Eighteen states are rushing to extend vaccination eligibility to all adults to meet Biden’s May 1 target

The New York Times

Some long-time COVID patients feel much better after receiving the vaccine

Judy Dodd began struggling with long-term COVID symptoms last spring – shortness of breath, headache, exhaustion. Then she got the vaccine. After her first Pfizer BioNTech shot in late January, she felt so physically miserable that she had to be persuaded to get the second. For three days after that, she also felt terrible. But on the fourth day everything changed. “I woke up and it was like, ‘Oh what a beautiful morning,” “said Dodd, a middle school teacher who is also an actor and director. “It was like doing ‘Sweeney Todd’ for months and now I’m running ‘Oklahoma’.” Sign up for the New York Times morning newsletter. Dodd, who continues to feel good, is among a number of people who report that post-COVID symptoms that have been on for months have improved significantly after receiving the vaccine. It’s a phenomenon that doctors and scientists are closely watching, but as with much about the year-long coronavirus pandemic, there are many uncertainties. Scientists are only just beginning to study possible effects of vaccines on long-term COVID symptoms. Anecdotes determine the range: aside from those who report feeling better after the shots, many people say they haven’t seen any change, and a small number say they feel worse. Doctor’s reports also vary. Dr. Daniel Griffin, an infectious disease doctor at Columbia University, said about 40% of the long-term COVID patients he treated reported improvement in symptoms after the vaccine. “You notice, ‘Hey, I’ve got better as the days go by. The fatigue is not that bad. Maybe the smell will come back, ”said Griffin. Other doctors say it’s too early to know. “Too few of our participants have been vaccinated so far to really get an insight into this question,” said Dr. Michael Peluso, an infectious disease specialist working on a study of long-term COVID patients at the University of California at San Francisco. “I’ve heard anecdotes too, but so far I haven’t seen enough data.” This month, a small study by UK researchers that has not yet been peer-reviewed found that eight months after hospitalization for COVID-19, those vaccinated had an improvement in longer-term COVID symptoms than those not yet vaccinated. The 44 vaccinated patients in the study were older and had more underlying illnesses as people with these traits qualified for vaccines earlier. One month after vaccination, these patients reported an improvement of 23% in their long-term COVID symptoms such as joint pain and breathing, while 5.6% of their symptoms had worsened. The 22 unvaccinated people interviewed at the time said that 15% of their symptoms were better and 14% 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 prolonged COVID symptoms, many of whom were never hospitalized because of the illness. A survey of 345 people, mostly women and mostly in the UK, found that two weeks or more after their first dose of vaccine, 93 felt slightly better and 18 felt normal again – a total of 32% reported improved long-term COVID symptoms. In this survey by Gez Medinger, a London-based filmmaker who experienced symptoms after COVID, 61 people, just under 18%, felt worse. Most of them reported only a slight decrease in their condition. Almost half – 172 people – said they didn’t feel any different. Another Survivor Corps survey of a group of more than 150,000 COVID survivors found that as of March 17, 225 out of 577 respondents reported some improvement, while 270 felt no change and 82 felt worse. Jim Golen, 55, of Saginaw, Minnesota, believes some long-term COVID symptoms have worsened since he was vaccinated. Golen, a former hospice nurse who also has a small farm, has had months of trouble including blood clots in the lungs, chest pain, brain fog, insomnia, and shortness of breath with every effort. At the end of last year, after seeing several doctors, “I finally felt better,” he said. Since he received the second dose of the Pfizer vaccine in mid-January, his chest soreness and shortness of breath have returned with a vengeance, especially when he taxes himself with activities like collecting sap from the maple trees on his farm. Even so, Golen said he was “very happy” to be vaccinated, stressing that the effects of COVID are worse and that preventing it is crucial. Some people told stories of severe symptom improvement that took them by surprise. Laura Gross, 72, of Fort Lee, New Jersey, rattled off a long list of debilitating long COVID symptoms she’d had since April, including fatigue, joint pain, muscle aches, and a “zizzy-dizzy-weak thing that was like an inside.” , Headache, whole body vibration. “Her cognitive fuzziness and forgetfulness were so intense that” brain fog barely describes it, “she said. “It’s more like a brain cyclone.” She also felt unusually “hopeless, sad, lonely, unmotivated,” she said. Everything changed three days after her first Moderna shot in late January. “It was like a revelation,” she said. The brain fog cleared up completely, muscle pain was gone, joint pain was less severe, and she suddenly had a lot more energy. It felt, she said, “like the old me.” This continued after the second dose. “It’s like my cells went kerflooey last year when they hit COVID,” Gross said, and the “vaccine said,” Wait, you fool, that’s not how you fight this. Do it like this. She recently walked briskly for 23 minutes and even walked “a little bit because I was so happy,” she said. “I’m a very happy little guy.” Scientists say that understanding whether vaccines help some long-term COVID patients but not others could help uncover the underlying causes of various symptoms and possible treatments. “The disease processes can be different and you manage them differently,” said Dr. Adam Lauring, virus expert and infectious disease doctor at the University of Michigan. “There may be a subset of people who have a certain type of long-term COVID and respond well to vaccines, but there may be other people who have a different subtype that we haven’t fully defined.” Akiko Iwasaki, an immunologist at Yale, said a vaccine could potentially eradicate traces of the virus or viral RNA residues that might be left in some patients by generating antibodies against the coronavirus spike protein. If this happens, it could indicate that the vaccine could be “like a permanent cure” for these patients. Iwasaki said the vaccine could also help people whose long-term COVID symptoms could be caused by a postviral 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, that relief “wouldn’t last very long and they would return to symptoms like fatigue,” she said. Dr. Eric Topol, a professor of molecular medicine at the Scripps Research Institute in San Diego, said he was beginning a study to measure physiological information like heart rate, respiratory rate, temperature, and markers of immune system response in people with long-term COVID before they received a vaccine and weeks ago after that. It’s plausible that “you got your immune system back on its feet fighting a reservoir of viral or RNA debris,” he said, “and that could explain why your heart rate is in overdrive.” He wants to see if these biological indicators improve re-vaccination. “We want really objective metrics that show that you’re not just feeling better,” said Topol. “The placebo effect might make you feel better, but your heart rate is unlikely to increase from 100 to 60 because of a placebo effect. And if we continued to see this pattern, it would be like Eureka. “He added,” I think there is probably something, but I just don’t know how big it is and how many people will benefit from it. ” There are many other questions: Are there certain characteristics – such as age, gender, type, or duration of symptoms – that can make some long-term COVID patients more likely to feel better? Would a vaccine be less effective for people with more complex diseases: people whose symptoms are controlled by multiple biological pathways (possibly both an RNA residue and autoimmune activation), or whose symptoms have changed or fluctuate over time? Are certain types of vaccines more likely to be of benefit? Bridget Hayward, 51, an operating room nurse in Alexandria, Virginia, said that after contracting COVID a year ago, her body ached from hands to hips and became so brain foggy that she asked for a scalpel instead of asking for a scalpel to do this say, “Give me that sharp thing we’re cutting with.” She passed out briefly almost every day while bending down to repair a patient’s intravenous line or attach a cord to a hospital bed. “It was awful,” she said. “It was horrible to think that it could never get better, like, ‘Is this my new normal? Am I corrupted this way now? ‘”After a few months, her worst symptoms improved, but she was still easily tired, felt hot even in cold weather, and found it too taxing to do some ordinary chores, she said. One day after her first dose of the Pfizer vaccine in late December, she said, “Click, everything is fine.” Her body temperature has returned to normal and “it felt like a darkness was lifted.” While “it’s not 100% every day,” she said that she now has so much energy that “I don’t just get from A to B; I jump up.” One day she was doing several overdue errands. “That sounds maybe not after much, but it’s a 180 turnaround from three months ago, “she said.” I’m back! “Kim Leighton, 64, of Vancouver, Washington, has had a similar experience. She was hospitalized in March 2020 and long had COVID symptoms like mini blackouts, shortness of breath, loss in her own neighborhood, depression and fatigue. “It really was hell,” she said. When she felt better in late January, she didn’t even think about the vaccine However, she later found that she had started to improve significantly four days after receiving her first Moderna shot, and she is delighted that she can now walk in downtown Portland, Oregon, and has the desire to see herself again with To join friends. “I feel stronger every day,” said Leighton. “All of the stuff I had to let go of, I’m trying to get back.” Dodd, like some others, said that she did not take her improvement for granted. “I’m still wary of what’s around the corner. This disease is so unpredictable, ”she said. But she added, “Even if, God forbid, I relapse, it’s really amazing to have this time now when I’m feeling better.” This article originally appeared in the New York Times. © 2021 The New York Times Company