Welcome to COVID Questions, TIME’s advice column. We’re trying to make living through the pandemic a little easier, with expert-backed answers to your toughest coronavirus-related dilemmas. While we can’t and don’t offer medical advice—those questions should go to your doctor—we hope this column will help you sort through this stressful and confusing time. Got a question? Write to us at [email protected].
Today, A.B. asks:
“I’m fully vaccinated, boosted and have recently recovered from a breakthrough infection. Can I go back to normal now?”
There are certain pathogens that the human immune system learns to block forever after a single encounter. But others, like coronaviruses that cause the common cold, can sicken a person year after year.
Unfortunately, the virus that causes COVID-19 is, like other coronaviruses, able to infect the same person multiple times. The body gets better at fighting it after each exposure or vaccine dose, meaning future brushes with the virus will likely be milder, but there doesn’t seem to be a point at which the risk of infection completely disappears.
“There’s probably always a level of exposure to the virus that could overcome the level of immunity you have,” says Dr. Rachel Presti, an infectious disease researcher at the Washington University School of Medicine in St. Louis. That’s especially true if you’re elderly, have underlying medical conditions or are immunocompromised.
Even with those caveats, there’s a lot of good news for fully vaccinated and boosted people who have recovered from a recent COVID-19 infection. People in that category have several layers of defense against the virus. And, assuming you’re generally healthy, experts say that leaves you with a grace period of at least three to six months during which you’re unlikely to get sick again.
According to the latest federal analysis, which included data from fall 2021, a fully vaccinated and boosted person in the U.S. was 10 times less likely to test positive for COVID-19—and 20 times less likely to die from it—compared to an unvaccinated adult. More recent data gathered during the Omicron surge in the U.K. confirms that fully vaccinated and boosted people remain significantly less likely to get infected than unvaccinated people. Still, breakthrough infections happen. Among boosted adults who experience them, cases tend to be mild.
You should never try to catch COVID-19, but there is a silver lining to getting it. The infection sparks an immune response that imparts an extra layer of safety.
The body mounts a wider-ranging immune response when it encounters the actual virus as opposed to a vaccine, Presti says. So if you had a breakthrough infection, you probably walked away from the (hopefully mild) experience with an even stronger and more robust immune profile than you had before you got sick.
One small study of fully vaccinated health care workers who had breakthrough infections before the Omicron surge found that they experienced “substantial” jumps in antibodies after their illnesses, even though most were mild. Other research has found that people who recover from Omicron infections gain immunity against both the Omicron and Delta variants. And a recent report from the U.S. Centers for Disease Control and Prevention found that case rates during the Delta wave—which was before Omicron and widespread boosters—were lower among people who were previously diagnosed with COVID-19 than people who were just vaccinated.
So why get vaccinated at all, if infection-derived immunity provides strong protection? For one thing, vaccination is a much safer way to gain immunity. Post-infection immunity is also less predictable than vaccine-derived protection, Presti says. Some people generate many antibodies after an infection while others are left with few, and the average person won’t know how many they have.
Infection-derived immunity also wanes over time, so you can’t count on it forever. One December 2021 study suggested reinfection could occur anywhere from three months to multiple years after a COVID-19 illness, with variations from person to person depending on age, health status and many other factors.
Immunity gained from vaccines wanes over time, too, but early evidence suggests booster shots provide longer-lasting protection than initial shots, says Dr. Abinash Virk, an infectious disease physician at the Mayo Clinic.
Based on what researchers know about how the immune system responds to this coronavirus and others, Virk says a fully vaccinated, boosted person who recovers from COVID-19 can feel pretty safe for the months following their breakthrough infection. “We don’t know” exactly how long protection lasts, Virk says. “But we think you will be protected for at least three to six months after your infection.”
During this window of time, when your immunity is strongest and you’re unlikely to get sick, you can also be fairly confident that you aren’t spreading the virus to anyone else. That makes activities like indoor dining and visiting loved ones safer, if not 100% risk-free. “If somebody just recently had Omicron after they already got boosted, maybe [they can be] a little bit more cavalier about wearing a mask and social distancing,” Virk says.
But you shouldn’t ignore COVID-19 completely. While you may be well protected—at least for a few months—others in your community are more vulnerable, which makes it important to slow COVID-19’s spread as much as possible. It’s always smart to limit your exposure to sick people, stay home if you develop respiratory symptoms and keep an eye on hospitalization trends in your area. If the health system is struggling, authorities might ask everyone to temporarily resume some precautions, like indoor mask wearing, to avoid a collapse.
There’s also no predicting if or when there will be another new variant that challenges your hard-won immunity. And researchers are still learning about long-term complications from the virus that could affect both unvaccinated and vaccinated people, like Long COVID.
Still, many Americans are far more protected than they were in 2020 or even last year, thanks to vaccines and prior exposures to the virus. If you’re generally healthy, fully vaccinated and boosted and have recently recovered from a breakthrough infection, you are currently about as safe from COVID-19 as you can be.
“For a lot of people, the risk is kind of the same as the risk of getting a cold or a mild flu,” Presti says. “We used to live with that.” And before too long, we will again.
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