As the epidemic progresses, the recommendations of the Haute Autorité de Santé in terms of vaccination strategy evolve. Recently, she recommended a booster dose from the age of 40, when immunity begins to decline, ie 6 months after the last injection. She added a new element: if you contract Covid-19 by being vaccinated, you will need a booster dose, regardless of your age. For the time being, this is an opinion, the government has not yet confirmed it.
Contracting Covid after vaccination “resets the counters to zero”
If you had the Covid BEFORE being vaccinated, nothing changes. HAS maintains its position. The available data indeed confirm that natural infection protects against reinfection. “HAS maintains its recommendation to administer a single dose of vaccine in people who have been infected with Covid-19, regardless of their age. This vaccination should be carried out 6 months after infection with the Comirnaty® vaccine from Pfizer or Spikevax® from Moderna (full dose). However, aware that people may need an additional dose for administrative reasons, in particular to travel abroad, the HAS emphasizes that “This additional dose is not contraindicated and can be administered to those who wish to do so.”
If you had Covid AFTER the vaccination (one or two doses), the HAS modifies its recommendations. The President of the HAS College, Professor Dominique Le Galudec explained to France Info than contracting the virus while being vaccinated would reset “the counter to zero”. What does that mean ?
According to the explanation of the HAS on its dedicated document, having the Covid would testify to a form of “vaccination failure”, if one is symptomatic, or because the immunity conferred by the vaccine is no longer sufficient, for example. “An infection occurring after a complete primary series may be the consequence of insufficient immunity conferred by this initial vaccination, vis-à-vis a new variant in particular, or by the reduction of this immunity or by the inefficiency of the memory immune response“, notes the HAS.
A post-infection booster dose open to all
“An infection occurring after a complete vaccination may be the consequence of insufficient immunity conferred by this initial vaccination, in particular against a new variant, or by the reduction of this immunity or even by the inefficiency of the immune response memory”, analyzes the HAS in its opinion. When this infection is symptomatic, we speak of vaccine failure. In France, only 1,349 serious vaccine failures were notified with the Pfizer vaccine, of which only 16 cases concerned people with no comorbidities.
What do we know about these serious vaccine failures? According to the HAS, they mainly concern older people and/or people with comorbidities, who are the first to be targeted by the recall campaign. The time to onset of these vaccine failures suggests that they result from insufficient immunity induced by the primary vaccination rather than from a drop in immunity.
However, in most cases if the vaccine does not completely protect against catching Covid-19, this does not necessarily translate into a serious manifestation of the disease. But anyway, if you contract it after the vaccine, the HAS now recommends:
- of receive an additional dose 6 months after infection “for people eligible for the booster and in whom the infection occurred after a complete vaccination schedule”,
- of receive a second dose 6 months after infection for all people in whom an infection has occurred after having received a first dose of vaccine (incomplete vaccination schedule). This recommendation is valid regardless of their age and regardless of the time of onset of the infection after this first dose.
The president of the HAS college summarized to France Info that this post-infection dose could be administered “regardless of age, regardless of the time between the vaccination(s) they had and the Covid”. The objective is also to renew protection against new variants.
Sources:
- Covid-19: what vaccination schedule for people infected before or after vaccination?, HAS, opinion of November 19, 2021.
- Interview Dominique Le Guludec (president of the HAS), France Info, November 19, 2021.
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