In this episode, I’ll discuss the CDC Recommendations if a patient develops COVID-19 before receiving the 2nd vaccine dose.
As with most clinical decisions during the current pandemic, CDC recommendations on what to do if a patient gets COVID-19 before receiving their 2nd vaccine dose is based on expert opinion, and not direct evidence.
There are two general scenarios to consider:
1. Patients who get COVID-19 before their 2nd vaccine dose and are treated with a monoclonal antibody, and
2. Patients who get COVID-19 before their 2nd vaccine dose and are NOT treated with a monoclonal antibody
As of this recording, the CDC recommendation and rationale if a patient gets COVID-19 before the 2nd vaccine dose and is treated with a monoclonal antibody is the following:
Currently, there are no data on the safety and efficacy of mRNA COVID-19 vaccines in persons who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. Based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon in the 90 days after initial infection, vaccination should be deferred for at least 90 days, as a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses. This recommendation applies to persons who receive passive antibody therapy before receiving any vaccine doses and those who receive passive antibody therapy after the first dose but before the second dose, in which case the second dose should be deferred for at least 90 days following receipt of the antibody therapy.
For patients who are not treated with a monoclonal antibody but get COVID-19 before the 2nd vaccine dose, the recommendations are much more simple. As of this recording the CDC recommends the following:
People with COVID-19 who have symptoms should wait to be vaccinated until they have recovered from their illness and have met the criteria for discontinuing isolation; those without symptoms should also wait until they meet the criteria before getting vaccinated. This guidance also applies to people who get COVID-19 before getting their second dose of vaccine.
There are many other potential scenarios and exceptions to routine vaccination for which the CDC has developed interim guidance on, and they can be found at this CDC page.
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