The New York Times
Some patients with COVID have long felt much better after receiving the vaccine
Judy Dodd started battling the long symptoms of COVID last spring – shortness of breath, headaches, exhaustion. So she got the vaccine. After her first shoot for Pfizer-BioNTech in late January, she felt so unhappy physically that she had to be persuaded to get the second one. For three days after that, she also felt terrible. But on the fourth day, everything changed. “I woke up and thought, ‘What a beautiful morning,’” said Dodd, an elementary school teacher who is also an actor and director. “It was like I was directing ‘Sweeney Todd’ for months, and now I’m directing ‘Oklahoma’.” Subscribe to the New York Times Dodd newsletter The Morning, which continues to feel good, is among some of the people who report that the post-COVID symptoms they experienced for months began to improve, sometimes significantly, after they received the vaccine. It is a phenomenon that doctors and scientists are watching closely, but as with the major coronavirus pandemic, there are many uncertainties. Scientists are just beginning to study any potential effect of vaccines on prolonged COVID symptoms. Anecdotes vary: in addition to those who report feeling better after the injections, many people say they have not experienced any changes, and a small number say they feel worse. Doctors’ reports also vary. Dr. Daniel Griffin, an infectious physician at Columbia University, said that about 40% of the patients with COVID for a long time that he has been treating mention improvement in symptoms after the vaccine. “They realize, ‘Hey, as the days go by, I’m feeling better. Tiredness is not so bad. Maybe the smell is coming back, ‘”said Griffin. Other doctors say it is too early to know. “Few of our participants have so far been vaccinated to really provide information on this issue,” said Dr. Michael Peluso, an infectious disease specialist who works on a long-term study of COVID patients at the University of California, San Francisco . “I also heard anecdotes, but I have seen little data so far.” This month, a small study by British researchers that has not yet been peer-reviewed found that eight months after people were hospitalized for COVID-19, those who were vaccinated experienced improvement in longer symptoms of COVID than those who have not yet. have been vaccinated. The 44 patients vaccinated in the study were older and had more underlying medical conditions, since people with these characteristics qualified for vaccines earlier. One month after vaccination, these patients reported an improvement in 23% of long symptoms of COVID, such as joint pain and breathing, while 5.6% of symptoms worsened. The 22 unvaccinated people questioned at the time said that 15% of their symptoms were better, while 14% of their symptoms were worse. There was no difference in response between people who received the Pfizer-BioNTech and Oxford-AstraZeneca vaccines. Additional information comes from two surveys of several hundred people with long-term symptoms of COVID, many of whom have never been hospitalized because of the disease. A survey of 345 people, mostly women and mostly in the UK, found that two weeks or more after the first dose of the vaccine, 93 felt a little better and 18 returned to normal – a total of 32% reporting long-term symptoms of COVID improved. In that survey, conducted by Gez Medinger, a London filmmaker who experienced post-COVID symptoms, 61 people, just under 18%, felt worse, most of them reporting only a slight decline in their condition. Almost half – 172 people – reported not feeling different. Another survey, done by Survivor Corps, of a group of more than 150,000 COVID survivors found that on March 17, 225 of 577 respondents reported some improvement, while 270 felt no change and 82 felt worse. Jim Golen, 55, of Saginaw, Minnesota, feels that some long symptoms of COVID have worsened since his vaccination. Golen, a former hospice nurse who also owns a small farm, experienced months of difficulty, including blood clots in the lungs, chest pain, brain fog, insomnia and shortness of breath with any effort. At the end of last year, after consulting with several doctors, “it was finally starting to get better,” he said. Since receiving the second dose of the Pfizer vaccine in mid-January, he said, his chest burn and shortness of breath have returned with full force, especially if he is overloaded with activities like collecting sap from the edges of his farm. Even so, Golen said he was “very happy” with the vaccination, pointing out that the effects of COVID were worse and that preventing it is essential. Some people shared stories of dramatic improvements in symptoms that took them by surprise. Laura Gross, 72, of Fort Lee, New Jersey, listed a long list of long and debilitating COVID symptoms she had been experiencing since April, including exhaustion, joint pain, muscle pain and a “zizzy-dizziness-weakness thing that looked like a internal, headache, vibration throughout the body. ”His cognitive confusion and forgetfulness was so intense that” the fog of the brain barely describes it, “she said. “It’s more like a brain cyclone.” She also felt strangely “hopeless, sad, lonely, unmotivated,” she said. Three days after his first shoot with Moderna, at the end of January, everything changed. “It was like a revelation,” she said. The fog of the brain has completely dissipated, the muscle aches have disappeared, the pains in the joints were less intense, and suddenly, she had a lot more energy. It seemed, she said, “like the old self.” This continued after the second dose. “It’s like my cells went crazy last year when they met COVID,” Gross said, and the “vaccine said, ‘Wait, you idiots, that’s not how you fight it; do like this. ‘”Recently, she walked quickly for 23 minutes and even“ ran a little because she was very happy, ”she said. “I am a very happy little boy.” Scientists say that understanding whether vaccines help some patients with prolonged COVID, but not others, can help unravel the underlying causes of the different symptoms and possible ways to treat them. “They can be different disease processes, and you manage them differently,” said Dr. Adam Lauring, a virus expert and infectious disease physician at the University of Michigan. “There may be a subset of people who have a certain type of long COVID that responds well to vaccines, but there may be other people who have a different subtype that we haven’t yet defined.” Akiko Iwasaki, a Yale immunologist, said that a vaccine, by generating antibodies to the coronavirus spike protein, could eliminate traces of the virus or remnants of viral RNA that may remain in some patients. If this is happening, she said, it may suggest that the vaccine “may be like a permanent cure” for these patients. Iwasaki said the vaccine can also help people whose long-term symptoms of COVID can be caused by a post-viral response similar to an autoimmune disease if “the vaccine stimulates innate immune responses that dampen these types of autoreactive responses,” she said. But based on the experiences of people with other autoimmune diseases, this relief “would not be very long-lasting and they would return” to experiencing symptoms such as fatigue, she said. Dr. Eric Topol, professor of molecular medicine at the Scripps Research Institute in San Diego, said he is starting a study to measure physiological information such as heart rate, respiratory rate, temperature and immune response markers in people with long COVID before receiving a vaccine and weeks later. It is plausible that “you have your immune system boosted when you are fighting a reservoir” of viruses or RNA remnants, he said, “and that could be an explanation of why you have a fast heart rate.” He wants to see if these biological indicators improve after the vaccine. “We would really like objective metrics that show that you don’t just feel better,” said Topol. “You could feel better about the placebo effect, but your heart rate is unlikely to go from 100 to 60 because of the placebo effect. And if we continue to see that pattern, it would be like, eureka. “He added:” I think there is probably something there, but I just don’t know what the magnitude is, how many people will benefit. ” There are many other questions: Are there specific characteristics – such as age, sex, type or duration of symptoms – that can make some patients with long COVID more likely to feel better? Would a vaccine be less effective for people with more complex conditions: people whose symptoms are driven by multiple biological pathways (perhaps both a RNA remnant and autoimmune activation) or whose symptoms have changed or fluctuated over time? Are certain types of vaccines more likely to produce benefits? Bridget Hayward, 51, an operating room nurse in Alexandria, Virginia, said that after contracting COVID a year ago, her body ached from her hands to her hips, and she was so confused that instead of asking for a scalpel, she would say, “Give me that sharp thing that we cut with.” Almost daily, she passed out briefly while bending down to fix a patient’s IV line or connect the cord to a hospital bed. “It was awful,” she said. “It was awful to think that it might never get better, like, ‘Is this my new normal? Now am I hurt like that? ‘”After several months, her worst symptoms improved, but she was still tired easily, felt hot even in cold weather and found it very tiring to do some common tasks, she said. The day after her first dose of the Pfizer vaccine in late December, “it was like, click, it’s okay,” she said. Her body temperature normalized and “it seemed that the darkness had dissipated”. Although “it’s not 100% every day”, she said she has so much energy now that “I’m not just going from A to B; I’m, like, jumping. “One recent day, she did a lot of tasks long overdue.” That may not seem like much, but it’s a 180 turnaround from three months ago, “she said.” I’m back! “Kim Leighton, 64, from Vancouver , Washington, had a similar experience. She was hospitalized in March 2020 and had prolonged symptoms of COVID, which included mini-kidnappings, shortness of breath, getting lost in her own neighborhood, depression and fatigue. “When she started feeling better in late January, she didn’t even think about connecting her to the vaccine, but then she realized that her marked improvement had started four days after she received her first injection of Moderna. She is delighted that she can now go hiking in downtown Portland, Oregon, and want to reconnect with friends. “Every day, I feel like I’m feeling stronger,” said Leighton. “All the things I had to give up, I’m trying to get them back.” Dodd, like several others, said she did not take her improvement for granted. “I am still a little suspicious of what is to come; this disease is so unpredictable,” she said. But, she added, “even though, God forbid, I have a relapse, having this moment now, when I feel better, is really amazing. “This article was originally published in The New York Times. © 2021 The New York Times Company