Dear Doctor: Should I get the COVID-19 vaccine if I just tested very positive for antibodies?

DEAR DOCTOR. COCKROACH: I have had regular swab tests for COVID-19, which have always been negative. The last one was a few days ago. Six weeks ago I had an antibody test that was negative as well, but this time my antibody test was very positive. I’ve been very careful protecting myself and haven’t had any symptoms! I am scheduled to receive my first dose of vaccine tomorrow. That I have to do? – CW

ANSWER: With frequent negative smear tests and no symptoms, your chance of having COVID-19 is less than that of the average person in your community. But if your community has been hit hard, like most, it is very likely that you have recently had an asymptomatic infection.

The antibody test result you submitted showed a very positive result using a very specific laboratory test. Although it is possible that this is a false positive test result, I suspect that you had a true case of COVID-19 so mild that you did not notice any symptoms.

You probably have some immunity against another case of COVID-19, but that immunity can wear off quickly. I recommend that you get vaccinated as scheduled. It’s safe to get the vaccine as long as you don’t have symptoms. However, people who were treated with a monoclonal antibody for their COVID-19 case must wait 90 days before receiving the vaccine.

DEAR DOCTOR. COCKROACH: I know someone who received the first and now the second dose of the Moderna vaccine and did not have any of the side effects of either of them. Does it mean that the vaccine is not working or does it mean that your system is quite strong? Everyone talks about side effects, but no one mentions if they don’t have side effects. Please clarify, as I am going to receive my second vaccination next Saturday. – MJ

ANSWER: I often hear doctors and patients explain reactions to vaccines, such as arm pain and fever, as evidence that “the vaccine is working.” It is natural to worry because if there is no reaction it means that the vaccine is not working. However, that is not the case. Even people who don’t have any side effects (most people have some arm pain, at least) benefit from the vaccine. The Moderna vaccine was 94% effective in preventing infections.

It is true that people who have a history of COVID-19 infection are more likely to experience a side effect such as fever or fatigue. Therefore, I would not say that the person you know who did not have side effects necessarily had a “strong” immune system. The immune system needs to be perfectly regulated both to protect you from invaders and to avoid autoimmune reactions. But it does mean that they are less likely to have had COVID-19 in the past.

Part of the danger of COVID-19 infection is the body’s immune and inflammatory response to the virus. You might speculate that people who have very strong reactions to the vaccine could be the ones most likely to be at risk for serious complications from COVID-19. Speculation aside, vaccination is effective whether a person has side effects or not.

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Dr. Roach regrets not being able to answer individual letters, but will incorporate them into the column whenever possible. Readers can email their questions to [email protected] or email 628 Virginia Dr., Orlando, FL 32803.

(c) 2021 North America Syndicate Inc.

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