Although restrictions and lockdowns might be a distant memory, COVID is far from over. This winter hospitalisations and cases have increased, and new variants have popped up.
So it’s normal to wonder about your potential for long COVID. Scientists are slowly learning more about the condition, including how to try to prevent it in the first place. Now, new research suggests there’s a clear way to lower your risk of developing long COVID: the COVID-19 vaccine.
That’s the main takeaway from a study published in The New England Journal of Medicine. For the study, researchers analysed medical records of nearly 450,000 people from the US Department of Veterans Affairs health system who had COVID-19 diagnosed between 1 March 2020, and 31 January, 2022. Those patients were compared with around 4.7 million people who weren’t diagnosed with COVID-19 during the same time.
The researchers found that the lowest rates of long COVID (3.5%) were in people who were vaccinated against COVID-19. Of the people who were unvaccinated, 7.8% developed long COVID.
The study covered the original COVID-19 strain, along with Delta and Omicron strains. The variants circulating now (like LB.1 and FLiRT variants) are off-shoots of the Omicron strain. The rates of long COVID dropped over time, regardless of whether people were vaccinated, but the researchers said that was likely due to a combination of changes in the virus and other factors. Overall, the researchers found that the vaccine was responsible for nearly 72% of the drop in cases.
It’s important to point out that the vaccine wasn’t perfect at preventing long COVID. Some people who were vaccinated still developed long COVID, and some people with minor cases of COVID-19 went on to develop long COVID. But the vaccine did seem to be a major factor in lowering people’s risk of developing long COVID.
So, what’s behind this? Doctors break it down.
Why might the vaccine lower the risk of long COVID?
Doctors have long recommended the COVID-19 vaccine to help lower the risk of developing long COVID, but data on how effective this is has been mixed.
In 2022, the United Kingdom’s Health Security Agency released a scientific review of 15 studies and found that while most of the studies found that vaccinated people who contracted COVID-19 were less likely than unvaccinated people to develop long COVID, a few studies didn’t find that the vaccine made a difference.
Why might the vaccine help? There are a few potential reasons. One is that the vaccine helps to lower the risk of developing severe illness, and severe illness is linked with a greater risk of having long COVID.
“Current findings indicate that it has to do with the creation of chronic inflammation,” says infectious disease specialist Dr William Schaffner.
Having COVID-19 can cause a strong inflammatory response, especially if you have a severe case, he says. “If the vaccine tamps down on that inflammatory response, the risk of long COVID is also reduced,” Dr Schaffner says.
Infectious disease expert Dr Amesh A. Adalja agrees. “Vaccination induces one’s immune system to mount a robust response against the virus,” he says. “The immune response may be the major factor in how the virus interacts with the host and a better immune response may preclude the development of long COVID in some manner.”
But scientists still “don’t really know what the cause of long COVID is,” Dr Schaffner says.
Why are vaccinated people still vulnerable to long COVID?
Unfortunately, some people follow the recommendations to get vaccinated against COVID-19 and still end up developing long COVID. “Vaccines lower the risk of long COVID; they don’t completely eliminate it, leading to the conclusion that other factors are involved,” Dr Adalja says.
Infectious diseases expert Dr Thomas Russo agrees. “Vaccination decreases the likelihood of long COVID, but it’s not perfect,” he says. “You still have a chance of developing long COVID.”
It’s all about lowering your risk of long COVID, Dr Schaffner says. “We’re not dealing with perfection here,” he says. “We’re dealing with reducing the risk.”
What should people take away from this?
Doctors recommend getting the COVID-19 vaccine to lower your risk of developing long COVID. “Stay up to date with your vaccines,” Dr Schaffner says.
Most Australians now have their first or primary course of COVID vaccinations, reports the government, and all adults are eligible for a booster every 12 months. This yearly booster is recommended for people over 65 and the immunocompromised. Some people are even recommended to have a booster every six months.
Where do we stand with long COVID treatments?
As of now, there are no specific treatments for long COVID. “It is important to realise that long COVID is an umbrella term and not a specific disease process,” Dr Adalja says. “For treatment to be successful, it will be necessary to actually untangle all the different things that are grouped under this umbrella. There may be different treatments for different types.”
If you suspect that you have long COVID or have been diagnosed with the condition, Dr Schaffner recommends trying to be seen at a specialised long COVID clinic where possible. There, doctors who regularly treat patients with the condition should be able to offer a tailored approach to your treatment based on the latest research and what they’ve seen be effective for patients.
“We have guarded optimism about the future of long COVID treatment,” Dr Schaffner says. “Most people with long COVID get better. They do it rather slowly, but they usually do get better.”
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