If you or your child has COVID, here are your options for when to get the vaccine or booster.
As Omicron cases rise along Australia’s east coast, many people are faced with having to rebook their vaccination agreements.
If you or your child test positive for COVID, you clearly cannot get to the vaccination or booster agreement you had this week. So when can you go?
There are no hard and fast answers to this; Although there is some guidance, this issue is still under consideration in the Australian Technical Advisory Group on Immunization (ATAGI).
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But here are some general principles that will help guide your decision making.
I am an adult with COVID, and have had to postpone my booster time. So when can I get it?
The current ATAGI advice is that you can get your booster once you have recovered from the acute infection.
However, based on vaccinological principles, it would be reasonable to consider waiting at least three months after you recover to receive your booster dose. A COVID infection stimulates the immune system like a vaccine, which means you will produce antibodies that help increase your protection against COVID.
If you or your child has COVID, here is what you can do to get the vaccine or booster injection. Source: iStock
COVID vaccination can also be postponed for up to 6 months if preferred
This is because previous infections reduce the chance of re-infection for at least this time, but there is still much we do not know about the Omicron variant.
Currently, the booster dose is recommended four months after the primary two-dose dose (that is, four months after receiving your second dose).
At the end of January, it changes to three months.
With Omicron, the duration of protection against natural immunity is unclear. So you should still get your booster shot and make sure you end up getting the required number of doses.
This is because we can not exactly quantify the extent to which COVID infection stimulates your immune system.
People’s bodies respond differently to infection depending on age, underlying medical risk factors, the particular strain they are infected with and a number of other factors.
That is why, even if you receive COVID, we still recommend vaccination and the required number of doses to ensure you the best long-term protection.
So after COVID you can consider getting your booster 3-6 months later. However, you can choose to increase your booster dose if:
- you have underlying health conditions that put you at higher medical risk
- you work in a workplace where you have a higher risk of COVID exposure or
- you need a booster dose to go to work
Under these circumstances, you may want to consider getting the booster a few weeks after you have recovered from the acute illness.
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2. My child has COVID and will miss their vaccination agreement. So when can they be vaccinated?
Again, the current ATAGI advice is that your child can get their vaccine once they have recovered from the acute infection, but I would recommend waiting at least four weeks before the first dose of vaccine. This is also currently stated in the guidelines of the UK Joint Committee on Vaccination and Immunization (JCVI).
This is because we develop what is known as “mucosal immunity” in the nose and throat from natural infection. Then we can give a boost to systemic immunity with the first dose of vaccine. The combination of both natural infection and vaccination provides longer and stronger protection.
This also provides a window for the child to recover, bearing in mind the risk of a rare but severe post-infectious inflammatory condition called pediatric multisystem inflammatory syndrome after SARS-CoV-2 or PIMS-TS (also known as multisystem inflammatory syndrome in children) or MIS-C).
It occurs in about one in 3,000 children and can occur between 2-6 weeks after the acute infection. Waiting at least four weeks gives you more confidence that your baby has fully recovered.
If your child has persistent symptoms after a month, I would recommend waiting another month until it is vaccinated. Then wait eight weeks until the second dose.
In general, a COVID infection will stimulate an immune response and the child will develop antibodies. But as described above, we do not yet know how much protection you get against natural infection versus vaccination in children. So to get the best protection, they still need to be vaccinated.
That said, we need to be pragmatic. Some parents may worry that if they cancel an upcoming appointment, they may not get a new one until much later.
So if a parent has an appointment on the way and their child has fully recovered and has no symptoms, then I – by knowing the pressure on the system and approaching the new school year – would not refuse that appointment. It is about making a judgment call at the time of the appointment.
Hopefully, parents can use this information to make an informed decision. If they are worried, they can talk to their doctor or other health care provider.
To summarize: in general, I would say wait four weeks after the first infection and make sure the baby has fully recovered – but if you have a slightly earlier time, then it is reasonable to keep it as well.
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3. Is there anything else I need to know?
I think it’s worth highlighting an update to the CDC guidelines that says people are most contagious for 1-2 days before they develop symptoms and 2-3 days after.
So the clear guide is to abide by the rules and isolate as a positive case or close contact for seven days, but please check the guidelines in your state or territory.
I know there is so much changing advice about it – for example in relation to critical employees – but the best advice is to stay isolated for at least five days if you are a positive cause or a close contact.
This article was published in The Conversation and has been republished here with permission.