For evidence of the effect of the Covid vaccine on Covid long haulers, we have one professionally done survey with a control group, and a number of informal surveys.
First, the results of the professionally done survey. The vaccine was either the Pfizer or AstraZeneca, assessed one month later. This survey does include a control group but it does have some limitations: It has not yet received peer review and comes with a warning it is not to be used to make clinical decisions. They refer to patients as having been vaccinated, which presumably means that patients receiving the Pfizer vaccine received both doses, and were assessed one month after the second dose, although they do not explicitly state that detail. With that said here are the results:
Forty-four vaccinated participants were assessed at a median of 32 days (IQR 20-41) post vaccination with 22 matched unvaccinated participants. Most were highly symptomatic of Long Covid at 8 months (82% in both groups had at least 1 persistent symptom), with fatigue (61%), breathlessness (50%) and insomnia (38%) predominating. There was no significant worsening in quality-of-life or mental wellbeing metrics pre versus post vaccination. Nearly two-thirds (n=27) reported transient (<72hr duration) systemic effects (including fever, myalgia and headache).
When compared to matched unvaccinated participants from the same cohort, those who had receive a vaccine had a small overall improvement in Long Covid symptoms, with a decrease in worsening symptoms (5.6% vaccinated vs 14.2% unvaccinated) and increase in symptom resolution (23.2% vaccinated vs 15.4% unvaccinated) (p=0.035).[Emphases added]
Note that the ratio of those individuals better versus those worse over the duration of the study is about even for the unvaccinated. For the vaccinated group, the ratio of those better versus those worse is about 4:1. Quite a striking change, and statistically significant in spite of the small sample size.
Among the informal surveys we have a video report by U.K. COVID long hauler Gez Medinger:
Summary:
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 ... 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. [Emphases added]
Here is a screen grab from video, comparing results by vaccine. Note that the sample size is small, particularly for the Moderna vaccine, so these results are not necessarily statistically significant:
Here is another informal survey:
When Survivor Corps informally surveyed its members recently, 216 people said they felt no different after vaccination, 171 said their conditions improved and 63 reported that they felt worse, ...
Discussion of theoretical underpinnings for these results, by immunologist and Yale Prof. Akiko Iwasaki:
Back when I first learned about long Covid in June 2020, I proposed three possible mechanisms that might be causing it: 1) a persistent viral reservoir; 2) “viral ghost,” which are fragments of the virus (RNA, proteins) that linger after the infection has been cleared but are still capable of stimulating the immune system; and 3) an autoimmune response induced by the infection. Of course, other mechanisms may also contribute.
Since then, many studies have provided support for all three of these mechanisms. Research has shown that viral reservoirs are present in tissues, viral RNA is found in non-respiratory tissues and is associated with inflammation, and diverse autoantibodies are detected in some Covid patients.
The three mechanisms of long Covid I proposed above are not mutually exclusive, and all three may benefit from the vaccines. If the first is true, vaccine-induced T cells (immune cells that attack and kill infected cells) and antibody responses may be able to eliminate the viral reservoir. If the second is true, vaccine-induced immunity may be able to eliminate the viral ghost if such viral components are associated with the spike protein, which the virus uses to gain entry into cells...
Clinical advice from the CDC:
Vaccination should be offered to eligible persons regardless of whether they have a history of prior symptomatic or asymptomatic SARS-CoV-2 infection. Data from clinical trials indicate that mRNA COVID-19 vaccines can be safely administered in persons with evidence of prior SARS-CoV-2 infection.
Based on the foregoing this can be expected to prove to be good advice for the vast majority of long haulers. What about the small number who experience worsening of symptoms - can anything be done to mitigate the risk?
A two-step vaccine offers a chance to assess its effect midway through the process, unlike a single step vaccine which can be expected to provoke a full immune response after a single dose. This would favor the Pfizer or Moderna vaccines over the AstraZeneca (or Johnson & Johnson) which are single-dose. The stats from the Medinger survey above also favor these two vaccines.
(Please note that this writer is not a medical doctor and this does not qualify as personal medical advice. Please consult with your own M.D. for personal medical advice in this matter.)
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