Vaccine Efficacy and Long COVID Concerns for Teens - Influenza

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Regarding vaccine efficacy?


Hello Doctor, I am a senior high school student.
I would like to ask: 1) Is the likelihood of experiencing long COVID symptoms after contracting COVID-19 high, meaning that they may never fully resolve? 2) I received my first dose of the BNT vaccine last September, but I have been hesitant to get the second dose because it significantly worsened my ankylosing spondylitis.
I really want to get the second dose like my classmates.
Now that more than six months have passed since last September, if I get the second dose (whether BNT or Moderna), will the increase in antibodies be negligible? Would I need to start over and receive two doses for it to be meaningful? 3) My classmates received their second dose nearly five months ago.
Considering the waning immunity over time, is it possible that while their vaccine protection is still better than mine, the difference is not as significant anymore? 4) Should I be very concerned that having only received one dose of the vaccine means that if I contract COVID-19, my symptoms will be more severe compared to my classmates who received their second dose a long time ago? Thank you, Doctor.

Zhong, 20~29 year old female. Ask Date: 2022/04/18

Dr. Yang Zongyan reply Influenza


1) Is the rate of long COVID symptoms that may never improve high? Regarding long COVID symptoms, since there is currently no long-term data, whether it lasts a lifetime still depends on future studies, as the pandemic has only been ongoing for a few years.
2) I received my first dose of the BNT vaccine last September, but I have been hesitant to get the second dose because it noticeably worsened my ankylosing spondylitis.
I really want to get the second dose like my classmates.
I would like to ask the doctor, since it has been over six months since last September, if getting the second dose now (whether BNT or Moderna) will have a negligible effect on antibody enhancement.
Will I need to restart the two-dose series for it to be meaningful? What is the maximum interval between doses? Dr.
Huang from National Taiwan University mentioned that there isn't enough long-term data on COVID-19 vaccines, but based on studies of the HPV vaccine, where two doses are administered six months apart, research shows that administering the second dose 12 months later actually produces higher antibody levels than two doses given six months apart, indicating that immune memory can last a long time.
However, if BNT is not available now, mixing with Moderna or High-End vaccines is still an option.
3) My classmate received their second dose nearly five months ago.
Given the time decay, is it possible that their vaccine protection, while still better than mine, is not significantly different anymore? The effectiveness of receiving two doses is certainly better than just one, so it is still recommended to complete the two-dose series.
4) Should I be very concerned that having only received one dose of the vaccine means that if I contract COVID-19, it will be more severe than for my classmates who received their second dose a long time ago? No, it is advised to complete the two-dose vaccination series.

Reply Date: 2022/04/18

More Info


As a high school senior, it's understandable to have concerns about COVID-19 vaccines, especially regarding their efficacy and potential long-term effects. Let’s address your questions one by one.

1) Long COVID and its Persistence: Long COVID refers to a range of symptoms that can persist for weeks or months after the initial infection. The exact percentage of individuals who experience long-term effects is still being studied, but research suggests that a significant number of people do report lingering symptoms. However, the severity and duration of these symptoms can vary widely. While some individuals may experience long-term issues, many others recover fully. The ongoing research aims to provide clearer insights into the long-term implications of COVID-19.

2) Timing of the Second Vaccine Dose: You mentioned receiving your first dose of the BNT vaccine (Pfizer-BioNTech) in September and experiencing a worsening of your ankylosing spondylitis, which has understandably made you hesitant to get the second dose. It’s important to note that while the immune response may diminish over time, receiving the second dose is still beneficial. The immune system can still mount a response even after a delay. Current guidelines suggest that if you have not received your second dose within six months, it is advisable to get it, as it will significantly enhance your protection against COVID-19. If you are concerned about your condition, discussing this with your healthcare provider can help you make an informed decision.

3) Vaccine Efficacy Over Time: Your classmates who received their second dose five months ago may have a higher level of protection compared to you, but it’s important to recognize that vaccine efficacy does wane over time. However, studies show that even after some decline, vaccinated individuals still have better protection against severe illness compared to those who are unvaccinated. Therefore, while their protection may decrease, they are still likely to be better protected than someone who has only received one dose.

4) Concerns About COVID-19 Severity: It’s natural to worry about the severity of COVID-19 if you have only received one dose of the vaccine. While it is true that fully vaccinated individuals generally have a lower risk of severe illness, hospitalization, and death from COVID-19, having even one dose of the vaccine still provides some level of protection. However, it is advisable to complete the vaccination series to maximize your immunity. If you do contract COVID-19, being fully vaccinated can help reduce the severity of the disease.

In summary, while concerns about long COVID and vaccine efficacy are valid, the benefits of vaccination—especially completing the two-dose series—far outweigh the risks. Vaccines are designed to enhance your immune response and protect you from severe outcomes. If you have specific health concerns, particularly related to your ankylosing spondylitis, consulting with your healthcare provider is crucial. They can provide personalized advice based on your medical history and current health status. Remember, staying informed and proactive about your health is key to navigating these challenging times.

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