Can You Get COVID-19 More Than Once?

Despite what you've heard, no one is truly immune
person getting sick with covid twice

By this point in the pandemic, you probably heard the following facepalm-worthy statements from friends or family members…

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“I’ve already had COVID-19. I can’t get it again.” 

“You know, I did get really sick after going on vacation last fall. That probably was the coronavirus.”

“I’ve been around crowds without a mask and nothing. I must be immune.”

Sorry, but these statements simply aren’t true in many cases. The thing with COVID-19 is that there are still a lot of unknowns. With that being said, we can’t assume that we know how it all works. So, with the help of pediatric infectious disease specialist Frank Esper, MD, we’ll get to the bottom of those statements and learn why it’s still important to observe the protocols put in place to stay safe. 

Can you get COVID-19 twice — or more?

There seems to be a lot of misconceptions around this question. While the CDC has said that cases of reinfection have been reported but remain rare, that doesn’t mean you’re totally in the clear should you contract COVID-19. And since things are always changing, the “rare” status for cases could always change as well. 

Dr. Esper explains. 

“It’s very premature to make the assumption that just because you had COVID-19 that you’re safe from it. I don’t think anyone wants to be infected with COVID-19, whether it’s the first time or the second time or the third time — nobody wants it. Your previous infection may prevent you from getting sick, but that doesn’t necessarily mean that you can’t become infected and then spread it to others. You might think you’re safe because your antibodies are there, but if you’re still able to spread it to others for a short period of time, that’s doing no one any good either.”

Dr. Esper adds that being infected once is not a hall pass to ignore all of the protocols put in place — masking, hand washing and physical distancing. If anything, to protect yourself and others, you need to stay on top of those recommendations. 

Your bad illness last fall most likely wasn’t COVID-19

Many people have pinned their terrible illnesses that popped up right before the pandemic on the coronavirus. But Dr. Esper says this is highly unlikely. Why? Because a lot of viruses can cause similar symptoms to those of COVID-19.

“It is way too early for you to assume that you’re out of the woods if you had COVID-19 or you think you had it but weren’t tested. There are a lot of other viruses out there that cause similar symptoms. You could have had a really tremendous cold or flu, or you could have had any number of viruses — adenovirus, etc. You can’t really tell the difference between the coronavirus infection and adenovirus infection or any of these other viral infections. They can all be bad. So, I would not just assume that you’ve already been infected with COVID-19,” says Dr. Esper.

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He adds that while we might be under the impression that many have already been infected, most people to this point have not. That means a great deal of us remain susceptible to COVID-19. 

“If most people to this point had already been infected we wouldn’t be seeing the skyrocketing case numbers every day, beating the last day’s record. It just tells you how many susceptible people are out there and that we all have to work together to try to minimize how many people get infected.” 

Being around people without a mask and not getting sick — so far — does not mean you’re immune to COVID-19

According to the CDC, 4.5 million Americans get bitten by dogs every year. Where are we going with this? We’re getting there. 

You might be around dogs regularly or you might even own a dog. If you’ve never been bit by one, you’re most likely thinking, “What does that statistic have to do with me?” Well, just because you haven’t been bitten yet doesn’t mean that you’ll never experience a dog bite. Also, your personal experience doesn’t change the fact that millions of others have these painful encounters throughout the course of a year. 

With COVID-19, it kind of plays out in a similar manner. You might be doing all the things and hanging around everyone without a mask or social distancing and feel like you’re invincible because you have yet to show any symptoms of the virus. However, you could actually be infected and spreading the coronavirus to others. And when you think about it, are you really OK with the idea of making your friends and family sick or possibly being the reason why they’re no longer here? Most likely not. 

Dr. Esper explains. 

“Even if you don’t get sick, it doesn’t necessarily mean that you couldn’t spread COVID-19 to other members of your family, your neighbors, or your friends. And so, it is still very important that everyone masks up regardless. The masking recommendations from the CDC and state and local health departments don’t say that masks are only for people who have not had the illness. They’re saying masks are for everybody. The best thing for us to do is come together as a group — the people who have thankfully survived the infection and those who have not been infected or diagnosed — and all work together in order to prevent further infection especially now when the numbers skyrocketing.”

With the rare cases of reinfection, what exactly is happening to the immune system?

Dr. Esper says that the medical community it still examining these rare cases. For instance, a recent study out of Oxford showed that antibodies offered about a six-month window of protection for study subjects. However, it’s worth noting that this study still has yet to be evaluated and peer-reviewed. While this might seem like encouraging news, it doesn’t mean that we should start disregarding everything we’ve been doing to stay safe.  

“The vast majority of individuals who have effective antibodies against this virus are probably protected for several months. But like with many coronaviruses, these antibodies just don’t seem to last very long. So we expect that immunity to wane over time,” says Dr. Esper.

This also brings into question how vaccines will work. 

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“Right now, we don’t necessarily know exactly how long the immunity lasts. That’s one thing that we need to take a closer look at. We’re not seeing tremendous numbers of reinfection, so that might suggest that once you get an immune response, you’re likely to be safe. So, if we get an effective vaccine, you’re likely to be safe against reinfection or infection. That good since this virus doesn’t mutate. That could also mean it’s likely that the vaccine response is going to last a little bit longer.” 

Dr. Esper says that he wouldn’t be surprised if a drop of antibodies in vaccines occurs over time and requires us to get yearly coronavirus vaccinations like we do with flu vaccinations. But right now he says the main goal is to start getting the virus under control and to keep fine tuning the process as we head into 2021. 

If you’ve had COVID-19, should you get vaccinated?

While the CDC and the vaccine manufacturers still haven’t answered this question, Dr. Esper says given the fact that antibodies drop over time, he feels that many people will get the vaccine. 

“I expect that mostly everyone, including people who may have had a bout with the virus earlier on in this pandemic, are probably going to get vaccinated. Again, antibodies are waning and the immune system is going down. So, maybe the vaccine will give your immune system a boost. And we definitely know that the immune system loves boosting your first infection — it has a big response, but then it goes away fairly quickly. But if you get a second infection, that tells your immune system, ‘Hold on. This is something I’m going to be seeing a lot of.’ When that happens, your immune system goes into a second round of protection that lasts a lot longer than the first round of protection. And so giving the immune system a boost, even if you’ve had the infection, is probably going to be something that’s going to happen.” 

Dr. Esper adds that he hasn’t seen any vaccine trials that currently address children and pregnant women, but this is mainly because these two very vulnerable groups present new sets of challenges that can often hold up the trial process. Since COVID-19 has hit older people harder, vaccine manufacturers have been working to get a vaccine out fast to get things under control, but will continue working on solutions for children and pregnant women in the meantime.

Now is not the time to give up

If you’ve been taking the proper precautions to keep yourself and your family safe, Dr. Esper strongly encourages you to keep doing so. Keep washing your hands, wearing a mask in public and even private places (especially when you’re around people who don’t live with you) and keep physically distancing when possible. The science behind it all has been proven to work despite what your neighbor, uncle or former classmate says in person or on social media.

“We’re getting close. Now is not the time to take your foot off the gas. It’s not the time to unlearn everything that we have done over the last eight months — everything that we’ve been through over the last eight months. Let’s not stumble at the finish line. We have to really keep up everything that we’re doing while we wait for these vaccines to get up in production to ensure that they’re safe first and foremost. And once we can get distribution up, we can get people some extra protection against this virus.”

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