Does a corona vaccination reduce lung covid?

Foreign figures indicate that vaccination helps against lung covid.

Last week, almost 1.7 million needles in Dutch upper arms disappeared. With more and more people getting vaccinated, infection rates and hospital admissions are plummeting. But something else seems to be happening, a surprise effect for virologists and vaccinologists. Foreign media report that people with ‘lung covid’, who are still ill months after being infected, are recovering after a vaccination.

According to foreign figures from the Yale School of Medicine it would be thirty to forty percent of the patients who say they notice an improvement after the injection. In the Chicago Tribune told one American woman how she felt healthy again for the first time in seven months after the first dose of the Pfizer vaccine. The Guardian described results of a British survey of more than 800 people with long-term complaints. Of them, 57 percent felt better after vaccination, 24 percent noticed no difference. A small group actually felt worse after vaccination. If you scrape together the scarce evidence, there is quite a bit to be said for the positive sounds from abroad.

No control group

So far, the “proof” consists only of anecdotes. Results from scientific studies are not yet available. You have that British survey, but there is no conclusion to it. The initiator of the survey, the LongCovidSOS organization that represents the interests of people with long-term covid in the United Kingdom, distributed the questionnaire to support groups on Facebook. Of the participants with long-term complaints, 41 percent had tested positive for the corona virus. The rest had never been determined to have been infected with corona. Furthermore, it was almost exclusively white women who took part, a group that generally has more fatigue complaints. And then the participants also had to remember symptoms from before their vaccination, sometimes weeks ago.

Perhaps the biggest problem with the numbers so far: there is never a control group. The results of questionnaires suggest that the vaccine has an effect on lung covid, but you can’t really conclude anything without a control group. What about people with long-term complaints who do not receive a vaccine? “You want to know that in order to be able to compare, to exclude a placebo effect,” responds virologist at Amsterdam UMC and OMT member Menno de Jong. A placebo effect is the phenomenon that you can feel better because you have positive expectations of a drug. De Jong hears stories from people who already recovered within an hour after the injection. “Of course it’s nice that these people feel better, even if in those cases it’s probably a placebo effect, because that’s not possible from a biological point of view. A vaccine needs more time to work.”

Follow patients

Another option: It’s not a placebo effect. The vaccine really does something in the body that reduces the symptoms. But what? Anke Huckriede, professor of vaccinology at UMC Groningen, thinks it is an interesting issue, let them know by email, but could not come up with a possible immunological explanation. “Except for the common explanation that the vaccine may be cleaning up the last bits of virus that the body cannot get rid of itself.” It is an interesting subject, an immunologist at RIVM Cecile van Els also responds by email. A subject we simply know too little about.

Since May last year, the Amsterdam UMC and the GGD Amsterdam have followed more than three hundred people from the moment they had covid, within the RECoVERED-studie . Half were in the hospital, the other half were sick at home. Six months later, more than half of the people who had been seriously ill still had complaints, such as fatigue, shortness of breath, fever and muscle pain. Among people with a mild infection, that was one in five. A year later, these numbers are not much lower, according to a latest update of the analysis.

De Jong would like to measure the effect of a vaccine on the complaints, but does not have a control group for this. “Everyone is vaccinated. Withholding a vaccine from people is not possible.” So he takes a different tack. His group is first trying to figure out where long-term covid is coming from. Are there virus particles or bits of it left in the body that maintain long-term inflammation? Was the immune system overactive during the infection, causing organ damage? Is there a disease that occurs after a viral infection, without a clearly identifiable cause, as you also see in chronic fatigue syndrome (ME/CFS)?

Stock of virus particles

Currently, the study focuses on 180 people who had covid, half of whom still have complaints. Since the infection, these people have come to the UMC or GGD every month to provide blood and throat, nose and stool samples. De Jong: “Perhaps there is a reservoir of virus particles in the intestines or upper respiratory tract, which we are trying to find.” The participants’ monthly tube of blood is also checked for substances that indicate chronic inflammation.

The Amsterdam UMC is investigating whether virus particles are still floating around in the body of lung covid patients.

The researchers are also looking at the effect of the vaccination. Blood was collected from each person before and after vaccination. “We are now looking at differences in immune response in people with and without long-term covid, the effect of vaccination on the inflammatory substances in their blood, and whether anything changes in their complaints.”

What does he expect? “It could just be that we find a possible biological cause in one person with lung covid and not in another. In the best casescenario, I expect that in some of the patients we will find something that you can do something about, such as chronic inflammation. In that case, you can think of an anti-inflammatory such as dexamethasone, which is also prescribed to dampen the inflammatory response during severe covid. Worst case we do not find any virus or signs of inflammation in anyone, but that is also important information.” The group is currently working on analyzing the data and can’t say anything about it yet.

Different vaccines

In the British survey, people who received an mRNA vaccine reported more improvement in symptoms compared to people who received a classic vaccine (Astrazeneca). On the contrary, a study by the North Bristol NHS Trust in the United Kingdom, which followed 66 people after their covid infection, indicates that the type of vaccine does not matter. The 44 people (more than eighty percent of whom with long-term complaints) who received a shot generally improved slightly afterwards compared to the group still waiting for the vaccine. Whether that jab had come out of the Pfizer or Astrazeneca factory made no difference.

All people in the RECoVERED study received a shot with Pfizer’s mRNA vaccine. De Jong: “We know that mRNA vaccines are slightly more effective in protecting against covid. In our group, we saw a boost in antibodies against the virus after vaccination. We would probably have seen that peak with Astrazeneca, perhaps a little less high.” It won’t matter much, he thinks.

Sources:

  • The impact of COVID vaccination on symptoms of Long Covid. An international survey of 900 people with lived experience, rapport LongCovidSOS, May 2021.

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