Advice for “Long-Haulers” Following COVID-19 Infections

Consider Having the Vaccine. It Can’t Hurt, But Might Help

By Howard Wolinsky

In an unexpected development, so-called “long-haul” patients with persistent symptoms from COVID-19 infections have seen their symptoms improve after getting the COVID-19 vaccine.

Robert Murphy, M.D, the John Philip Phair Professor of Infectious Diseases at Northwestern University, where he serves as executive director of the Institute for Global Health, said “This has everybody really surprised. Nobody understands why the vaccine would make a person feel better. There are hypotheses and theories out there.”

“But nobody knows why they get the long-haul syndrome, why some people do and some people don’t, and nobody knows why these vaccines work. We just can’t get our heads around it at this particular point, but it’s now taken seriously.”

Murphy is co-founder of Northwestern University's CoVAXCEN, a coalition of academic, government and industry experts on the COVID-19 pandemic.

Virologist Judd Hultquist, Ph.D., Assistant Professor in the Division of Infectious Disease and the Associate Director of the Center for Pathogen Genomics and Microbial Evolution at the Feinberg School of Medicine at Northwestern University, said the long-haul phenomenon is mysterious.

“There are still way more questions than answers when it comes to COVID-19 ‘long-haulers,’” he says.

“It is estimated that up to 10% of people infected by COVID-19 become ‘long-haulers’, who experience symptoms that linger for weeks and months after infection,” Hultquist said. “Most commonly, this includes fatigue and ‘brain fog.’ There are several theories as to why this might happen, but scientists are still trying to figure out the exact cause or causes.”

He said one theory is that the virus might be able to continue replicating at low levels in some people and this could drive persistent symptoms. Another theory is that viral fragments might be slow to clear from some individuals and this might drive prolonged inflammation and illness.

Others hypothesize that infection may induce an autoimmune response in some people and this is what leads to long-haul symptoms. Or it might be a combination of these things.

The Survivors Corps, a grassroots COVID patient group, found in an online survey that about 40% of COVID long-haulers reported mild to full resolution of their symptoms after they were vaccinated. Researchers at the Yale New Haven Health Center for Outcomes Research and Evaluation are working on a follow-up study with Survivors Corps to characterize patients’ symptoms and response to vaccination.

Hultquist said, “If long-haul symptoms are caused by persistent infection or residual viral fragments, then there is reason to believe that vaccination could improve those symptoms by clearing the remaining virus and resolving any ongoing inflammation. But studies are still ongoing to test these hypotheses and determine how to best assist long-haulers that did not show improvement after vaccination.”

Murphy advised patients with long-haul symptoms: “It’s going to be studied, and we’ll have an answer, but we don’t know when. Until then, if you have any of these long-haul symptoms like fatigue and are not feeling well, weak, take the vaccine. It can’t hurt you.”

Northwestern COVID-19 Vaccine Communication and Evaluation Network (CoVAXCEN) seeks to achieve consensus on a variety of issues related to the safety and efficacy of COVID-19 vaccines and then produce and disseminate written materials for scientists, healthcare professionals, and the general public describing its conclusions.

Headquartered in the Institute for Global Health's Center for Global Communicable and Emerging Infectious Diseases with the cooperation of the Center for Communication and Health, we seek to achieve consensus on a variety of issues related to the safety and efficacy of COVID-19 vaccines and then produce and disseminate written materials for scientists, healthcare professionals, and the general public describing its conclusions.

Howard Wolinsky is a Chicago-based freelance medical writer and author. He is the former medical reporter for the Chicago Sun-Times. He has won awards for medical writing from the American Public Health Association, the American Bar Association, and the Association of Health Care Journalists, the Chicago Headline Club’s Peter Lisagor Award (“the Chicago Pulitzer''). The Sun-Times twice nominated him for the Pulitzer Prize.