En español | It was close to Christmas when Thomas Goldsmith, a musician in Raleigh, North Carolina, knew he'd been hit with COVID-19. “I had lots of terrible aches and pains, serious fatigue, loss of appetite, shortness of breath and a weird disorientation,” Goldsmith, 69, recalls. Testing soon confirmed he'd contracted the virus. “It was two weeks of the flu-beyond-the-flu,” he says. “The worst part was it didn't really go away after two weeks. It was more like two months."
Goldsmith was afflicted with what's commonly called post-COVID syndrome or long COVID. The National Institutes of Health only recently named it: Post-Acute Sequelae of SARS-CoV-2 infection. Sufferers experience lingering COVID-19 symptoms including chronic cough, chest pain, shortness of breath, memory and sleep problems for four to six weeks — or much longer — after they no longer test positive for the infection.
A study published by researchers from the University of Washington suggests that between 10 percent and 30 percent of COVID patients are so-called long-haulers, which, given the nearly 33 million cases in the United States, could add up to more than 9 million people.
Swift improvement after second dose reported
Fortunately for Goldsmith, his symptoms seemed to disappear after he received his second dose of the Pfizer vaccine. “The improvement was amazingly quick,” he says. “My appetite, energy, concentration all returned, and I felt almost human again."
Goldsmith says he didn't connect the vaccine to his improved health until he began hearing others describe similar experiences. In a survey conducted by Survivor Corps, an online grassroots group of COVID-19 survivors, roughly 40 percent of participants reported partial to full resolution of their symptoms after they were vaccinated. About 23 percent of long COVID patients in a small U.K. study said they had an “increase in symptom resolution” after being vaccinated, compared to about 15 percent of people who were not vaccinated.
Yale School of Medicine immunologist Akiko Iwasaki is eager to know if the shot developed to prevent the disease might also be what long-haulers desperately need. “Hearing that people with long COVID were having their symptoms reduced or recovering got me excited, because this might be a cure for some people,” Iwasaki says.
How the vaccine could be “curing” symptoms
There are several reasons the vaccine could alleviate or reduce lingering coronavirus symptoms. But without more investigation, researchers say they can only hypothesize about what those might be.
One theory is that people with long COVID have a reservoir of the virus in their bodies that is wiped out, along with the lingering symptoms it's been causing, when the vaccine produces a strong immune response.
Another possibility is that COVID-19 may trigger a hyperactive autoimmune response in which immune cells mistakenly continue to attack the body's own cells. In this case, the vaccine may work by minimizing the immune response and clearing up the symptoms it's been causing.
John M. Baratta, M.D., co-director of the UNC COVID Recovery Clinic in Chapel Hill, North Carolina, believes the post-vaccine response that seems to resolve patients’ symptoms is more than a placebo effect. However, he says it's unclear whether the improvement is temporary or permanent.
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"A few people have reported that their symptoms got better for a short period of time, and some had a temporary worsening of symptoms,” says Baratta. “This is what I would expect, because there is an immune response to the molecules in the vaccine that causes the body to begin to fight what it thinks is an infection.”
Not a panacea for everyone
The possibility of feeling worse, even for a short time, is what makes people like Doug McClain, 53, hesitant to get vaccinated. McClain was first diagnosed with COVID-19 in September. The husband and father of three was hospitalized twice. The last time, he seriously doubted he would come home.
Eight months later, he is much improved, though he still has long-haul symptoms, including shortness of breath and stabbing chest pains. Nonetheless, he has resisted his doctor's push to get vaccinated. “I'm afraid to because I don't want to go through what I went through before — the struggle to breathe and the searing pain in my chest,” says McClain. “I've heard that the vaccine makes you feel like you have COVID all over again, and I'm really, really nervous about that."
While side effects from the vaccine overwhelmingly tend to be minor and short-lived, Iwasaki says she can sympathize with people like McClain. “They have already suffered so much from the long COVID that they are afraid that the vaccines might make their symptoms worse.”
While surviving COVID seems to provide at least some long-term immunity, Iwasaki advises getting the vaccine because it appears to add important additional protection “with respect to the levels of antibodies generated after the second shot."
Iwasaki is now focused on generating hard data on the questions surrounding vaccination and long-hauler symptoms. She and the Yale School of Medicine research team are launching a data-driven study with members of the Survivor Corps to determine the effect of vaccination on people with long COVID by monitoring their symptoms pre- and post-vaccination and collecting blood samples to study their immune response at different stages.
Goldsmith hopes the ongoing research will unravel the mystery of why the vaccination helps some people and not others. In the meantime, he's just glad it made a tremendous difference for him and his family. While he says the virus at first seemed to age him practically overnight, he notes, “Now I'm back to where age isn't something I think about that much.”