Are there specific warning symptoms of COVID-19 infection for patients who have received a SARS-CoV-2 vaccination?
What the research says:
In general, COVID-19 symptoms in vaccinated people are milder those who have not received a SAR-CoV-2 vaccination (WHO 2021; CDC 2021a; CDC 2022; Bergwerk et al 2021), unless they occur within 24 hours of vaccination. There is no evidence to suggest that vaccinated individuals experience different symptoms to those who are unvaccinated and there are no specific symptoms or warning signs that can be used to identify SARS-CoV-2 infection in vaccinated individuals. Data from the UK-based Zoe project indicate that the most common symptoms in vaccinated patients are runny nose, headache, sneezing, sore throat and persistent cough (similar to those of the common cold) (ZOE 2021); these data are for a time period when the Delta variant was dominant. Breakthrough infections may be more common and present with a different symptom profile as new variants emerge
What this means for your clinical practice:
- Continue to advise patients to get a COVID-19 test per National guidelines and availability if they experience symptoms suggestive of COVID-19 illness, even if they are fully vaccinated
- Continue to follow precautions, including wearing of masks, social distancing and sanitisation, as per National guidelines of your country
- Continue to advise patients to get the required booster vaccinations, as per the guidelines for your respective countries
With grateful thanks to Dr Osman Yusuf (Chief Consultant of the Allergy & Asthma Institute, Pakistan) for and on behalf of the IPCRG practice driven answers review group.
Useful links and supporting references:
Bergwerk M, et al. Covid-19 breakthrough infections in vaccinated health care workers. N Engl J Med 2021;385:1474–84. Available at: https://www.nejm.org/doi/full/10.1056/NEJMoa2109072. Accessed March 2022.
CDC. COVID-19. Possibility of COVID-19 illness after vaccination. December 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html. Accessed February 2022.
CDC. COVID-19 vaccine booter shots. February 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. Accessed February 2022.
WHO. Can I still get COVID after I have been vaccinated? Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-(covid-19)-vaccines
ZOE COVID study. What are the new top 5 COVID symptoms. June 2021. Available at: https://covid.joinzoe.com/post/new-top-5-covid-symptoms#part_1. Accessed February 2022.