The effect of SARS-CoV-2 vaccination on post-acute sequelae of COVID-19 (PASC): A prospective cohort study, 2022, Wynberg et al

Highlights

• Vaccination did not reduce symptoms of post-acute sequelae (PASC).
• Antibody kinetics did not differ between participants with and without PASC.
• Early antibody titers were comparable between participants with and without PASC.
• Therapeutic potential of COVID-19 vaccination on PASC seems unlikely.

Abstract

Background
Symptoms of post-acute sequelae of COVID-19 (PASC) may improve following SARS-CoV-2 vaccination. However few prospective data that also explore the underlying biological mechanism are available. We assessed the effect of vaccination on symptomatology of participants with PASC, and compared antibody dynamics between those with and without PASC.

Methods
RECoVERED is a prospective cohort study of adult patients with mild to critical COVID-19, enrolled from illness onset. Among participants with PASC, vaccinated participants were exact-matched 1:1 on age, sex, obesity status and time since illness onset to unvaccinated participants. Between matched pairs, we compared the monthly mean numbers of symptoms over a 3-month follow-up period, and, using exact logistic regression, the proportion of participants who fully recovered from PASC. Finally, we assessed the association between PACS status and rate of decay of spike- and RBD-binding IgG titers up to 9 months after illness onset using Bayesian hierarchical linear regression.

Findings
Of 349 enrolled participants, 316 (90.5%) had ≥3 months of follow-up, of whom 186 (58.9%) developed PASC. Among 36 matched pairs with PASC, the mean number of symptoms reported each month during 3 months of follow-up were comparable between vaccinated and unvaccinated groups. Odds of full recovery from PASC also did not differ between matched pairs (OR 1.57 [95%CI 0.46–5.84]) within 3 months after the matched time-point. The median half-life of spike- and RBD-binding IgG levels were, in days (95%CrI), 233 (183–324) and 181 (147–230) among participants with PASC, and 170 (125–252) and 144 (113–196) among those without PASC, respectively.

Interpretation
Our study found no strong evidence to suggest that vaccination improves symptoms of PASC. This was corroborated by comparable spike- and RBD-binding IgG waning trajectories between those with and without PASC, refuting any immunological basis for a therapeutic effect of vaccination on PASC.

Open access, https://www.sciencedirect.com/science/article/pii/S0264410X22007484

 

The sad truth is that this won't make any difference with the many physicians who asserted, as a matter of fact, that this was a guaranteed thing. There won't be any consequences for them, for making baseless claims, and neither for the people who mindlessly thought it was a good idea to just blindly go ahead with this.

The lack of accountability in medicine is massively diminishing it. The same people who made those assertions will keep on making baseless predictions that will turn out false and never skip a beat. There are very few professions where this is even possible, let alone almost universal to the point of never leading to consequences. Only in politics.

Almost true in business, but as examples like Theranos show, bit shot investors have far more protections against even high-risk investments than people have about their health. When something doesn't work it's generally impossible to BS forever. Only in medicine and politics can failure be, somehow, celebrated, awarded, praised, as being genius and 100% effective even when it's a complete lie.

 

Have only read the abstract.

While their conclusion is probably correct and vaccines are unlikely to fix long covid, the way they arrived at the conclusion looks more shaky.

1) They're still counting symptoms. The important thing is not the number but the severity of symptoms!

I was one of the lucky ones whose ME symptoms eased for a couple of weeks after each vaccination. This would not have shown up in the number of symptoms, they were all still there, it was their severity that had reduced. Equally, symptom counting would also have missed those the unlucky ones who got a worsening of existing symptoms after their vax but no new ones.

2) They only looked at IgG levels. Yet they conclude that because there's nothing to see there, there isn't "any immunological basis for a therapeutic effect of vaccination on PASC".

Surely that conclusion is much too strong? They only have data for IgG but IgG is only part of the immune system so the conclusion should be limited to IgG, not extend to the whole immune system?