I’m vaccinated and still got COVID-19. Can I get it again?

We are answering your questions about the coronavirus vaccines and what we need to do next. To submit your question, email Lois Solomon at AskLois@sunsentinel.com.

Q. “I was vaccinated with Pfizer shots in January and February and had COVID in August. Symptoms are mostly gone. Can I get COVID again?” — Ali Burney, Tamarac

A. Yes, but it’s unlikely, said Dr. Geeta Nayyar, an associate professor at the University of Miami specializing in rheumatology and chronic diseases.

According to the U.S. Centers for Disease Control and Prevention, you should have immunity from re-infection for at least six months after the virus hits. And having been vaccinated, you have even more protection. Still, a new variation could emerge and all bets are off.

“It is possible to get COVID again but the fact that you are vaccinated makes it much less likely,” Nayyar said. “Breakthrough infections are possible but limited in those that have been vaccinated. Talk with your doctor about whether you are eligible for a booster.”

Q. I’m 75. I got the two Pfizer vaccine shots in March. I got a breakthrough case of COVID in August and received monoclonal antibodies within three days of symptoms. I am now fully recovered. Do I need to get a booster? If so, when?” —

Bill, Tampa

A. Because of your age, you are eligible for the booster. But don’t run out to the pharmacy just yet. The U.S. Centers for Disease Control and Prevention recommends that anyone treated with monoclonal antibodies wait three months before getting a COVID19 vaccine. So if you had the treatment in August, you should wait until at least November to get your booster.

Q. “Palm Beach County has ended its COVID-19 state of emergency. That implies that buildings could remove their mask rules. But should our condo building base our decision, as does the CDC, on “Community Transmission” (and positivity is just one aspect of community transmission), and not specifically on positivity (which does vary based on who collects the data)? The CDC is reporting a 4.35% transmission rate for Palm Beach County while the state health department reports 3.4% (as of Oct. 26).” — Alan, Boca Raton

A. It would be great to have some consistency, wouldn’t it? That would make it easier to bring life back to normal. But if you want to follow the recommendations of the Centers for Disease Control and Prevention, here are the five factors to consider as you decide whether to take off the masks in your condo building:

1. Look at the community transmission rate (levels over 5% are considered “too high.”) 2. Is the health system overloaded past its capacity? 3. What percentage of the population is vaccinated?

4. Are the health systems able to widely test for new COVID-19 cases? 5. How big are the populations at increased risk for severe outcomes from COVID-19?

Even as positivity rates continue to decline, the CDC still recommends that fully vaccinated people wear masks in public indoor settings in areas of substantial or high transmission. According to Dr. Joanna Drowos, an associate professor of family medicine at Florida Atlantic University, substantial transmission is a positivity rate between

8% and 10%, and high transmission is a positivity rate of 10% or higher.

“When there is a discrepancy, the CDC recommends using the higher metric, although in this case both numbers are below the ‘substantial’ threshold,” Drowos said.

Drowos recommends that everyone wear a mask in public indoor settings, regardless of transmission level, if they or someone in their household is at increased risk for severe disease or if someone in their household is unvaccinated, including children under 12 who are currently ineligible for a vaccine.

Q. “I had an antibodies test

(months after receiving two Pfizer shots), and the number was 7.6. However, I can’t find any explanation for what that means.” — Sharon Kersten, Wilton Manors

A. Unfortunately many of our local doctors are anti-antibody tests and would not answer this question.

“Test results from currently authorized SARS-CoV-2 antibody tests should not be used to evaluate a person’s level of immunity or protection from COVID-19,” said Dr. Geeta Nayyar, an associate professor at the University of Miami. “The U.S. Food and Drug Administration is reminding the public and health care providers that results from currently authorized antibody tests should not be used to evaluate a person’s level of immunity or protection from

COVID-19 at any time, and especially after the person received a

COVID-19 vaccination.”

Dr. Hila Beckerman of Delray Beach agreed.

“As of now, we don’t really recommend antibody testing as a way of directing your care because even if you have some antibodies after vaccination or disease, you should still get vaccinated or receive the booster,” she said. “This is because you don’t know when the level will wane low enough to not really be protective anymore for you as an individual. Most labs will give you a reference number, above which you are considered to be ‘protected’ but the number per se is not very indicative of what would happen should you become re-infected.”

Antibody levels are only one measure of how you will fight a

COVID-19 attack. Your immune cell levels are another important component, and they’re not measured in the antibody test.

I was disappointed about all this because I’ve been wanting to get an antibody test, too, to see if I really need a booster. But this is one of those situations where health officials are afraid people will become too dependent on the technology and ignore their warnings about how to stay safe. According to the FDA: “If antibody test results are interpreted incorrectly, there is a potential risk that people may take fewer precautions against SARSCoV-2 exposure.”

Q. “I’m 73 years old, I live in Florida and was fully vaccinated (Moderna) eight months ago. When can I get the third vaccine and will it be at 50%?” — Rey Curva

A. Federal health officials completed authorization of a Moderna half-dose third shot on Oct. 21. Publix, which has both Moderna and Pfizer in pharmacies, has been offering fullstrength Moderna booster doses since August to people who are immune-compromised, and likely will be prepared to offer the half-dose in the coming days. Call Publix or any pharmacy offering vaccines and see if they are ready for the new population of people who are now eligible for the halfdose, which includes you as a senior citizen.

Q. “My wife and I were both vaccinated with Pfizer in January and February but came down with breakthrough infections in July. Our symptoms were fairly mild. We would like to get the booster shot but are getting conflicting and confusing information from the doctors we see.

One said wait three months, then get an antibody test to see if you need a booster. Another said we don’t need boosters because having had the virus is more protective than a booster and we should wait until next year sometime. Yet another said to get the booster now and to forget about antibody tests because results tend to be inaccurate, hard to interpret and yield different results depending which test is used.

Can you offer any information or sources that will help us determine if a booster is appropriate at this time?” — Joe Solomon

A. Isn’t it the worst when every doctor is giving you a different opinion? Well here’s another opinion, this one from Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“You should receive a booster one month after your infection if it’s been at least six months since your second vaccine,” Beckerman said. “Antibody testing is not recommended for a few reasons: There is no target amount of antibodies that will keep you ‘safe,’ each test is different with no good standard, and you also don’t know at which point your antibody level will wane as to leave you unprotected. You would have to test yourself weekly.”

She added that she doesn’t like the term “breakthrough infection.”

“The vaccine protects you from becoming seriously ill, not preventing you from acquiring the infection,” she said. “You were infected in July and had mild symptoms probably either because you still had some protection from the vaccines or you would have had a mild course naturally. There is no way to know, which is why we recommend that everyone receive their vaccines — we don’t gamble.”

Q .“I’m 71 and in very good health. I received my second

Pfizer vaccine in late February. In mid-September, I came down with a very mild breakthrough infection. I was tested again a week later and am still positive. According to my doctor, you can’t be positive for COVID-19 and get the booster. I was told I can get the booster once I’ve been negative for 30 days. I have another test scheduled soon. If it comes back positive for a third time in a month, can

I get the booster?” — Bill Bradley, Fort Lauderdale

A. You can get the booster if a month has passed since your infection and you no longer have symptoms, even if you’re still testing positive, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“You can test positive for COVID for many weeks after your initial test because you may still have broken down viral particles that are still hanging out in your respiratory system,” she said. “This is why I don’t recommend getting retested after an infection. Ten days after an infection, as long as you don’t have symptoms, you are no longer considered contagious, even if your tests keep coming back positive.