When to get a vaccine after a Covid-19 infection

New NACI recommendations on when to get a vaccine after an infection.

If you are infected BEFORE you received two-doses, wait (ages 5+):

  • If not moderately to severely immunocompromised: 8 weeks after symptom onset or positive test
  • If moderately to severely immunocompromised: 4-8 weeks after symptom onset or positive test
  • If you had MIS-C: until fully recovered or ≥90 days, whichever is longer

If you are infected BEFORE you received a booster but AFTER two-doses, wait (ages 12+):

  • 3 months after symptom onset or positive test, provided it is 6 months after second dose

Rationale for NACI’s recommendations:

The previous recommendations used to allow vaccination as long as one was out of their isolation period and not in the acute phase of the infection. The reason for this change is not safety-related, but in fact to strategically prolong immunity. We know a longer interval between doses offers more robust immunity. Plus, if infection offers some immunity, then riding that until it may begin to wane to then get a dose could help make immunity last longer. My feeling is still that we need to balance this with the current Omicron risk, as well as the risk of people forgetting to get next dose/booster.

My thoughts: NACI has made these recommendations unnecessarily complicated. You do have some immunity after an infection (especially if symptomatic), but we don’t have data on how long and how robust this immunity is. While you don’t need to rush out to get next dose, waiting ~6 weeks if not already fully vaccinated (two doses) or ~8 weeks if fully vaccinated (two doses) is my personal sweet spot (for those not immunocompromised).

Importantly, NACI has said very clearly that clinical discretion is advised, so hopefully provinces allow discretion based on circumstances.