People with autoimmune diseases, such as rheumatic or neuroinflammatory diseases, have expressed concern that the COVID-19 vaccines could aggravate their symptoms.
Health experts widely believe the benefits of the vaccine outweigh the risks of a potential reaction or flare-up.
People may need to work with their physician to adjust the timing of their medications around their vaccination.
Many patients with autoimmune diseases, such as rheumatic or neuroinflammatory diseases, have expressed concern that the COVID-19 vaccines could aggravate their symptoms or trigger a flare-up.
The American College of Rheumatology (ACR) believes the benefits of the vaccine outweigh the risks of a potential reaction or flare-up, considering how people with chronic conditions face an increased risk of a severe form of COVID-19 and hospitalization.
The ACR recently released recommendations for patients with autoimmune diseases who are concerned about how they may react to the vaccines.
The recommendations explain how certain immunocompromised people may need to work with a doctor who can adjust the timing of their medications to improve the efficacy of the vaccines.
“Vaccine side effects have more to do with an individual’s immune system and the reaction of that individual’s immune system to the vaccine than their chronic disease state,” said Dr. Ramin Ahmadi, the chief medical officer for Graduate Medical Education Global LLC.
People who are immunosuppressed, such as those on chemotherapy or people who have had a bone marrow transplant, may mount a less robust immune response, compared with the general population, but the vaccine is believed to still provide protection.
Patients with autoimmune and inflammatory rheumatic diseases face a higher risk of hospitalization from COVID-19.
Every person will react differently to the vaccines.
“What’s important to keep in mind is that all diseases of the immune system were not created equally. Some may impact the development of vaccine-mediated immunity, and some stand to benefit a great deal from the vaccine,” Ahmadi said.
“There may be a risk of a flare-up after the COVID vaccination in some individuals with severe disease,” said Ahmadi, noting this risk is theoretical.
But the benefits of being vaccinated against COVID-19 far outweigh any risks, experts say.
Though the data on the COVID-19 vaccines in immunocompromised individuals is limited, past research on other vaccines has shown that vaccination rarely causes adverse events in patients with autoimmune inflammatory rheumatic disease.
A recent study published in The Lancet Rheumatology says that given this past data, the theoretical potential for an adverse event to occur shouldn’t be a reason to advise patients with autoimmune disorders against vaccination, especially when they are at an increased risk of a severe form of COVID-19.
Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, says getting vaccinated during a flare-up is generally OK.
Because steroid medications can suppress the immune system, it’s often advised that people taking such medications avoid them for 2 weeks before or after vaccination, says Cutler.
That said, you definitely don’t want to delay getting vaccinated against COVID-19, so talk with your doctor about the timing of your medications and disease state prior to vaccination.
Some of the side effects that occur after vaccination, such as fever, muscle aches and pain, and fatigue, may resemble symptoms related to an underlying condition.
The reactions can also be localized. For example, some people may develop lymph gland enlargement after vaccination, says Cutler.
“These reactions are generally mild, short-lived, and self-limited,” Cutler said.
Cutler says it’s OK to take Tylenol or ibuprofen for pain or Benadryl for itching after the vaccine if need be.
“The most important thing is getting the COVID vaccine as soon as you become eligible because this will reduce your chance of getting COVID, transmitting COVID, or experiencing any of the long-term effects of even asymptomatic COVID infection,” Cutler said.
Many patients with autoimmune diseases, such as rheumatic or neuroinflammatory diseases, have expressed concern that the COVID-19 vaccines could aggravate their symptoms or trigger a flare-up.
Health experts widely believe the benefits of the vaccine outweigh the risks of a potential reaction or flare-up, since immunocompromised people have an increased risk of a severe form of COVID-19.
People may need to work with their physician to adjust the timing of their medications around their vaccination.
“Certainly, immunity will fade,” Dr. Paul Offit, an infectious disease physician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia, told TODAY.
“The question is does it fade to the extent that you’re not protected against severe disease?”
Researchers may know in about six months whether booster shots might be needed, he added.
“Unfortunately, like so much else in COVID, it’s one of those things where we won’t really know when we are going to know until we have evidence that things are no longer working,” said Dr. Daniel Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School.
“We need the accumulated experience over time to know what it all means.”
For now, the shots are working well, with Offit calling them “powerful immunogens.” Both he and Kuritzkes predicted immunity given by the COVID-19 vaccines would last two to three years.
What’s known now:
This month, Pfizer and BioNTech said trial data showed their vaccine still offered high levels of protection against COVID-19 six months after their second dose.
Moderna also touted a study showing “antibody persistence” six months after the second dose of its vaccine.
Studies are now underway to measure immune responses beyond six months.
How will we know boosters are needed?
A rise in breakthrough COVID-19 infections — those happening in people who are vaccinated, but who still get infected when exposed to the virus — would be a warning sign, Kuritzkes said.
People in vaccine trials are being monitored long-term by the CDC and other groups. Currently, a tiny minority of them still gets infected, 4-5%, but if that number grows, that would be a reason to recommend booster immunizations for COVID-19, he noted.
What about COVID-19 variants?
It’s possible a separate new vaccine may be needed if a COVID-19 variant that’s resistant to the current shots emerges, both Offit and Kuritzkes said.
That hasn’t happened yet, but in a recent survey of 77 epidemiologists from 28 countries, two-thirds believed it would take year or less for the new coronavirus to mutate to the extent that most first-generation vaccines would become ineffective, requiring new or modified shots. The survey was conducted in February and March 2021 by the People’s Vaccine Alliance, a coalition of organizations and activists.
“We may have cycles where we have to keep boosting people — either boosting them with the original vaccine, which gives you enough antibodies to spill over to the variants, or develop a vaccine that’s specific for one or more of the variants,” Dr. Anthony Fauci said last month on MSNBC.
“The only trouble with the latter is that otherwise you may find yourself playing whack-a-mole with the variants because we have lot of different variants… what you really need to do is to get a vaccine that’s potent enough and broad enough that it will overlap all of the other variants.”
That’s what researchers are working towards to avoid repetitive vaccination, Fauci added.
Pfizer and BioNTech said trials suggest their vaccine is effective against a coronavirus variant that first emerged in South Africa.
In March, the National Institutes of Health said that “out of an abundance of caution” it began testing a new coronavirus vaccine from Moderna designed to protect against that variant “should there be a need for an updated vaccine,” Fauci explained.
“If it turns out that we have to do a better job of matching the vaccine to these emerging variants, then another round of vaccination might be needed with a vaccine that is a closer match,” Kuritzkes said.
“It would be a bit of a hybrid because it will boost antibody levels… and enhance the specificity of the immune response.”
Would new clinical trials be needed?
Not like before. In February, the U.S. Food and Drug Administration said modified COVID-19 vaccines against variants may be authorized without the need for lengthy clinical trials.
The flu shot is needed every year — would it be the same for the COVID-19 vaccine?
Not likely since the new coronavirus doesn’t mutate as fast as the influenza virus does.
“Flu is in its own league,” Offit noted. “This virus is actually fairly slow in mutating.”
Still, lifetime protection from the COVID-19 vaccine won’t happen, he predicted.
Other coronaviruses cause common colds and it’s pretty clear having a cold doesn’t protect you from catching another one a couple years later. That’s the main reason to think a booster shot may indeed be necessary, Kuritzkes said. But at the present time, it’s unlikely that boosters will be needed in the next couple of years, he added.
How would a booster be rolled out?
Offit believed it would happen similar to the vaccine rollout, with the oldest and most vulnerable patients as well as health care workers given priority for the shot.
Kuritzkes said it would depend on vaccine supply.
“People will retain some level of immunity, so there won’t be the same urgency and mad dash to get everybody boosted within some very, very narrow window of time,” he noted. “But I think we would want to see everybody get re-immunized.”
A. Pawlowski is a TODAY senior contributing editor focusing on health news and features. Previously, she was a writer, producer and editor at CNN.
The current covid-19 pandemic has affected and changed lifestyles a lot. There is a big difference in prioritizing things now as it was before. There is a new normal lifestyle. With the COVID-19 pandemic, eating, living, working, and socializing patterns have completely changed. Even socio-economic stability has suffered a lot.
Food is an important aspect of life and a means of living. During the current situation, diet planning is an important question to most people about the suitable options to add to a routine diet and what foods should be given up. While planning a diet for yourself and your family, there are many things to keep in mind. Some aspects are elaborated for a more concise understanding.
Avoid Eating Outside
It is safe to eat at home and prepare meals by yourself. Going outside in public places increases the risk of getting in contact with the virus’s carriers and the virus itself. Restaurants and food places are among the most crowded places, and it is more likely for viruses to spread quickly in such places.
It is advisable to avoid visiting such public places and make sure to stay at home. Eat and drink with your family and prepare meals at home. Also, avoiding unhealthy food such as processed food is very important. Processed foods have less nutritional value and are made from synthetic ingredients.
Giving Up Alcohol
It is important to give up certain foods and beverages which are injurious to overall health and increases the risk of getting into serious disease and illnesses. Alcohol is one such beverage that negatively affects each organ of the body, especially during the current pandemic when there is no much physical exercise.
Alcohol abuse increases the risk factors and severity of disease and infection. It negatively influences immunity and the defense system of the body. It is important to look for ways to limit and abandon the use of alcohol. It might become troublesome for many people. People can get professional guidance to cope with addiction from numerous rehab centers.
Drink Enough Water Everyday
Drinking plenty of water is essential in keeping the body hydrated during the COVID-19 pandemic. Water is essential to many processes and functions in the body. It is recommended to take 8-10 glasses of water a day. It is especially important during the current pandemic as water is an essential way to keep air passages moist and secure with sufficient amounts of mucus, which protects the membrane and lining of air passages.
It makes it difficult for viruses and germs to get access to the body through air passages in the nose and throat. Also, it is very helpful in regulating body temperature. Maintaining good hydration is essential for overall health and wellbeing. It is as important as taking a healthy and nutritious diet.
Antioxidants To Strengthen Immune System
Foods rich in antioxidants help the body against free radicals and reduce inflammation. Different nutrients and antioxidants such as Vitamin E and B carotene help the body’s immune system in different ways and protect the body against infections and viruses. They also may help in building up your bodies natural immune system against the COVID-19 pandemic.
Eat Nutritious And Well Balanced Diet
Nutrition and hydration are essential for a healthier body, and it boosts immunity. It also reduces the risk of getting serious and chronic diseases and infections. There are a number of healthy food options to add to a routine diet.
It is important to consider what food and food groups to add to diet on a routine basis as it has a lot to do with overall health, building immunity, and dealing with stress and anxiety of pandemic.
Citrus fruits are rich sources of Vitamin C, and they play an important role in the body as an immunity booster. Incorporating Vitamin C-rich citrus fruits in a routine diet can have numerous benefits.
Common examples of citrus fruits are lemon, orange, mandarin, and grapefruit.
Research shows that Vitamin C helps with shrinking the duration and severity of a cold. So it is beneficial to incorporate a Vitamin C-rich diet and food sources.
If you are looking into what to add to a routine diet during the current pandemic, then these spices are a must for a healthy diet. Ginger, Garlic, and turmeric are extremely beneficial for health and can easily be incorporated into the diet.
These spices are part of many food recipes. These spices have antiviral and antiseptic properties, which are extremely useful in boosting immunity against cold viruses and other viruses.
Zinc Rich Food
Zinc is an important mineral found in food and is required by the body for many functions. Foods rich in Zinc, such as seafood including shellfish, oysters and mussels, seeds, nuts, red meat, and egg yolk, must also be added to a routine diet.
Zinc is found in many medicines used to treat cold thus has properties to fight viruses. A zinc-rich diet must be added to the diet as it boosts immunity against viruses and reduces inflammation.
Magnesium Rich Food
Magnesium is an important mineral found in many foods such as green vegetables, dark chocolate, Tofu, bananas, legumes, seeds, and nuts. Foods rich in magnesium are very helpful in reducing stress and anxiety.
With sufficient magnesium intake, a person may feel calmer, and it also supports immunity. Recent research supports the role of magnesium in reducing the severity of the COVID-19 virus.
Fatty fish is loaded with omega-3 fatty acids. Omega 3 reduces stress and anxiety. Also, it has countless health benefits; it is also effective against the common cold and flu. It also boosts immunity against viruses and should be incorporated into routine diets.
COVID-19 pandemic has brought in an elevated concern about diet and healthy diet options. It is important to avoid eating outside and making sure to prepare and take meals at home. Incorporating foods rich in various nutrients can help to boost immunity. Many foods with anti-inflammatory, antiviral, and antiseptic properties are available. These foods also reduce the risk factor of diseases and infections. A body with stronger immunity can cope with viruses better.
Two studies published in the open-access journal PLOS Pathogens provide new evidence supporting an important role for the immune system in shaping the evolution of SARS-CoV-2, the virus that causes COVID-19. These findings — and the novel technology behind them — improve understanding of how new SARS-CoV-2 strains arise, which could help guide treatment and vaccination efforts.
For the first study, Rachel Eguia of Fred Hutchinson Cancer Research Center in Seattle, Washington, and colleagues sought to better understand SARS-CoV-2 by investigating a closely related virus that has circulated widely for a far longer period of time: the common-cold virus 229E.
229E and SARS-CoV-2 are both in the coronavirus family, which features a “spike protein” that enables infection of human cells. A person who is infected with 229E develops an immune response against the spike protein that protects them from reinfection, but only for a few years. Whether reinfection then occurs because the immune response wears off or because 229E evolves to escape it has been unclear.
Eguia and colleagues addressed this question by testing the activity of serum samples collected from patients in the 1980s-90s against spike proteins from both old 229E strains and strains that evolved later on. They found that the old spike proteins were vulnerable to the older sera. However, modern spike proteins were able to evade older sera while remaining vulnerable to sera from modern patients.
This analysis suggests that modern strains of 229E have accumulated spike protein mutations that enable them to evade older sera. These findings raise the possibility that SARS-CoV-2 and other coronaviruses could undergo similar evolution, and that COVID-19 vaccines may require periodic updates to remain effective against new strains.
The authors add, “The human common-cold coronavirus evolves over the span of years to decades to erode neutralization by human polyclonal serum antibodies. This work suggests that human coronaviruses undergo significant antigenic evolution that may contribute to eventual re-infections.”
For the second study, Sung Hee Ko of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, and colleagues developed new technology for genetic sequencing of the SARS-CoV-2 spike protein, enabling detection of multiple SARS-CoV-2 strains that may be present at the same time within a single infected patient.
Previous studies have used standard sequencing methods to produce a single genetic sequence from an individual patient, obscuring the potential presence of multiple SARS-CoV-2 strains. By contrast, the new technology highlights virus diversity within each patient and enables tracking of the evolution of new SARS-CoV-2 strains during acute infection.
Indeed, when the researchers applied the new method to human respiratory samples, they found new SARS-CoV-2 variants arising within the same patient over the course of acute infection. The precise mutations in these variants suggest that they arose in response to selective pressure from the immune system.
Future application of the new technology could improve understanding of how the evolution of new SARS-CoV-2 variants within a single patient impacts their outcomes. The findings also suggest that patients might see greater benefits from early treatment with antiviral drugs capable of targeting multiple strains, than from delayed treatment with a single antiviral drug.
The authors add, “We used new technology to show that coronavirus variants with mutated spike proteins can arise early in the course of infection. Our results suggest more virus evolution in each person than previously thought, with potential implications for clinical outcomes and for the emergence of transmissible variant strains.”
Together, these two studies deepen understanding of how new SARS-CoV-2 strains arise in response to immune system activity, potentially paving the way for additional research and improved treatment.
Materials provided by PLOS. Note: Content may be edited for style and length.
A recent study fromBen-Gurion University of the Negev (BGU) found that isolated molecules from probiotic-rich dairy products could have potential as novel drug candidates for fighting against pathogenic bacteria and treating inflammatory diseases, including the cytokine storm related to coronavirus disease 2019 (COVID-19). Findings from the study were published in the peer-reviewed publication Microbiome.
Probiotics are considered beneficial bacteria found in fermented foods like kefir and yogurt. Previous research suggests that probiotics may also support the immune system, improve the diversity and balance of microbial populations in the gut and possibly protect humans from harmful bacterial infections.
A studyfrom Monash University in Melbourne identified two molecules in the gut microbiome, which houses probiotic bacteria, that may play a role in treating severe COVID-19 and asthma attacks.
In this recent study, researchers from BGU isolated molecules from a predominant yeast in probiotic-rich kefir. These molecules significantly reduced virulence of the bacteria that causes cholera.
According to the investigators, the anti-bacterial effect of the kefir-secreted molecules centered on their ability to disrupt bacterial cell communication and interfered in assembly of bacterial aggregates. They added that the achievement of blocking cell communication with these molecules among bacterial cells represents a promising and potentially effective approach to combating antibiotic-resistant bacteria.
A follow-up study found that the isolated molecules also exhibited anti-inflammatory properties when tested in several different pathological conditions and diseases. In one case, the molecules accelerated the healing of mice that were undergoing a “cytokine storm,” a potentially lethal immune response involved in COVID-19 and another conditions. The molecules isolated from the probiotic yogurt eliminated the cytokine storm and also improved immune system function. The investigators believe that these isolated molecules could thus be used as novel drug candidates for inflammatory conditions.
Professor Raz Jelinek, a corresponding study author, said in a statementthat the findings from this study are notable, given that they are the first to demonstrate that molecules secreted in probiotic dairy products can reduce human pathogenic bacteria virulence.
“In fact, our research illuminates for the first time a mechanism by which milk fermented probiotics can protect against pathogenic infections and aid the immune system,” Jelinek said. “Following promising results in animal models, we look forward to administering these drug candidates to humans, for example to patients who are experiencing a cytokine storm due to COVID-19 infection, or people suffering from acute inflammatory bowel pathologies, such as Crohn’s disease.”
“In a reality where antibiotic-resistant bacteria are becoming an imminent threat, the novel molecules discovered by BGU scientists pave a completely new path for fighting bacterial infections by disrupting cell-cell communications in pathogenic bacteria,” added Josh Peleg, chief executive officer of BGN Technologies. “Moreover, the dramatic anti-inflammatory activities of the molecules may open new avenues for therapeutics and scientifically proven probiotic food products.”
BGN Technologies is a technology transfer company of BGU and works to develop and deliver technological advancements from the lab to the market. Since its inception, BGN established more than 100 biotech, hi-tech and cleantech startups.
“Years of breakthrough research have now reached a validation point that led to the establishment of a biopharma company for the further development and clinical evaluation of this exciting new technology that can potentially revolutionize the treatment of bacterial infections as well as inflammatory conditions,” Peleg said.
With delays in global production and distribution, mixing two doses of vaccines may end up becoming inevitable. But questions concerning its safety and efficacy remain unanswered.
As Covid-19 vaccine rollouts continue across the globe, people are being administered two-doses: a ‘prime’ first dose, followed by a ‘boost’ second dose some weeks later.
Thirteen vaccines are currently in use against the virus and an additional 67 are in clinical development around the world, with nearly two-thirds designed to generate immunity with two or more doses.
But with supply scarcity and distribution of certain vaccines an ongoing issue and many hunting for leftovers, a question is starting to cross people’s minds: what happens if you get two different vaccine doses? What if you were to pair a first dose of the AstraZeneca vaccine with a second dose supplied by Moderna?
And, most importantly, would it be safe?
It could be possible that greater immunity is generated if different vaccines are used one after the other, in what is known as “heterologous prime boosting”.
Both the Pfizer and AstraZeneca vaccines prime the immune system to target the coronavirus’ spike protein, which plays an instrumental role in the infection process.
But they hone in on different parts of the spike and deliver their payloads by two different means. Pfizer hands over genetic instructions for making the spike protein and relies on human cells to produce it, while AstraZeneca uses a modified cold virus to present the spike protein to the immune system.
Moderna also uses the same mRNA platform that Pfizer does.
“We’re not sure why a mix-and-match approach can be more potent. But it’s possible combining two different vaccines – which give the same antigen target but stimulate the immune system in different ways – could better focus our immune cells’ attention on the right target,” wrote Dr Kylie Quinn, a Vice-Chancellor’s Research Fellow at the School of Health and Biomedical Sciences at RMIT University.
According to the Centers for Disease Control and Prevention (CDC) in the US, while more research is needed on the subject, there should be no side effects to mixing. The CDC maintains that medical professionals administering vaccinations should do their best to ensure patients receive two of the same shots if they’re administering the Pfizer or Moderna vaccine.
However, in an “exceptional situation” where a second shot of the first vaccine type isn’t available, “any available mRNA Covid-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the mRNA Covid-19 vaccination series.”
Dr Bulent Sekerel, Director of Hacettepe University’s Faculty of Medicine, is skeptical about mixing and matching until there is clear scientific backing.
“As far as I know neither of these protocols have been evaluated in clinical trials. We need to have evidence to discuss it with the public or suggest it as a treatment alternative,” he told TRT World.
TRT World reached out to BioNTech and AstraZeneca for comment, but both declined until conclusive studies on vaccine mixing were available. Other experts were also reluctant to discuss it until evidence from trials emerged.
For the moment, experiments in mice have shown promising results, in which combinations of the Pfizer and AstraZeneca vaccines boosted immunity better than two doses on their own.
But there is no evidence that it works in humans – at least, not as of yet.
Significance of the UK’s mix-and-match trial
As of last month, Oxford University has begun conducting a clinical trial to test whether it’s safe to mix vaccination types after the UK government gave medical professionals the go ahead to mix shots in January.
The trial, referred to as the Covid-19 Heterologous Prime Boost study or ‘Com-Cov’ study, will recruit over 800 volunteers aged 50 and above. Using an eight-armed clinical trial, it will evaluate the four different combinations of prime and booster vaccinations: volunteers will either receive one dose of the Pfizer vaccine followed by one dose of the AstraZeneca vaccine, the reverse, or two regular doses of each vaccine type.
Volunteers will then be evaluated at two different dosing schedules: a four-week interval for early interim data and a twelve-week interval. Using blood samples, the study will monitor the impact of different dosing regimens on participant’s immune responses.
Overall, the study will last for thirteen months.
“As we roll out vaccination in the UK, we have the opportunity to look at how to get the most out of the vaccines available to us. This innovative study looks at whether using different combinations of two currently approved vaccines is a good alternative to the standard schedule. We will also be looking at the impact of the interval between doses on immune responses,” Dr Maheshi Ramasamy, Senior Clinical Researcher and Investigator on the trial, said in a statement.
If the results are positive, it could help ease supply chain issues and help boost a more robust immune response in recipients.
Professor Jonathan Van-Tam, Deputy Chief Medical Officer and Senior Responsible Officer for the study, said: “Given the inevitable challenges of immunising large numbers of the population against COVID-19 and potential global supply constraints, there are definite advantages to having data that could support a more flexible immunization programme, if needed and if approved by the medicines regulator.”
“It is also even possible that by combining vaccines, the immune response could be enhanced giving even higher antibody levels that last longer; unless this is evaluated in a clinical trial we just won’t know.”
New strains in South Africa for example, underscore the importance of having an immunisation strategy that preserves or improves vaccine-induced immunity as novel variants of the virus emerge.
There is also precedent for combining vaccines that use different vehicles to deliver their payloads. Two doses of Russia’s Sputnik V vaccine use two kinds of viruses to transport the genetic instructions that tell the immune system which coronavirus surface proteins to look for.
In clinical trials, research revealed that Sputnik V had an efficacy of 91.6 percent and is now in use in Russia and 56 other countries.
Russia’s Gamaleya Research Institute, which designed Sputnik V, took a similar approach to formulating the first and second doses of its Ebola vaccine. Several experimental HIV vaccines are being tested using the same approach too.
Recently, Gamaleya and AstraZeneca have teamed up to register a pair of clinical trials – one in Azerbaijan and the other in Russia – to see how well their vaccines work in tandem.
But the problem with testing the safety of mixing vaccine combinations is ultimately compounded by the complexity of immunity itself.
“What we know to measure is only half the story,” said Dr Gregory Poland, a vaccine researcher at the Mayo Clinic in Minnesota. While the British trial will measure the antibodies in the bloodstream, it’s not clear if immunity can be achieved through neutralising antibodies alone.
“If you alter one component of that, you no longer know if you have the same efficacy and safety,” said Poland.
But in the midst of a global pandemic that level of caution might be a luxury – and mixing vaccines may end up being inevitable.
Reinfections from Covid-19 continue to seem rare, and are not responsible for the current, stubbornly high case counts in the United States, according to scientists and the latest findings.
At least, that’s what researchers are left to conclude. Experts say the country and individual states don’t have strong systems to determine how frequently people are getting reinfected — another consequence of the nation’s limited surveillance network. They’re calling for better data collection and analysis around second cases of Covid-19.
The main factors driving coronavirus transmission in the United States are a mix of the old — easing restrictions, people coming into close contact with others — and the new, like the more transmissible variants, experts say. And Caitlin Rivers, an infectious disease epidemiologist at the Johns Hopkins Center for Health Security, said she thought that reinfections are still uncommon.
But without better data, she said, “we don’t know, and I want to know.”
“It’s not the most likely explanation” for what’s spurring cases, she said about reinfections. “But I would like to see more evidence and data around that.”
The Centers for Disease Control and Prevention has outlined how suspected reinfections can be investigated and has a form for jurisdictions to report them, which Rivers called the “building blocks” for tracking cases. Still, she said, not a lot of data is being produced. The U.S. also doesn’t have the level of studies set up like those in England to track reinfections over time.
The notion of reinfections is not some unexpected twist in the rollercoaster pandemic. Scientists anticipate that with a respiratory infection like Covid-19, people won’t be protected for life after recovering from an initial case. Rather, the immunity generated from their first infection will wane over time. But one predominant hypothesis is that whatever reinfections occur with Covid-19 will generally (with some exceptions) be milder than the initial case, perhaps even asymptomatic. Even if the immune system can’t fend off the virus entirely, it still remembers the pathogen well enough to vanquish it quickly.
Researchers don’t yet have estimates for how long protection lasts after a Covid-19 infection, but there isn’t going to be one precise answer. Factors like age and even how sick people get from their initial case can influence that variability. Some people — including those who have really mild or asymptomatic infections the first go — don’t generate that strong of an immune response, and might become susceptible again sooner.
Already, there have already been several dozen documented reinfections around the world, though current numbers are almost certainly an undercount. If subsequent infections are indeed mild or asymptomatic, many of them will go undetected. It can also be difficult to establish two separate infections in the same person.
But so far, the available research suggests just a tiny subset of the more than 30 million people in the United States — and 132 million globally — who’ve had a confirmed Covid-19 case have become infected again. Studies indicate that the vast majority of people mount a robust and long-lasting immune response after being infected for the first time with SARS-CoV-2, the virus that causes Covid-19. A study that followed health care workers in U.K. for six months, for example, found that those who had an initial Covid-19 infection carried protective antibodies for the length of the study period; the few who tested positive again generally had no symptoms (it’s unclear, though, if they could still transmit the virus). A study out of Denmark also found reinfections were rare, though they were more common in people 65 and up.
“We anticipate reinfections will be a part of the epidemiology at some point, but I don’t think they’re accounting for the cases now in any major shape or form,” said Michael Diamond, a viral immunologist at Washington University in St. Louis. He noted in the U.S., the biggest wave of cases occurred only recently, at the end of 2020 and beginning of 2021.
“The majority of people who’ve had prior infection in the recent past” — six months, he said — “are going to have protection against” the forms of the virus that are dominant in the U.S. now.
At this point in the pandemic, there are two potential forces that could increase the number of reinfections, though experts say there’s not clear evidence of either occurring to a great extent.
For one, the first wave arrived in the U.S. more than a year ago. Perhaps enough time has passed that the immunity of some people infected early on has waned. Older people, for example, tend to have weaker immune responses — though at this point, that population is increasingly vaccinated, giving them an even stronger immune boost against the virus. (Health officials say that people who have had Covid-19 should still be vaccinated because the shots appear to generate greater levels of protection than infections.)
Michigan was one of the states hit early in the U.S. last spring, for example, and is again experiencing one of the country’s biggest outbreaks. But experts there think second cases are not playing any major role in the state’s surge.
“The large majority of what we’re seeing in Michigan is not reinfection,” said Anurag Malani, an infectious disease physician at St. Joseph Mercy Health System in Ann Arbor.
The other factor is the presence of certain newer versions of the coronavirus. Two variants that first appeared in South Africa and Brazil — called B.1.351 and P.1, respectively — as well as iterations that cropped up in California — B.1.427 and B.1.429 — appear to be able to sneak past certain elements of the immune response elicited after infections by other forms of the virus. It’s possible then that these variants are more likely to infect a person again who would otherwise be able to block other iterations of the virus entirely.
But Diamond noted that the number of cases of B.1.351 and P.1 remains low in the U.S., suggesting the variants are not spreading widely through reinfecting people. While just a small fraction of cases are sequenced, the available numbers indicate other strains of the virus far outnumber B.1.351 and P.1.
Even if someone contracts a second infection from a variant like B.1.351 or P.1, Diamond said his guess was that the immune system would generally still be able to recognize the virus well enough despite its genetic differences to fend off the most severe outcomes. He added, though, that scientists needed to verify that through additional research, and it’s something experts will be watching for as the variants continue to circulate.
“It may not prevent you from feeling lousy, it may not prevent you from transmitting,” Diamond said, “but it may prevent you from getting serious disease.”
Despite the vaccine developments, the pandemic is far from over, with coronavirus variants appearing in various countries.
“The variants are to be expected because that’s what viruses do,” Brainard said. “Viruses survive by changing themselves, and they change themselves so that they can avoid the body’s immune system.”
To combat those mutations, companies are looking at various strategies. Especially with mRNA, it is easier to modify the vaccine to carry the new virus sequence, which would signal the immune system to produce a different antibody.
“There’s active research into how effective the current vaccines are against the variants and whether or not a booster shot designed to target those variants and provide a broader protection would be necessary,” Brainard said.
The ongoing research will be crucial in determining future steps.
“Because the COVID-19 infection outcome is much much worse, the worst-case scenario is if the SARS-CoV-2 continues and we need to get a vaccine every year,” Wang said. “Both Pfizer and Moderna are working on follow-up booster doses for vaccines against virus mutations. If the virus keeps on circulating, if we don’t have herd immunity, if people don’t get the vaccine, there might be even more mutations.”
Even so, herd immunity in one country will not help.
It’s a competition between human beings’ immunity and virus evolution.”
— Jing Jin
“Now it’s just a competition between human beings’ immunity and virus evolution. If you look at the data nationally, the cases are rising, and this is under the condition with parts of the population already fully vaccinated,” Jin said. “If other countries cannot control the variants, eventually the U.S. will also have new problems. With the new variants circulating, it’s very hard to predict what will happen, but it will not end very soon.”
However, the world is, undoubtedly, a step closer to returning to normal as companies and the government are doing their best to make the vaccines more available.
Carly Ramirez, a senior who works in food service, has recently gotten her first Pfizer vaccine. She is hopeful that the vaccine will be vital in ending the pandemic by creating immunity.
“I’ve always had trust in the vaccines. I know a lot of people are worried about how fast the vaccines were developed or if they got the right amount of testing or if side effects are fatal,” Ramirez said. “A lot of people say they want to wait for a better one, but I totally disagree with that. I’d rather risk getting the vaccine than getting the coronavirus itself.”
There is no telling how long the pandemic will last, but people can do their part to stay safe by taking any protection measures available.
“Vaccines are the most powerful weapon humans have against infectious diseases. Unfortunately, nobody will 100% guarantee that you will be protected, even if you get the two doses for Pfizer or Moderna because the immune response is different for each individual,” Wang said. “Whether you have the vaccine or not, we are still recommended to take universal precautions to protect yourself and protect others.”
With the recent surge of coronavirus infections, conscious people are seeking all the possible ways to boost immunity. Although vaccines are available, the whole world wouldn’t be vaccinated overnight. It will take years to vaccinate the seven-billion people. And for third-world countries, vaccination could be a rare thing. Hence, defending COVID-19 with our body’s immune system will be the only way to survive.
Strengthening your immune to prevent COVID-19 is collective and long-term work. One cannot simply gain the immune right away. However, you can gradually achieve the proper immune system through a healthy lifestyle and physical activity.
Boost your Immune through Practicing Healthy Lifestyle
Having a proper sleep, taking nutritious meals, and leading a stress-free lifestyle can definitively raise the functionality of your immune system.
Getting quality sleep is a significant health behavior to function the immune system properly, which also works on boosting physical and mental health as well as the quality of life. According to the experts and doctors getting more than seven hours of sleep is essential to make your adult body’s metabolism work suitably. However, 11-14 hours of sleep for infants or toddlers, 10-13 hours for preschoolers, 9-12 hours for school-going kids, and 8-10 hours for the teens are necessary.
With the surge of COVID-19, our stress level is also getting high accordingly. It is normal to get stress during this global pandemic. But, staying stress-free is highly essential to keep your body fit. For a stress-free lifestyle, you can take healthy meals, practice regular exercise, take self-care and maintain COVID-19 health protocols. Each of these behaviors is connected to our stress-free lifestyle.
Increase Immune System with physical activity and exercise
A mild, intense physical activity is connected with a better immune function. Hence you should continue regular physical activity to increase your immune system. However, physical activity can be in many forms, which you can practice for the wellbeing of your health.
The first thing you can do is keep your body moving. It can be any kind of intense aerobic physical activity. Experts recommend having moderate exercise at least 150-300 minutes per week. This can keep your body’s metabolism on track.
If you are unable to do aerobics activity, you can try indoor activities. It can be walking briskly in the house or even up and down the stairs every day for 10-15 minutes for 2 or 3 times. Besides, you may also dance with your favorite music, or exercise on home cardio machines, or even you can try jump rope.
If you can go outside of your home, you can also walk or run on the f roads. Though you cannot go outside of your house, working out at home should be okay. Outdoor activities are way more useful than indoor activities. Nevertheless, if you are going out, you should keep in mind that you will need to stay at least 6 feet away from others.
Furthermore, regular physical exercise at home will also work. You can download a workout app on your smartphone and follow that to start your physical exercise at home.
Yoga is another way to keep your body moving. Deep breathing, along with mindfulness, works as a catalyst to reduce anxiety. Therefore, your stress level will definitely reduce through yoga. You try watching a yoga video with instructions to start yoga at home.
Take Food to Enhance the Immunity
All your exercise will not work if you don’t take proper nutrition. Even though you don’t exercise, you need nutrients to strengthen the body’s immunity during the COVID-19. You can take the nutrients from natural resources such as fruits and vegetables.
Vitamin C is the ultimate shield against the coronavirus and any bacteria. You can get Vitamin C on green fruits and vegetables such as grapefruit, lemon, broccoli, bell peppers, green peppers, etc.
Vitamin D is also essential to fight off any infections. Besides, it can work on building strong bones. You can find Vitamin D on mushrooms, cereals, bread, and fortified milk. However, if you want to take Vitamin D via a natural source, you can stay under the sunlight for 5-10 minutes every day.
Vitamin A keeps your skin and tissue healthy which also works against infections and boosts the immune system. Sweet potatoes, spinach, carrots are the common sources of Vitamin A.
Vitamin E is another vital element for your body’s immune system. It is an essential antioxidant that works in fighting against cell damages. Plant-based foods are a great source of Vitamin E. Commonly, nuts and peanut butter are usual sources to get Vitamin E.
Finally, Zinc is one of the essential antioxidants for COVID-19 patients as well as healthy persons. It increases the metabolism that also boosts the healing process. You can find Zinc on shellfish, beans, meat, and seeds/nuts.
Apart from these natural sources, you can also take supplements as we may not buy these foods always. Vitamin supplements are available over the counter, so you don’t need prescriptions to buy those. But it is recommended to take advice from medical practitioners or doctors.
Limitations of Immune System Against COVID-19
It is essential to keep in mind that the strong immune system will not work to prevent you from getting COVID-19. It can just help you to recover quickly if you ever contract coronavirus. So, if you have a strong immune system, coronavirus may not damage your body parts.
It is always good to maintain COVID-19 health safety protocols such as wearing a mask, keeping social distance, washing your hands frequently, maintaining good hygiene, and cough etiquette.
There is a saying that “prevention is better than cure,” which everyone should follow during this coronavirus global pandemic. New variations of COVID-19 do not have a significantly proven cure yet. But we can prevent it or even fight it by strengthening our immune system.
Darwin’s concept of the ‘survival of the fittest’ rings louder even more with the ongoing pandemic as the COVID-19 cases surges. The medical community has risen to the challenge and have made fair progress with the inoculation drives, however with the various viral strains mutating, very reliable treatment is yet to be found. Looking back to a year since the lockdowns were imposed the world over; it has been observed that while there were several that succumbed to the deadly disease, the rate of recovery was witnessed with the pool of people with good immune response who were able to fight off the infection. Unquestionably, the global pandemic has made us realise why it is important to pay attention to our immune system and keep it strong. Much like it is crucial to put on a mask, taking care of our immunity is a reminder we need to keep giving ourselves.
How do we build up our immunity? These simple practices, according to Dr Mitali Madhusmita, senior Ayurveda physician with The Art of Living’s Sri Sri Tattva Panchakarma, can help you put together a good defence.
1. Load up on Antioxidants
Antioxidants are compounds that reduce oxidative stress and fight the free radicals that otherwise attack and destroy healthy cells in the body. Fresh fruits and vegetables, especially the seasonal ones are packed with these fighters. Loading up on citrus fruits is a simple way to replenish the vitamin C levels in your body and it is the most effective antioxidant when it comes to fighting off respiratory tract infections. Include fruits like guava, pomegranate and berries in your diet. Vitamin E found in almonds, avocados, hazelnuts helps to fight against bacterial and viral infections and increases the concentration of antibodies in addition to improving the production of natural killer cells in the immune system. Beta carotene found in carrots, sweet potatoes and red and yellow peppers, and flavonoids found in berries, bananas, nuts, beans, tomatoes are some of the most effective antioxidants when it comes to boosting immunity.
2. Herbs and Spices
Traditional spices like turmeric, ginger and black pepper are well known for their excellent immunomodulatory and anti-inflammatory properties. Spices such as cloves, cinnamon, star anise, cardamom, with their rich aroma not only enhance the taste of your dishes but also prevent you from a number of health problems; they have excellent anti-microbial properties and are crammed with antioxidants that promote your immune system. Power-packed herbs like Tulsi (Holy Basil) and Giloy(Tinospora Cordifolia) work wonders on your immune response; chewing on 5-6 leaves of Tulsi on an empty stomach is one of the most effective ways to boost your immunity. Giloy is known to increase platelet counts.
3. Increasing the Quality of Sleep
Studies indicate that lack of sleep affects the immune system. The quality of sleep determines the strength of your immune system, the ability to fight diseases and the level of faster recovery. Sleep is an essential period of rest that the body requires for healing. Improving the quality of sleep by practising ‘switch off’, ie getting off gadgets an hour before bedtime, dimming the lights and sounds are effective.
4. Increasing the Prana in our Bodies
Fresh fruits and vegetables, whole grains, legumes and dairy products have a good amount of Prana (life energy); such foods help in strengthening the immune system. On the other hand, frozen, stored and processed food is devoid of nutrients, therefore, locally grown fruits and vegetables are always a wiser and healthier option than the imported ones.
Freshly prepared food has a good level of Prana, whereas stale food produces Ama (sticky toxins). Other practices such as reheating the food that has been prepared for the previous meal increases the trans-fat in the food which indirectly brings your immunity down. Just as a salad needs to be eaten fresh, treat each meal with the same rule.
Consuming undercooked food overloads the digestive system. Digesting this meal burns more energy and in turn hampering immunity whereas overcooking burns the essential micronutrients; it is important to maintain a healthy balance while cooking food.
5. Avoid Overloading the Digestive System
Consume a full meal only if the previous meal is fully digested, else it is better to limit yourself to lighter options like clear vegetable soup, tender coconut water, or a few slices of cucumber.
The proper functioning of the immune system depends on various functions, the proper functioning of the liver, proper digestion and assimilation of food. Munching, especially when not hungry, taxes the liver, making it sluggish. Eating anything after 10 pm also puts an unnecessary load on the liver and leads to the accumulation of Ama. Nighttime is meant for rest and one must have a good night’s sleep for good immunity. Inadequate or disturbed sleep also affects immune health.
6. Sun, Fresh Air and Exercise
Sunlight is the ultimate source of energy for all beings on earth. Not only does it help maintain Vitamin D levels in our body which is essential for the immune system to function effectively, but also helps in regulating the secretion of various hormones in our body which are important for a healthy sleep-wake cycle and a balanced mental and physical health. It is important to spend 15-20 minutes preferably in the morning sun and inhale the fresh morning air. Pranayama (breathing exercises) play an important role in improving not only our lung capacity and mental functioning but also as studies show, enhances our body’s ability to fight against infections.
Along with these six essential practises, it is also important to continue staying safe with the basic practices of wearing a mask, maintaining social distancing and use of sanitizers.
Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.