Why You Still Need a Booster, Even After a Breakthrough COVID Case

Why You Still Need a Booster, Even After a Breakthrough COVID Case
Photo: hedgehog94, Shutterstock

If you haven’t personally caught any variant of COVID-19 by this point, you might have an attitude of “well, I’m gonna get it eventually.” That isn’t necessarily true (nor is it the best attitude to have), but it sure can feel that way.

More than ever, the current surge of positive COVID-19 cases and hospitalizations highlights what we always knew was a possibility, but seems to be more and more common: breakthrough cases after vaccination. But what does a breakthrough case mean for your immunity? Why should you still get a booster after already getting the virus?

Lifehacker spoke with Dr. Sachin Nagrani, medical director for Heal, about the latest learnings around Omicron, and what the variant means for your vaccine schedule. If you’re one of the many positive cases from the past few weeks, here’s what you need to know about still getting that booster.

What’s the difference between vaccines and natural immunity?

Both natural infection and vaccination allow your body’s immune system to produce antibodies that are necessary to fight the disease — but they are not equally effective.

It’s true that you do get a temporary boost of immunity from a natural infection. “Temporary is the key word,” Nagrani says. Immunity from infection wanes faster than immunity from a vaccine. “We don’t yet have studies that directly compare a breakthrough case with a booster dose [in terms of immunity],” Nagrani says, “but given what we know about the initial vaccine, the expectation is that a booster provides longer-lasting immunity compared to your breakthrough infection.”

Why should you still get vaccinated after an infection?

Amber D’Souza, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told Verywell that “among those who have had COVID, the risk of getting COVID again is higher among those who did not get vaccinated than those who got vaccinated.” Therefore, experts recommend still getting a booster, even if there isn’t Omicron-specific data to back that up quite yet.

The lack of data might sound discouraging, but experts like Nagrani say that level of uncertainty is exactly why you should still get vaccinated. “You can’t be certain about the extent of ‘natural immunity’ you gain, or how long it will last,” Nagrani says, “and a vaccine will provide a much better guarantee.”

Do I really need a booster?

The need for the booster doesn’t mean that the initial vaccines weren’t doing their job well. “COVID-19 vaccines are working well to prevent severe illness, hospitalisation, and death,” the CDC reports. “However, public health experts are starting to see reduced protection over time against mild and moderate disease, especially among certain populations.”

Lifehacker’s senior health editor Beth Skwarecki argues that Omicron makes vaccination even more important than it already was:

If you’ve had COVID before and figured that you’re probably immune, you may be more susceptible to Omicron than to previous variants. And vaccines protect you and the people around you for all the reasons they did before. Remember, vaccines are now available for everyone aged 5 and older, so get your shots if you haven’t already.

Nagrani also points out that the guiding purpose of the vaccines was to prevent large-scale hospitalisation and death. That means that even though vaccines should make individual cases less severe, there’s still a risk of individual transmission–especially with the highly infectious Omicron.

When should you time your booster after infection?

If you tested positive for COVID and want to get your booster as soon as possible, it’s recommended that you at least wait until your symptoms are gone.

Otherwise, given the lack of Omicron-specific data, Nagrani estimates that you likely have a 30-day window of natural immunity between your breakthrough case and your booster appointment. Other experts give a larger window, like Dr. Angela Branche, who told the Miami Herald that vaccinated people who have a breakthrough infection likely do not need a booster “for three to six months after they have recovered, though it would be safe to obtain a booster dose as early as two weeks after full resolution of symptoms.”

While immunity timelines will vary from person to person, Nagrani’s stance is that it’s simply better not to wait. The protection you get from the vaccine will last longer and provide far more certainty than natural immunity. We don’t know exactly how a breakthrough infection compares to a booster vaccine, but we do know that natural immunity is imperfect.

Final thoughts

The rise of Omicron seems to have coincided perfectly with widespread availability of booster doses in the U.S., and Nagrani notes that most models have Omicron reaching peak transmission around mid-late January.

“As time goes on, we’ll continue to find ways to manage the virus,” Nagrani says. Vaccines (including booster doses) are the forefront of fighting COVID-19. Still, boosted or not, it’s important to keep practicing safety measures like proper mask-wearing and social distancing.

Finally, and maybe this should go without saying: Breakthrough infections are not recommended as a deliberate method to “hack” your immunity even further. Here’s the CDC’s guide to getting your booster.

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