• A recently unveiled study indicates that patients suffering from a long Covid do not incur a specific risk of being vaccinated against the coronavirus.

  • The results of the study even suggest the possibility that anti-Covid vaccines could alleviate or even eliminate the persistent symptoms.

  • A hopeful hypothesis, which must be supported by additional work.

What effect will the vaccine have on them?

For patients suffering from a long Covid, who have lived for long months with persistent symptoms of the coronavirus, the gradual opening of vaccination is a source of questions.

Should I get vaccinated?

Intense fatigue, shortness of breath, muscle and neurological pain, not to mention the loss of taste and smell: what if the symptoms of Covid long worsen after receiving the vaccine?

Scientific studies have thus been launched to find out whether anti-Covid vaccines could have specific deleterious effects on these patients.

And if necessary, allow the vaccination schedule to be adapted for this population.

And according to the first results observed, the vaccination is safe for these patients.

It could even have unexpected benefits.

No contraindication for vaccination

Since the opening of the anti-Covid vaccination, patients suffering from persistent symptoms have already been inoculated, fearing - even more since the appearance of the variants - of being reinfected while they still suffer the consequences of disease.

And the first testimonies of vaccinated people vary: some attest to a condition that has worsened when others have the impression of getting better since the injection.

So, are vaccines safe for these patients?

This is what Dr. Fergus Hamilton, an infectious disease researcher at the University of Bristol's Faculty of Medicine, UK, who conducted a study on the effects of vaccination on a patient, tried to find out. cohort of long Covid patients divided into two groups: one vaccinated, and the other not.

The study, unveiled at the beginning of March, is still only in “preprint” - it has not yet been validated and published by a leading scientific journal - but its conclusions are reassuring. "Vaccination with a messenger RNA or viral vector vaccine has not been associated with worsening symptoms of Covid long," conclude the researchers, who see no objection to vaccinating these patients.

In France, it is the Haute Autorité de Santé (HAS) which issues anti-Covid vaccination recommendations. And she assures him, "the presence of persistent symptoms after a Covid-19 is not a contraindication to vaccination", but "an appropriate medical consultation is necessary before vaccination". However, it provides that if the contamination is recent, infected people "must be considered as protected for at least three months by post-infectious immunity". And therefore recommends waiting three months, or even "a period close to six months" after infection. And since “people who have already been infected retain an immune memory, the HAS only offers a single dose to people who have been infected with SARS-CoV-2, regardless of how old the infection is.The single dose of vaccine will thus act as a booster ”.

Symptoms reduced or even gone

Not only does vaccination not seem riskier for long-term Covid patients, but British researchers even see their results as a "slight hint" that vaccines could improve the condition of these patients. "According to this work, vaccination could lead to a reduction or even disappearance of persistent symptoms," comments Dr. Benjamin Davido, infectious disease specialist and Covid-19 crisis referent doctor at Raymond-Poincaré hospital in Garches (Hauts-de-Seine). This is all the more interesting as the persistent Covid could be due to an imperfect immune response with incomplete viral clearance, which would be improved by vaccination thanks to the contribution of antibodies ”. In short: the immune response of these patients would not allow the virus to be completely eliminated from the body,which would then do its own in the long run, but the antibodies produced through vaccination would help to clean up.

These results, although encouraging, were obtained in a small cohort of patients.

"This is an avenue that deserves to be further explored, knowing that for these cases of long Covid, whose recognition and management are still not obvious, there is no treatment, recalls Dr. Davido .

We can already see that vaccines not only prevent severe forms of coronavirus as well as mild forms, but also reduce the transmission of the virus.

If these specific effects on the long Covid were confirmed, the vaccination would also have a therapeutic effect on the persistent forms of the disease ”.

Therapeutic and incentive potential

A lead that is all the more hopeful since "the longer the symptoms of persistent Covid last, the more difficult it is to get rid of them", recalls Dr. Olivier Robineau, from the university infectious diseases department of the Tourcoing hospital center. . But can a vaccine also have a therapeutic effect? “Normally, a vaccine is preventive, never therapeutic,” replies Dr. Davido. This work must therefore be confirmed by larger studies to confirm this therapeutic potential of the vaccine on long-term Covid. Studies on patients who have lost their sense of smell have shown the presence of the virus in the olfactory bulb up to six months after contamination, continues the infectious disease specialist. We can imagine that providing antibodies will neutralize this rest of the virus which may be responsible for persistent symptoms ”.

A mechanism already observed with the vaccine against shingles, "which is a virus linked to a decrease in immunity, which one develops only if one has already had chickenpox and which can cause persistent pain, exposes Dr. Davido.

Shingles works by self-stimulation of the immune system, where it is the body that brings out the virus.

The vaccine provides antibodies that will fight against the resurgence of the disease ”.

And if the anti-Covid vaccination has this therapeutic benefit, "it will have the merit of being even more incentive," says the infectious disease specialist.

And this is all the more important since it is essential to massively vaccinate young people, who do not always feel concerned by the disease but who are more likely to develop persistent forms ”.

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