No help from COVID vaccines for long COVID problems

Yet another vaccine failure shown by new study

A trio of researchers affiliated with the Veterans Administration (VA) St. Louis Health Care System find that the COVID-19 vaccines don’t fully shield people against long COVID. In fact, the vaccines do little to protect people from long COVID. An important study outcome led by senior author Ziyad Al-Aly, a prominent epidemiologist at Washington University in St. Louis, the study tapped into and leveraged U.S. Department of Veterans Affairs real-world data based in the healthcare systems patient databases for a cohort including 33,940 individuals with breakthrough infection and several controls of persons without evidence of COVID-19 including 4,983,491, 5,785,273, and 2,566,369 in contemporary, historical, and vaccinated cohorts respectively. The St. Louis area investigators discovered disturbing evidence: by month six (6) after a SARS-CoV-2 infection, beyond the first 30 days of illness when comparing to contemporary controls, vaccinated persons with breakthrough infections (BTI) are at risk of higher death rates (hazard ratio (HR) = 1.75, 95%  confidence interval (CI): 1.59,1.93) and higher risks for long COVID (HR = 1.50, 95% CI: 1.46, 1.54) including cardiovascular, coagulation and hematologic, gastrointestinal, kidney, mental health, metabolic, musculoskeletal, and neurological disorders. These findings produce evidence that full COVID-19 vaccination doesn’t offer the population sufficient protection against not only breakthrough infections, but also serious death associated with COVID-19. In what may be considered bombshell findings, not only do COVID-19 vaccines not protect much against long COVID but when comparing to the unvaccinated, the COVID-19 vaccines only reduce the risk of long COVID by approximately 15%.

The overall burden of death and disease after BTI will likely be substantial, will further add to the toll of this pandemic, and will represent an additional strain on already overwhelmed health systems. As reported by Washington University School of Medicine in St. Louis, “Even vaccinated people with mild breakthrough COVID-19 infections can experience debilitating, lingering symptoms that affect the heart, brain, lungs, and other parts of the body.”

Highlighting the important nature of these findings, the authors point out:

“The findings suggest that vaccination before infection confers only partial protection in the post-acute phase of the disease; hence, reliance on it as a sole mitigation strategy may not optimally reduce long-term health consequences of SARS-CoV-2 infection.”   

The comprehensive VA data analysis reveals that when comparing vaccinated persons with non-infected controls, those who survive the first 30 days of a breakthrough infection are at risk for increased mortality and long COVID with symptoms in the pulmonary as well as several extrapulmonary organ systems.

These risks of death and long COVID associated with breakthrough infections “were evident among non-hospitalized people,” however, “increased among hospitalized people” while “highest among people who were admitted to the ICU during the acute phase of the disease.”

The study authors did compare groups for a better perspective on relative risks. The St. Louis-based trio report that risks for death and long COVID were lower in the breakthrough infection cohort versus those persons who became infected with COVID-19 yet were never vaccinated.

Two key takeaways from this important study include 1) vaccinated persons face significant risks of long COVID (including death as well as symptoms in the pulmonary and extrapulmonary organ systems) and 2) importantly, the range of post-acute sequelae in various organ systems among those vaccinated persons that get infected (BTI) “does not appear to be different than COVID-19 without prior vaccination.”

The authors warn that “the overall burden of death and disease after BTI will likely be substantial, will further add to the toll of this pandemic, and will represent an additional strain on already overwhelmed health systems.” Governments, argue the authors, must start considering the needs of the vaccinated persons with long COVID.

While vaccination does offer more protection than not, what’s becoming clearer from this study is that risks associated with breakthrough infection continue after full vaccination. The vaccines were designed for a specific job—that is protect against serious illness or death associated with SARS-CoV-2. When they were designed there was no knowledge of long COVID.

The elderly, immunocompromised, and other vulnerable persons may see any comparative vaccination protection benefits erode further when considering breakthrough infection-based long COVID. Additionally, risks associated with long COVID are higher in people with breakthrough infections than those with seasonal influenza—showcasing the criticality of prevention of both SARS-CoV-2 infection and breakthrough infection.

These findings suggest ongoing advanced vaccination programs. Since the first release of the COVID-19 vaccines the driving impetus for universal dependence on novel products has dominated the pandemic discourse. The study investigators, led by epidemiologist Dr. Al-Aly point out that these “findings emphasize the need for continued optimization of strategies for primary prevention of BTI and will guide development of post-acute care pathways for people with BTI.” More than likely, this means more protective vaccines than those of today. Although, the study data show that the mRNA vaccines afford more protection relative to the Johnson and Johnson vaccine.

TrialSite provides a brief breakdown of this study published in the peer-reviewed journal Nature.

Why is long COVID such a problem?

Anywhere from 10-30% of people that get infected with SARS-CoV-2, the virus behind COVID-19, become susceptible to post-acute sequelae (long COVID). This condition associates with consequences of the viral infection that persist for longer periods of time after the convalescence period. This condition can attack almost any organ of the body with symptoms including nervous system and neurocognitive disorders, mental health disorders, metabolic issues, cardiovascular disorders, and more.

Why is this study so important?

The study generates evidence that the COVID-19 vaccines do little if anything to protect against long COVID that results from breakthrough infections. Little has been known as to the true protective nature of the vaccines against long COVID.

Many people think that COVID-19 vaccines prevent long COVID, yet this hasn’t been clarified.

The authors remind all in the study write up that the vaccinated increasingly get infected with COVID-19, and this condition is referred to as a breakthrough infection (BTI). The authors notably point out that, “Addressing this knowledge gap is important to guide public health policy and post-acute COVID-19 care strategies.”

What data did the investigators use for this study?

Dr. Al-Aly and colleagues tapped into electronic healthcare databases of the U.S. Department of Veterans Affairs. This would be considered an observational, cohort population-type or real-world study.

Specifically, the investigators accessed what is known as the VHA Corporate Data Warehouse (CDW), a rich and robust repository of data as well as the COVID-19 Shared Data Resource used to access SARS-CoV-2 test results and SARS-CoV-2 vaccination status.

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