and adolescents using data from 20 US health systems collected in as part of the RECOVER PCORnet electronic health record (EHR) Program.

Three cohorts were constructed: (1) adolescents 12 to 20 years old during the Delta phase (July 1 to November 30, 2021), (2) children 5 to 11 years and (3) adolescents 12 to 20 during the Omicron phase (January 1 to November 30, 2022). Outcomes were compared among those who received a first dose of the Pfizer vaccine to those with no receipt of COVID-19 vaccines.

In total, 112,590 adolescents (88,811 vaccinated) were included in the cohort for the analysis against the Delta variant, and 188,894 children (101,277 vaccinated), and 84,735 adolescents (37,724 vaccinated) were included for the analysis against the Omicron variant.

Preventing long COVID by averting infections 

For adolescents during the Delta period, the estimated effectiveness of the BNT162b2 vaccine against long COVID was 95.4% (95% confidence interval [CI], 90.9% to 97.7%). During Omicron, the estimated effectiveness against long COVID among children was 60.2% (95% CI, 40.3% to 73.5%), and it was 75.1% (95% CI, 50.4% to 87.5%) among adolescents.

The risk reduction in developing long COVID was largely linked to reducing the risk of COVID infection in the first place. 

The effects through protecting againt SARS-CoV-2 infections were estimated as 0.04 (95% CI, 0.03 to 0.05) among adolescents during Delta phase, and 0.31 (95% CI, 0.23 to 0.42) among children and 0.21 (95% CI, 0.16 to 0.27) among adolescents during the Omicron period.

The higher effectiveness of the BNT162b2 vaccine during the Delta phase, relative to the Omicron period, can be attributed both to its protection against Delta infections and to the fact that the primary benefit of the vaccine on long COVID stems from its capacity to prevent infection.

"The higher effectiveness of the BNT162b2 vaccine during the Delta phase, relative to the Omicron period, can be attributed both to its protection against Delta infections and to the fact that the primary benefit of the vaccine on long COVID stems from its capacity to prevent infections," the authors concluded. "With the genetic evolution of Omicron strains that generally are more highly transmissible with much lower severity of symptoms, infection rates are higher and vaccine effectiveness has been lower."

Three or more doses tied to less long COVID in women 

In the second study, a population-based analysis from Japan, researchers found the vaccine effectiveness of three or more doses of COVID vaccine against Omicron-related long COVID to be 30%, and against neurologic symptoms of long COVID it was 39%. 

The protection, however, was found only in women. The study was published yesterday in Clinical Microbiology and Infection. 

A total of 7,936 participants aged 20 to 69 years, who were infected from July 1 to August 31, 2022, were included in the study. Of those, 940 (11.8%) had at least one post-COVID, or long-COVID, symptom, according to a self-administered questionnaire. 

Participants who had three or more COVID-19 vaccine doses had a 30% lower probability of long-COVID symptoms, with the odds ratio (OR) of 0.70 (95% CI, 0.53 to 0.90), although there was no association with one or two doses.

Furthermore, the risk reduction was seen in women with three or more COVID vaccine doses but not in men. 

There was no significant association for respiratory symptoms, but those with three or more COVID vaccine doses reported fewer neurologic symptoms compared to unvaccinated participants (OR, 0.61; 95% CI, 0.45 to 0.83).

What To Know About The Latest COVID-19 Vaccines

As the busy holiday season approaches, questions about COVID-19 loom—what variant is dominant now, how its symptoms compare to past variants and who should get the updated vaccine.

While newer strains of the Omicron variant are causing milder complications than the original 2020 Alpha and Delta variants, regional health officials are urging residents to get one of three new vaccines ahead of the holiday rush—when collective immunity is at its lowest and transmission the highest.

Tanis Maxwell, public health program manager at the South-Central Public Health District, told the Express that COVID-19 cases have historically surged in late October and early November, and residents have the highest chance of infection in December and January.

The good news is that "there have not been any identified, substantial differences [from previous variants] in self-reported symptoms of COVID-19 caused by currently circulating variants," she said.

According to Centers for Disease Control reports, the KP.3 strain—a descendant from the Omicron JN.1 family that was prevalent in early 2024—has dominated since August. A newer offshoot, called XEC, is on its heels, having originated in Germany in June. While XEC is more transmissible than KP.3, it is not expected to cause worse symptoms than other recent variants, according to the CDC.

What's available, where

Vaccines in 2022 were aimed at the original virus and the Omicron variants BA.4 and BA.5. The 2023 COVID-19 vaccine update was aimed at XBB.1.5, also an older Omicron subvariant.

Two FDA-approved vaccines that were reformulated this summer and became available this fall target the KP.2 strain, KP.3's springtime predecessor. Those are Moderna's Spikevax and Pfizer-BioNTech's Comirnaty vaccines. (All strains starting with "KP" are considered part of the "FLiRT" family of Omicron subvariants that gained traction around April.)

Maxwell said that anyone over 6 months should get either vaccine.

Luke Snell, owner of Luke's Family Pharmacy in Hailey, said the new vaccines have good "cross-protection" against all FLiRT variants. He said Luke's is exclusively administering Spikevax, and so far has given out around 500 doses.

Valley Apothecary pharmacist and co-owner Cathy Swink said her staff has administered 1,034 doses of the new Spikevax formula since the first shipment came in around Sept. 1, averaging about 11 per day. She strongly recommended that anyone 65 and older, pregnant women or those planning on becoming pregnant, or anyone in a long-term care facility get the new vaccine.

Maxwell said anyone who is immunocompromised or over 65 should schedule two doses of the Pfizer or Moderna vaccine about six months apart. Someone who has recently had COVID-19 "may consider delaying the vaccine by three months," she said.

St. Luke's began administering the updated Pfizer-BioNTech 2024-25 vaccine to adults in late September but does not offer the Moderna vaccine, according to its website. The Albertsons pharmacy offers both Pfizer and Moderna.

A third vaccine, called Novavax, specifically targets JN.1. It's a protein-spike vaccine, unlike the Pfizer and Moderna mRNA vaccines. While it has not been approved or licensed by the FDA, it has been authorized for emergency use and is available at CVS, Walgreens and Costco in Twin Falls.

Should You Still Get Vaccinated If You Already Had COVID-19?

So what do you do? If you've got COVID, do you still need to get vaccinated? The answer is yes. And here's why.

If you had COVID in the past, you do have some protection. There's natural immunity. And a lot of people are talking about it.

The problem is, it's very variable. And by that, I mean you could have had a mild case of COVID and may not have developed many antibodies. Or you might have got it early on, before the Delta variant existed. And you may not have protection against that variant.

What we do know with the vaccines, is they give a much more durable and stronger response. What do I mean by that? It means the response is creating more antibodies than if you just got COVID and developed antibodies and protection. They also last longer, probably at least six months, whereas natural immunity, when you get it from COVID-- that could just be a couple of months.

And the other big thing that we've learned in the last week or so is that those persons who got COVID and didn't get vaccinated are more than twice as likely to get reinfected. That's the real concern. So if you've already had COVID, you still need to get fully vaccinated so you have the best protection. ","publisher":"WebMD Video"} ]]>

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[MUSIC PLAYING]

JOHN WHYTE

So what do you do? If you've got COVID, do you still need to get vaccinated? The answer is yes. And here's why.

If you had COVID in the past, you do have some protection. There's natural immunity. And a lot of people are talking about it.

The problem is, it's very variable. And by that, I mean you could have had a mild case of COVID and may not have developed many antibodies. Or you might have got it early on, before the Delta variant existed. And you may not have protection against that variant.

What we do know with the vaccines, is they give a much more durable and stronger response. What do I mean by that? It means the response is creating more antibodies than if you just got COVID and developed antibodies and protection. They also last longer, probably at least six months, whereas natural immunity, when you get it from COVID-- that could just be a couple of months.

And the other big thing that we've learned in the last week or so is that those persons who got COVID and didn't get vaccinated are more than twice as likely to get reinfected. That's the real concern. So if you've already had COVID, you still need to get fully vaccinated so you have the best protection.

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