Dear DR. ROACH: I regularly did swabs for COVID-19, which has always been negative. The last one was just a few days ago. I had an antibody test six weeks ago which was also negative, but my antibody test was strongly positive this time. I was very careful to protect myself and had no symptoms! I will get my first dose of vaccine tomorrow. What should I do? – CW
ANSWER: With regular negative spotting tests and no symptoms, your likelihood of having COVID-19 is lower than the average person in your community. But if your community has been hit hard, like most, chances are you’ve recently had an asymptomatic infection.
The antibody test result you sent showed a very positive result by using a very specific laboratory test. While it may be a false positive test result, I suspect you had a true COVID-19 case that was so mild that you did not notice any symptoms.
You probably have some immunity to another case of COVID-19, but the immunity may quickly lapse. I recommend that you get your vaccine on schedule. It is safe to get the vaccine as long as you have no symptoms. However, people treated with a monoclonal antibody for their case of COVID-19 should wait 90 days before receiving the vaccine.
Dear DR. ROACH: I know someone who had the first and now second dose of Moderna vaccine and did not experience any of the side effects. Does this mean that the vaccine does not work, or does it mean that their system is quite strong? Everyone talks about the side effects, but no one mentions it if you do not have side effects. Please explain, as I am going to get my second vaccination this coming Saturday. – MJ
ANSWER: I often hear doctors and patients explain vaccine reactions, such as sore arm and fever, as proof that ‘the vaccine works.’ It is natural to worry that no reaction means the vaccine is not working. However, this is not the case. Even people with no side effects (most people have at least one sore arm) benefit from the vaccine. The Moderna vaccine was 94% effective in preventing infections.
It is true that people with a history of COVID-19 infection are more likely to get a side effect such as fever or fatigue. So I would not say that the person you know who has had no side effects necessarily has a ‘strong’ immune system. The immune system must be perfectly regulated to protect you from invaders, but also to prevent autoimmune reactions. But that does mean they were less likely to have had COVID-19 in the past.
Part of the danger in COVID-19 infection is the body’s immune and inflammatory response to the virus. I can speculate that people who have very strong reactions to the vaccine may be the ones at greatest risk of having serious COVID-19 complications. Apart from speculation, vaccination is effective whether someone has side effects or not.
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Dr. Roach regrets that he cannot answer individual letters, but will include them in the column where possible. Readers can email questions to [email protected] or email 628 Virginia Dr., Orlando, FL 32803.
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