Hannah Davis Profile picture
Mar 19, 2022 17 tweets 6 min read Read on X
How does being vaccinated impact the risk of #LongCovid?

A thread on 8 studies (I'll add to it as I find more):

1/
The summary: vaccination definitely seems to reduce the risk of #LongCovid, often by 40-50%.

*But* solidly 9.5%-14% of breakthroughs still result in Long Covid.

These figures make sense to me, given the estimated rate of LC in unvaccinated people (~10-30%).

2/
A caveat: many of these studied people who had been vaccinated relatively recently, so as always, we can expect these findings to change a bit as immunity wanes.

3/
Study 1: this is one of two studies rated as high quality by UKHSA.

10,024 breakthrough cases with matched controls, looking 6 months from onset, found vaccination:

medrxiv.org/content/10.110…

4/
-did not reduce overall #LongCovid risk, but did reduce risk of some key symptoms: fatigue, anosmia, hair loss, lung disease, myalgia
-did not reduce risk for other symptoms: abdominal pain, headache
-did reduce severe outcomes (hospitalization, death, respiratory failure)

5/
Study 2: also rated high quality, this found a 7-10x reduced rate of #LongCovid!

Why the difference between Study 1? Not clear, but the number of breakthroughs was smaller (2400) here; it was also pre-Delta, where Study 1 included some Delta cases.

medrxiv.org/content/10.110…

6/
Study 3:

3090 breakthroughs with controls (too new to be rated, but seems high quality) found a 41% decrease in #LongCovid risk.

However, #LongCovid still happened in 9.5% of vaccinated participants compared to 14.6% of unvaccinated. Still high!

medrxiv.org/content/10.110…

7/
Study 4: 16035 breakthroughs & 3.57 million controls. Found vaccination had specific impacts:

-Reduced risk in cardiovascular, coagulation, metabolic, pulmonary organ systems, & fatigue
-Not reduced in kidney, gastrointestinal, neurologic systems

researchsquare.com/article/rs-106…

8/
Study 5:

366 breakthroughs and unvaccinated controls found 26.5% of fully vaccinated and 34.9% of unvaccinated had #LongCovid.

After further analysis, they suggested that vaccination reduced the risk of Long Covid by 45%.

medrxiv.org/content/10.110…

9/
Study 6:

App-based study, 2370 breakthroughs with matched controls found that *full* vaccination reduced #LongCovid symptoms by roughly half. Notably, one dose resulted in the same Long Covid prevalence as unvaccinated controls.

thelancet.com/journals/lanin…

10/
The next 2 are weird or less comprehensive for different reasons.

11/
Study 7:

This one included a) uninfected controls & b) unvaccinated infected controls, along with vaccinated infected. Some false negatives or sick people were likely in the uninfected controls, because they had high baseline symptom rates (recruited from PCR test sites).

12/
Comparing unvaccinated to vaccinated, this study found some reductions in some symptoms, but not consistently across age groups.

-No reduction in loss of concentration, persistent cough, overall recovery

13/
-Did reduce fatigue, headache, weakness, myalgia, hair loss, dizziness & shortness of breath
-Most reductions higher in people >60 than age 19-35
-11% of vaccinated had fatigue vs 26% unvaccinated
-14% of vaccinated had headache vs 22% unvaccinated

medrxiv.org/content/10.110…

14/
Study 8: this one *only* looked at the effect of vaccination on olfactory dysfunction.

They found vaccination was protective against olfactory dysfunction between 14-88 days after the final dose, but began to wane after that. #LongCovid

medrxiv.org/content/10.110…

15/
In summary: get vaccinated to reduce your risk of #LongCovid, but be aware that if you get a breakthrough, the risk is still high!

16/
These findings might also suggest reductions in certain types of #LongCovid (respiratory and possibly cardiovascular stick out to me) but not to others (neurologic and gastrointestinal in particular).

17/

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More from @ahandvanish

Oct 30, 2023
Because this video has caused so much willful misinterpretation, I want to clarify: in the clip I’m countering the myth that #longcovid is lingering symptoms of acute COVID, since many people think it’s just a cough. I should‘ve said “acute COVID”; brain fogged & trying my best.
The interview was an hour long & they edited it to 5 min. I talked their ear off about all hypotheses & the science behind each & it didn’t make it in - the piece was for a general audience. I talked about all the other things COVID can cause, include diabetes & clots, at length.
Anyone who is suggesting I don’t think #longcovid is from COVID (????) or that I don’t think viral persistence is a high priority hypothesis (????) are *actively* ignoring 3.5 yrs of advocacy & that I’ve been highlighting viral persistence since 2020
Read 7 tweets
Sep 20, 2023
The most exciting hypotheses in #LongCovid and #pwME are ones that could have cures! This includes viral persistence and others, and also includes the itaconate shunt hypothesis. I'm going to tweet this video as I watch it to try to explain it more 1/
Dr. Ron Davis used to work on the Human Genome Project but switched to ME/CFS when his son got sick. He's the director at the Stanford Genome Center. He is focused on *a cure* for ME/CFS. "I believe it is a curable disease." 2/ slide that says "ME/CFS - A curable disease?"
He describes the common onsets of ME - usually viral, but can have other causes too, refers to a big parasite onset in Norway from a few years ago 3/ Image
Read 13 tweets
Sep 11, 2023
FDA Stakeholder meeting on #LongCovid today:

@TheCrankyQueer: highlight the need for trans inclusion in trials, including understanding how different labs may present; biomarker nuance

Oved Amitay: need to create a center of excellence to learn from trials in other diseases 1/
Oved: FDA needs to align on decisions across similar fields, needs cross-talk across similar groups

@Dysautonomia: Most even great researchers don't understand autonomic disorders, which happen in up to 2/3 of LC...is there an opportunity to offer autonomic training? 2/
@Dysautonomia: Also, need to make arms in these trials for pre-Covid POTS/MECFS - this helps learn about LC as well (ie does Paxlovid help pre-covid pts)

Me: There are over 50 drugs ready to be trialed: 3/docs.google.com/document/d/1JJ…
Read 24 tweets
Jul 27, 2023
A beautiful piece by @edyong209 that fully describes & communicates the complexity of fatigue & Post-Exertional Malaise in #LongCovid.

Ironically am crashy today so going to pull out amazing quotes:

"Now, at least, she can watch TV on the same day she takes a shower." 1/
"Fatigue turns the most mundane of tasks into an “agonizing cost-benefit analysis,” @turnoftheshrew said. If you do laundry, how long will you need to rest to later make a meal? If you drink water, will you be able to reach the toilet?"

2/
"Only a quarter of long-haulers have symptoms that severely limit their daily activities, but even those with “moderate” cases are profoundly limited. @julialmv still works, but washing her hair, she told me, leaves her as exhausted as the long-distance runs she used to do." 3/
Read 33 tweets
Jul 13, 2023
This is one of the most accurate papers on #LongCovid recovery I've seen. It's full of crucial points:

-Only 7.6% recovered.

-Recovery was *more* likely in people who were in the ICU. This was something we saw early, but why?

A few thoughts:

1/ https://t.co/kdPhkTVR5mpapers.ssrn.com/sol3/papers.cf…
Those hospitalized with COVID, esp in the early pandemic, seem more likely to have forms of #LongCovid that are *not* the neurological form.

The neuro form seems to last longer (& often overlaps with ME/CFS & dysautonomia, lifelong conditions).



2/
Other factors that correlated with INCREASED likelihood to recover from #LongCovid include:

-being male
-having cardiovascular comorbidities
-lost appetite in acute phase
-had smell/taste alterations (this is often its own subtype that can come with no other symptoms)

3/
Read 10 tweets
Jun 29, 2023
There is a National Academies conference today focused on *all* illnesses that start after infection & viruses, like multiple sclerosis & others.

Livestream:

(This is *not* the definition conference & *not* focused on #LongCovid, but LC is a part!)nationalacademies.org/event/06-29-20…
Tim Henrich from University of California shows the many, many viruses that have long-term sequelae. 2/
2 years after acute Ebola infection, patients have *higher* rates of markers of tissue damage, T Cell and B cell activation & exhaustion, markers of inflammation 3/
Read 11 tweets

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