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Can you get COVID-19 more than once?

6 minute read
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The short answer is yes. But there are science-backed ways to reduce that risk. Here’s what you need to know about immunity after a COVID-19 infection.

Beth Janes

By Beth Janes

More than 2 years into the COVID-19 pandemic, it’s likely you or someone you know has had a bout with the coronavirus. As of March 2022, there had been 79.5 million confirmed U.S. cases of COVID-19. That’s according to data from the Johns Hopkins Coronavirus Resource Center.

If you were among those millions, maybe you felt relieved once you recovered, thinking you couldn’t get it again. You may have even relaxed your pandemic precautions or put off getting a vaccination or a booster shot.

But it’s become clear that getting COVID-19 once does not mean you can’t get it again.

“We now are seeing that reinfection is common and only increases as time passes,” says Daniel Griffin, MD. He’s chief of the division of infectious disease with ProHealth at Optum.

And those reinfections can be severe. “Many reinfections can lead to serious disease resulting in hospitalization and death, even if the first case was mild,” he adds.

A big reason: the rise of the highly contagious Omicron variant. “The latest surge is unlike anything we’ve seen. Many people, both vaccinated and unvaccinated, are being infected with COVID-19 for the second or even third time,” says Devona Anderson, MD. She’s a family medicine physician in Kokomo, Indiana.

Unfortunately, nothing seems to be 100% effective at preventing infection. But knowing a few facts and following some basic precautions can help keep you healthy. This is true whether or not you’ve had COVID-19 before.

If you think you might have COVID-19, our providers are standing by to help. Schedule a virtual appointment as soon as today and get guidance on testing, how to treat your symptoms, and when to seek in-person care.

If you get COVID-19, you’re immune for a short time, but that protection may not be as strong as you think

Getting COVID-19 triggers an immune response that can help fight off reinfection. This is called natural immunity.

But that natural immunity begins to decline after about 3 months, says Zachary T. Levine, MD. He’s an infectious disease doctor with Newland Medical Associates in Southfield, Michigan.

How bad your symptoms were the first time may make a difference, according to the Centers for Disease Control and Prevention (CDC). If you had mild or no symptoms, it’s unclear whether the immunity you develop is enough to protect you from getting reinfected.

(Traveling soon? Here’s what you need to know about COVID testing.)

Vaccination after a COVID-19 infection offers additional protection against reinfection, but it’s not perfect

Adding a vaccination or 3 to your antibodies from a prior infection is your best line of defense against reinfection. The immunity you get from being fully vaccinated and boosted seems to be longer-lasting and stronger than the natural immunity you get after an infection, Dr. Levine says. “It definitely minimizes the risk of reinfection as much as possible.”

Unvaccinated people who had COVID-19 in 2020 were more than twice as likely to be reinfected during the spring 2021 surge than those who got vaccinated. That’s according to a study from the University of Kentucky.

When is the best time to get vaccinated or boosted after a COVID-19 infection? After your isolation period ends and you’re recovered, says Dr. Griffin.

“Previously, the recommendation was to wait 90 days after an infection to get vaccinated or boosted. But that was from the days when vaccines were in short supply. The recommendation has been updated.”

Vaccination protects against hospitalization and death

The latest surge shows that vaccination is truly best at reducing your chances of severe symptoms, being hospitalized and dying. That’s true even if you’ve been infected once or more than once with COVID-19.

Dr. Levine says he’s seen the power of vaccines firsthand. “I, along with all of my colleagues, have had several patients die of their second bout of COVID-19,” he says. “As far as I can remember — because at this point there have been too many for me to track — all those patients were not vaccinated.”

What is so powerful about vaccines that keeps you out of the hospital? “Vaccination plus a booster allows the body to develop a more consistent and robust immune response,” says Dr. Anderson. That and the immune memory from a previous infection gives even stronger protection against severe COVID-19 complications.

Need another reason to get vaccinated? Research suggests vaccination makes it less likely you’ll give the virus to others if you do contract COVID-19 again. Scientists in Denmark found that unvaccinated people are 41% more likely to pass the virus on to a family member.

It’s more likely you’ll be reinfected with a different variant

It’s possible to be reinfected by the same variant, but there’s not much data showing that this is happening.

“The dominant strains have been changing. Three months ago, the dominant strain was very different, so it’s more likely you’d be reinfected with a different one,” Dr. Levine says.

Your risk of reinfection after you’ve had COVID-19 and all your shots (booster included) should be very low, at least for several months, Dr. Anderson says. However, mutations of the virus can throw things off.

The more a virus circulates, the more likely it is to mutate and change. That’s what’s happened with Omicron, which is now the most transmissible variant yet. (Need a COVID home test? Shop now.)

It became the overwhelmingly dominant variant in just a few weeks. It also led to higher case numbers than at any other point in the pandemic. And this strain led to many second and third infections.

Recent research from Imperial College London estimated the risk of reinfection with Omicron is almost 5.5 times greater than with Delta, the previous dominant variant. (Delta was about twice as contagious as previous variants.) That means your protection from a past Delta infection now may be as low as 19%.

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Pandemic fatigue opens the door to getting reinfected

Early in the pandemic, many people were careful about wearing masks and avoiding crowded indoor spaces. After vaccinations became available, people relaxed their behavior. And official recommendations were relaxed, too.

Fast-forward several months to this latest surge. Many people are finding it hard to go back to their previous ways. “People are tired of the ‘pandemic lifestyle’ and have started throwing caution to the wind,” Dr. Anderson says.

Dr. Levine agrees that behavior, both personal and on a community level, likely plays a role in reinfection.

“It’s difficult to be as vigilant as possible all the time,” he says. Add in a highly transmissible variant such as Omicron, and there are probably just more opportunities for more people to get COVID-19 again.

The immune-compromised are at higher risk of infection (and reinfection) and should get vaccinated

If your immune system is weakened, your body can’t respond as well to a virus, Dr. Anderson says. As a result, any defense you gained from a prior infection can be lower. And it may not be enough to prevent getting COVID again.

That’s why it’s especially important for those people to get vaccinated and boosted, Dr. Levine says.

“I’ve had many unvaccinated patients tell me they thought they should not get the vaccine because of their immune-compromising condition. But this is not the case with COVID-19 vaccines,” he says. The COVID-19 vaccine does not contain live virus and cannot make you sick.

Bottom line: Get vaccinated and boosted. Take COVID-19 safety precautions, especially during surges. And stay healthy and fit to keep your immune system strong. Fighting off any other virus (such as the flu) may make you more susceptible to COVID-19.

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Additional sources
Reinfections with COVID-19: Centers for Disease Control and Prevention (2022). “Reinfections and COVID-19"
COVID-19 statistics: Johns Hopkins University Coronavirus Resource Center (2022).
Reinfection after vaccination (University of Kentucky study): CDC Mortality and Morbidity Weekly Report (2021). “Reduced Risk of Reinfection with SARS-CoV-2 After COVID-19 Vaccination — Kentucky, May–June 2021”
Vaccination and reinfection risk (Danish study): MedRxIv (2021). “SARS-CoV-2 Omicron VOC Transmission in Danish Households”
Risk of omicron reinfection: Imperial College of London (2021). “Report 49 - Growth, population distribution and immune escape of Omicron in England”