You’ve been vaccinated and boosted, but as you watch the virus spread among your similarly vaccinated friends and colleagues, it’s hard to avoid a feeling of inevitability. You’ve been told that vaccination provides robust protection against the worst outcomes in most cases. A breakthrough case is unlikely to land you in the hospital, or worse. You’re hearing a lot about being alert to “cold-like symptoms” — that doesn’t sound too bad. And after an infection comes “hybrid immunity,” right? The next best thing to actual superpowers?
You might not have said it out loud, but you may have started to think it… “I might as well just get COVID and get it over with.”
“Be careful what you wish for,” warns MIT Political Science Professor Barry Posen. While Posen understands how someone might reach this conclusion, he thinks it’s based on incomplete data. “What’s missing from most communications about COVID,” he says, “is the paragraph that says, ‘Here is what mild to moderate COVID is like, and here is why you would rather not get it if you could avoid it.’”
Posen knows what he is talking about. Despite being fully vaccinated, boosted, and generally healthy, he contracted what he classifies as a “moderate case of moderate COVID” in mid-December. He describes the illness as being like “a particularly tenacious and nasty cold or flu, with a few surprising additions.” The not-so-fun surprises included losing his sense of smell for five days more than a week after his first symptoms appeared, digestive problems, exacerbated tinnitus, a difficult-to-control cough lasting nearly two weeks, and continuing fatigue. “I was not good for much for about three weeks,” he notes. “I don’t think I could have taught in class or online. Even a month after my first symptoms, I still sleep more than normal and run out of steam earlier in the day than prior to the illness.”
As bad as his illness was, it could have been much worse if he and his wife had not been up to date on their COVID-19 vaccinations, Posen emphasizes. His wife avoided infection completely. He was not hospitalized, nor did he ever feel close to needing a trip to the emergency room.
“Huzzah for vaccines,” he says.
“Vaccination is highly protective against severe illness, which we’d define as ‘sick enough to be hospitalized,’” agrees Medical Director Cecilia Stuopis. “But sometimes, I think, people hear that as, ‘If you’re fully vaccinated and boosted, there’s no possibility that you’ll get really ill.’ In fact, someone can be very sick without ever needing to go to the hospital. There are a lot of miserable possibilities between ‘mildly ill’ and ‘sick enough to be hospitalized.’ And we still don’t know how often breakthrough infections result in ‘long COVID.’”
The prospect of “hybrid immunity” isn’t worth the risk of an infection either. While some studies suggest that a combination of vaccination and infection may be more protective and longer lasting than the immunity produced by vaccination alone, it’s important to note that the immune response to vaccination or infection varies from person to person. Your immunity might be boosted by an infection, but that might not be enough to prevent reinfection in the future.
Nor can we fully anticipate how the virus could change again. Infection with Omicron appears to increase immunity against earlier viral strains, but it may provide no additional advantage when the next antibody-evading variant comes along. “This virus will continue to evolve in ways we can’t predict,” Stuopis says, “but avoiding infection now makes it more likely that you’ll be able to reap the benefits of improved vaccines and better treatments in the future.”
Behaving in ways that increase your individual odds of infection puts others at risk as well, she emphasizes. Even in a highly vaccinated community like ours, some individuals remain vulnerable to serious illness if they become infected. And any increase in community spread, even if only a small percentage of cases are serious enough to require hospitalization, run the risk of overwhelming the state’s already seriously strained health system
“For good or ill, one cannot assign for oneself a probability estimate for a ‘truly mild’ case versus something worse,” Posen says. “To seek out opportunities to catch this thing would be a gamble with unknown odds and unknown stakes.”
Stuopis concurs. “With the highly transmissible Omicron variant, some of us will get infected despite taking precautions. But that does not mean precautions don’t work or are not worth taking,” she says. “There’s a difference between assuming we’ll all get exposed and assuming we’ll all get infected. Exposure is inevitable. Infection and illness are not.”
This news story has not been updated since the date shown. Information contained in this story may be outdated. For current information about MIT Medical’s services, please see relevant areas of the MIT Medical website.
