Could the Covid Vaccine Help Alleviate Symptoms for Those Experiencing Long-term Health Issues due to COVID?

Several recent studies on so-called ‘long-term COVID -19 symptoms’ have found that about 25% of people infected with the virus, even those who develop little to no symptoms associated with the initial infection, can suffer from persistent symptoms and impairment months after infection.  In a new Stanford study of Bay Area patients who were never sick enough to require hospitalization, 29% of people who returned to their doctor for treatment 3-4 months after infection reported fatigue, 21% reported shortness of breath, 24% reported loss of taste or smell, 17% reported muscle pain and 16% reported memory problems.  A multi-site study including University of California, Irvine found that long-hauler symptoms tended to cluster together in five groups, categorized in pairs: chest pain-cough, shortness of breath-cough, anxiety-fast heartbeat, abdominal pain-nausea, and low back pain-joint pain.  People who experienced a certain symptom during their initial infection were more likely to report a related cluster of symptoms later on.

New research has begun studying the effects of COVID-19 vaccination on patients with long-term COVID-19 symptoms.  It is too soon to tell whether the vaccines have a broad beneficial effect on patients with continued symptoms, but scientists are intrigued by a large amount of anecdotal evidence piling up.  In a recent New York Times article on the topic, Dr. Daniel Griffin, an infectious disease physician at Columbia University, said about 40% of his patients with long-term COVID-19 symptoms cite symptom improvement after the vaccine.  A small, not yet peer-reviewed study of 44 vaccinated patients in the UK found that 8 months after hospitalization for COVID-19, those who were vaccinated experienced improvement in more long-term COVID symptoms than those who weren’t yet vaccinated, reporting improvement in 23% of their long-term COVID symptoms like joint pain and breathing, while only 5.6% reported their symptoms had worsened.  There was no difference in response between people who received the Pfizer and AstraZeneca vaccines.  A survey of 345 people with long-term COVID-19 symptoms found that two weeks or more after the first vaccine dose, 93 people felt slightly better and 18 felt back to normal – a total of 32% reporting improvement in long-term symptoms.  Another survey by Survivor Corps, a group of over 150,000 COVID survivors, found that 255 of 577 respondents reported some improvement, while 270 felt no change and 82 felt worse after vaccination.  

Scientists hope that understanding whether vaccines help some long-term COVID-19 patients but not others could help unravel the underlying causes of different symptoms and ways to treat them.  The improvements patients have experienced after vaccination fit with some of the working hypotheses about why people develop long-term symptoms from COVID.  One theory is that, by generating antibodies to the coronavirus’s spike protein, the vaccine may eliminate vestiges of virus or remnants of viral RNA that may linger in some patients.  If this is occurring, it suggests the vaccine could be, as Akiko Iwasaki, an immunologist at Yale, says, “like a permanent cure,” for these patients.  Another theory suggests the vaccine might help people by dampening their body’s post-viral innate immune response that can resemble auto-immune disease.  If this is occurring, it may not be a very long-lasting response, as their immune system could revert back after being distracted by the vaccine.

We have a lot more to learn, but anecdotal evidence and postulated theories by leading scientists suggest there might be at least a subset of patients whose long-term COVID-19 symptoms respond positively to the vaccine.  We will await larger trials and keep you updated!

Jennifer Abrams, MD, March 23, 2021