When it comes to COVID-19 immunity, one of the issues people consider is whether to get a vaccine or acquire natural immunity through having an active COVID-19 infection. That means getting the virus rather than the vaccine shot.

The problem with natural immunity is having an active infection that is not benign. More than 800,000 Americans have died of COVID-19 in addition to multiple hospitalizations and quarantines. Of increasing concern is the “long COVID-19” problem of continued symptoms beyond one month. Fatigue, shortness of breath, chest discomfort, cough and combinations of those symptoms can persist over 50 percent of the time. In addition, physical symptoms of joint pain, headache, taste and smell are not uncommon. That does not include psychological, mental, memory issues of “foggy thinking,” poor concentration and anxiety/depression. A majority have noted a reduction in their quality of life.  

In general, the time course for recovery varies depending upon pre-infection risk factors, especially some chronic diseases and obesity. Those hospitalized when critically ill are more likely to have a protracted course. This is the objective data that one should weigh when deciding for natural immunity.  COVID-19 is not a benign, short-term infection, as compared to the common cold or even influenza.  Clinicians continue to learn as we observe the problems noted, and it becomes more disturbing as we follow these post-infection issues.

Contrast this with getting immunity via vaccines that are essentially perfectly safe, are free and readily available. Observational data after nearly a year of vaccine administration, including boosters, shows minimal short-term side effects of aching, fever and fatigue. Allergic reactions have been quite rare.

Conceptually, the immunity developed is similar through natural infection or vaccines, although observational data indicates the response to vaccines is more consistent than in natural infections. This is due, in part, to a known dosage of vaccine being administered versus variability in an infection, thus making the response more predictable.

Irrespective of the method of obtaining the original immunity, there is waning protection. It is apparent, now, that a good level of protection decreases after six to eight months, thus the need for a booster for either natural or vaccine-induced immunity.

A common misconception is that once one has the vaccine or infection, there is immediate full immunity. The vaccine effectiveness in preventing symptomatic infections prior to the developing variants was 90 percent, which has declined. Still, the protection provided is much better than having a COVID-19 infection. When vaccinated, those with COVID-19 infections are less likely to be hospitalized, end up in critical care units, be put on ventilators or die.  

Another concern, even for those with some immunity, is the ability to be a COVID-19 carrier and spreading the disease to others. Therefore, following the other protective measures of wearing a mask (remember, even with variants, the virus has not grown in size and physical barriers are proven effective), social distancing and hand washing are recommended.

Visit https://www.vaccines.gov to find the most convenient provider near you.