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Won’t Get the 2nd Vaccine Post COVID Infection: Vij. Is He Right?

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Haryana Health Minister Anil Vij on 1 March said that he did not need the second dose of COVID-19 vaccine because his antibody count was checked during the vaccine trial and it was too high.

He tweeted saying, "I will not be able to get the COVID vaccine because after being COVID positive my antibody count is 300 which is too high. Maybe it is because of my participation in the vaccine trials. I don't need the vaccine right now."

Is the Vaccine Not Necessary for People With Past COVID Infection?

Vij took part in the COVID vaccine trial on 20 November, and news about him being infected with the virus came on 5 December.

Government guidelines recommend you take the two doses of the COVID vaccine despite recovering from the COVID-19 infection as it will help to develop a strong immune response against the disease.
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The US Centers for Disease and Control (CDC) adds in the vaccine FAQ section that, “Due to the severe health risks associated with Covid-19 and the fact that reinfection with Covid-19 is possible, you should be vaccinated regardless of whether you already had Covid-19 infection.”

To a question on whether people should get the vaccine if they currently have COVID, the CDC says, “No. People with COVID-19 who have symptoms should wait to be vaccinated until they have recovered from their illness and have met the criteria for discontinuing isolation; those without symptoms should also wait until they meet the criteria before getting vaccinated. This guidance also applies to people who get COVID-19 before getting their second dose of vaccine.”

The news about Vij being infected with COVID-19 came about 2 weeks after he was enrolled in the vaccine trial.

Dr Shahid Jameel, virologist and director of Trivedi School of Biosciences, Ashoka University, says about such cases,

“The vaccine should be taken despite infection, as it will act as a booster. If an infection occurs after taking the vaccine, then it is like getting a second dose of the vaccine naturally. But if the gap between these two doses is less, then there is not enough time for antibodies to develop.”
Dr Shahid Jameel, virologist

He further adds, "There should be a gap of 4 weeks between these 2 doses. Now the studies are coming out, it seems that the interval time should be more - about 8 to 12 weeks. If doses are taken After 5 weeks, it works as an infection booster, but if the infection is early then it is better to take the vaccine dose in time. ”

Vij refers to the antibody count but Dr Jameel adds an important point about this, "If the antibody count is 300, it is not necessarily the same after 3 months. It is not just the antibody scale, T-cell testing is also necessary and for that, there should be a gap between doses. ”

Dr Jacob T. John, former Chief of Virology at ICMR's Center for Advanced Research, a government-funded institution, says, "Anil Vij's decision is scientifically correct. If people are aware of the antibody count then they can wait. After one year, if their antibodies reach very low levels, then they will only need a booster dose as they have become naturally immune due to infection. ”

According to the experts - vaccination can be avoided after infection, but this strategy can also be risky in the long run.

Dr Jameel says, “The antibodies in the blood are quantified based on standards and expressed in international units (IU). This is in a range of 0 to 1000. Usually, 10 IU is considered the cut-off. Levels between 10 and 1000 are considered protective. However, this may not always correlate. Even those below 10 may be protected from disease by cell-mediated immunity which is not measured by antibodies.”

“For the best immune response it is advisable to let antibodies drop after first shot to close to threshold levels say 10. A booster 2nd dose is then most effective. The window for that is generally 4-12 weeks and varies in individuals. In India the govt has advised taking 2nd shot after 4 weeks for quickly getting full protection. That may or may not be the best protection for each individual. But best can’t be the enemy of good in a pandemic.”
Dr Shahid Jameel, virologist

But it is not economically viable to screen everyone for their antibodies and then give them the vaccine. In such a situation, every person is advised to take the vaccine. As a protection for those who have not got the infection and as a booster dose for those who have recovered from the infection.

The World Health Organisation also recommends this.

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