Can You Get COVID-19 More Than Once?

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

You suffered through COVID-19 and made it to the other side, and now you’re feeling invincible. Surely you’re not going to get it again, right? Especially after you got vaccinated?

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Sorry to be the bearer of bad news, but that’s not exactly true. Experts say you’re not in the clear just because you’ve already contracted and recovered from the virus — and in fact, if you’re not vaccinated, you may be at an even higher risk of getting sick again.

Pediatric infectious disease specialist Frank Esper, MD, answers your questions about COVID-19 reinfection, including how you can best protect yourself from getting the virus again.

Why people are getting COVID-19 again

“We’re seeing more reinfections now than during the first year of the pandemic, which is not necessarily surprising,” Dr. Esper says.

The CDC says cases of COVID-19 reinfection remain rare but possible. And with statistics and recommendations changing so quickly and so frequently, that “rare” status could always change, as well.

Dr. Esper breaks down the reasons behind reinfection.

  1. The pandemic has been happening for a while: As we near year two of pandemic life, several hundred million people have now been infected with and recovered from coronavirus. “At this point, many of those infections happened months or even a year ago,” Dr. Esper says, “and the immunity from those initial infections begins to wane over time.”
  2. Vaccine immunity diminishes with time, too: For Americans who got vaccinated as early as last winter, immunity may be starting to wane as the one-year mark approaches.
  3. We’ve stopped being as careful: As travel and large events make a comeback, gone are the days of mass vigilance around safety precautions such as masking, handwashing and social distancing — all the things that initially kept the virus at bay.
  4. New variants are extra-contagious: COVID-19 variants are much more infectious than the first wave of coronavirus. “These variants are able to overcome some of the existing immunity people had developed via vaccination or a previous infection,” Dr. Esper explains.

“You put all four of those things together, and it’s not too surprising that we’re seeing more and more people becoming infected for a second time.”

Are variants to blame for reinfections?

Not necessarily. Dr. Esper says the coronavirus doesn’t mutate nearly as much as the flu, which changes nearly everything about its appearance from one year to the next. Rather, it’s COVID-19’s infectiousness that makes it so, well, infectious.

“This variant’s infectiousness — including its ability to evade immune systems and prevent long-lasting immunity for those people who are infected with it — is one of the reasons why it’s been able to persist and come back,” he explains.

Who is at risk of COVID-19 reinfection?

By now, we know that anyone can get COVID-19 — the vaccinated and unvaccinated, those who have had it already and those who haven’t. In the same vein, anyone can get COVID-19 again.

“It’s important to note that we’re still learning a lot about reinfections and who’s at risk for those reinfections,” Dr. Esper says. But doctors do know that some people are at higher risk of reinfection for COVID-19 than others.

Vaccinated people are at the lowest risk of reinfection

Can vaccinated people get COVID-19 again? In short, yes — but the likelihood is far lower than for unvaccinated people.

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“There is a very, very small chance,” Dr. Esper says.

Data shows that fewer than 0.005% of fully vaccinated Americans have experienced a breakthrough case resulting in hospitalization or death — and people who have already had COVID-19 may be even less likely to be reinfected.

Unvaccinated people are at high risk for getting COVID-19 again

Think you don’t need to get vaccinated because you’ve already had COVID-19? Think again.

“This virus can overcome a person’s host immunity and cause a second infection,” Dr. Esper says. “Reports indicate that vaccination provides longer protection than natural infection.”

He’s referencing a study that shows that unvaccinated people are 2.34 times more likely to be reinfected with COVID-19 than those who are fully vaccinated — which drives home the importance of being vaccinated, even if you’ve already had the virus.

“Almost all the cases that we’re seeing right now are people who have not been vaccinated,” he says.

Immunocompromised people are at risk of reinfection, too

People with immune problems are at a higher risk for COVID-19 reinfection than the general public, which is why the U.S. Food and Drug Administration (FDA) has authorized booster shots of Pfizer-BioNTech’s and Moderna’s COVID-19 vaccines for immunocompromised individuals.

“We always knew that people with immune problems were more likely to have less of a response to the vaccine and more likely to get a second infection after they got the vaccine,” Dr. Esper says. Booster shots are designed to help reduce that likelihood.

After getting COVID-19, how long are you safe from re-infection?

A year and a half into the pandemic, it’s a question on the minds of everyone who’s recovered from COVID-19: After you’ve had the virus, how long do your natural antibodies last?

Doctors and scientists don’t yet know the definitive answer, though research is ongoing.

“We don’t necessarily know exactly how long immunity lasts, but a patient rarely gets reinfected with a new virus before 60 days or even 90 days,” Dr. Esper says. “There are plenty of people who still test positive for COVID-19 60 or 70 days after their original diagnosis. But that is remnants of the old infection, not a new infection.”

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Again, though: Your immunity from an initial infection wanes over time, so the natural antibodies your body created in the immediate aftermath of the virus won’t protect you from reinfection in the long term.

You may still be able to spread it

Remember, just because you feel fine doesn’t mean you’re in the clear — and reinfection may not present the same as your first bout of COVID-19.

“Your previous infection may prevent you from getting sick, but that doesn’t necessarily mean that you can’t become infected and spread it to others,” Dr. Esper says. “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, you’re still a risk to others.

How to protect yourself from getting COVID-19 again

Being infected once is not a hall pass to ignore safety protocols like masking, hand washing and physical distancing. Even if reinfection doesn’t cause you to become sick, you could still become a transmitter of the virus and infect others.

“The number one way to protect yourself and your family from this virus is to be vaccinated, but it’s not a silver bullet,” Dr. Esper says. “We have to keep everything on the table and do everything that we can. That includes wearing masks, social distancing, good ventilation, hand washing and everything else we’ve been doing for the last year and a half.”

The COVID-19 vaccines work

Breakthrough cases, including cases of reinfection in vaccinated people, are not a sign that the vaccine doesn’t work.

“There is a very coordinated and concise effort against vaccines, and those people want to amplify breakthrough infections as a reason not to get vaccinated,” Dr. Esper says. “But the safety and benefit of getting vaccinated is very, very strong, and they far outweigh the risks of getting vaccinated, which are very, very small.”

Nearly 170 million Americans have received a COVID-19 vaccine. Driving home the fact that no medication is ever expected to be fully effective or side-effect-free, Dr. Esper draws an analogy to giving penicillin to the same volume of people.

“If we gave penicillin to 170 million people, we would end up with a whole bunch of people hospitalized, which is not to say that penicillin is a bad drug,” he says. “It’s just saying that if you give any medication to everybody, there are going to be some side effects and some breakthrough cases because no medicine is ever 100% effective.”

In short? Get vaccinated.

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