Medical Examiner

So You’re Triple-Vaxxed and Still Got COVID. Now What?

Three empty wine glasses at a bar.
Is this OK? Jacek Dylag/Unsplash

I’ve had both doses of an mRNA vaccine, plus a booster shot. At the end of December, despite taking a slew of preventative measures—while also, to a degree, “living my life”—I came down with a case of COVID-19. Now that I’ve completed isolation and recovered, I’m wondering, as I think many, many people might be right now: Having been triple-vaccinated, plus granted some immunity from my recent bout of COVID, am I now protected against another infection? At least for a little while?

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After speaking to a few experts, the best answer I have is: basically yes, with a few caveats.

Experts I checked with were pretty much unanimous that people like me are very likely safe from reinfection for the near future. “I would think these individuals are protected for at least several months,” says William Moss, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health. We know that coronaviruses in general do not reinfect people twice inside of a year, he explains, and that SARS-CoV-2 reinfection typically occurs only when a new variant pops up.

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“I would feel really comfortable being out and about if I had a recent omicron infection,” says Jennifer Dowd, a professor of demography and population health at the University of Oxford and the editor in chief of Dear Pandemic.

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Such a person is going to be “as immune as anyone on the planet” says Bob Wachter, the chair of the University of California, San Francisco’s Department of Medicine.* In addition to a high degree of personal protection, there will be a low chance of contributing to the spread of the virus in your community. “The chances that they will get reinfected seem very, very small,” says Wachter. “Therefore, their ability to infect someone else is very, very small.”

(The Centers for Disease Control and Prevention, I should mention, does not have guidelines for “When You’ve Been Fully Vaccinated”—per the new definition of ‘fully vaccinated’—“and Also Infected With a New, Highly Contagious Variant.” Its previous guidance on what vaccinated people can safely do was last updated in mid-October, and remains available only “for historical purposes.”)

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Scientists have learned from previous variants that an infection can act like a booster, in terms of the protection it offers (albeit a booster you acquire the difficult, dangerous, uncomfortable way). For instance, there are a couple preprint papers that examine the antibodies that a delta infection provides on top of vaccination. Then, there’s some omicron-specific data. A small lab study in South Africa (also in preprint) suggests that omicron infections provide some protection against delta as well. And researchers who examined the antibodies of two patients in Hong Kong found that those produced by the omicron infection are wide-ranging, able to tackle a variety of variants of COVID (at least the ones that we know about right now).

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How can you tell if you’ve had an omicron infection, which leaves in its path that broader immunity, and not delta, which could in theory still leave you a little vulnerable to an omicron infection? You can’t be certain, but the timing should tell you a lot, said Moss and Wachter. While early December saw more delta circulating, by the end of December, omicron was overwhelmingly the dominant strain in the U.S. (The CDC estimated that in one recent week, it made up 95.4 percent of cases.) Plus, there’s the fact that delta did not rip through the vaccines as easily as the more recent variant. If you’ve had three doses and still got a breakthrough, and the breakthrough happened in December or January—“that combination makes me think it has to be omicron,” says Moss.

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OK, here’s the big caveat: We don’t have much data on omicron and reinfection specifically right now. Note that everything in that paragraph rattling evidence off above involved preprints describing small studies. As has been a theme of this pandemic, even if you’re willing to accept the small risk and slight uncertainty yourself, public health folks hope you’ll consider doing all that you can to avoid spreading the virus. “Your behavior could still have ripple effects,” says Dowd, adding that while you’re probably at very, very low risk of catching and transmitting the virus, “we know it’s not zero.”

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Wachter put it a slightly different way: “Would I go into a crowded space, not wearing a mask, in a place where the infection was raging? I probably wouldn’t, mostly because I don’t want to look like a jackass.”*

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Moss himself has been vaccinated, boosted, and had a respiratory infection very recently. (He couldn’t confirm it was COVID for lack of a test, but others in his family tested positive.) “In general, my behavior has not changed,” he said. But he added that he would feel more comfortable visiting his elderly parents, who have also had three shots and a recent infection.

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All the experts I checked with mentioned that we’re in a big COVID surge right now—and that it won’t last forever. Instead of doing anything wild, no matter your exact immunity status, maybe “it’s just best to wait a few more weeks for this wave to pass,” Moss said.

But “hole up at home” and “drop all other caution now that you feel invincible” aren’t the only two options. You can dine out indoors and mask at Target. You can revel with friends and take a rapid test before seeing a grandparent. Doing some things is reasonable, said Moss. “I also feel that someone who has been vaccinated and infected could feel pretty comfortable going to restaurants, and going out, and things like that.” As for me? I’m headed to a yoga class.

Correction, Jan. 14, 2022: This piece originally misspelled Bob Wachter’s last name and misidentified his university. He works at the University of California, San Francisco, not the University of San Francisco.

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