When is peak immunity after COVID booster shot?

By Lois K. Solomon

We are answering your questions about the coronavirus vaccines and what we need to do next. Submit your question using this form or email Lois Solomon at AskLois@sunsentinel.com.

Q. “How long after receiving the booster does peak immunity occur?” — Richard, Safety Harbor

A. Everyone has their own rate of antibody development, but the range is mostly from one to three weeks for peak immunity, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“Some people, mostly young and healthy, can develop peak antibody levels after seven days,” she said. “Older people, or those with compromised immune systems, can take much longer, up to three weeks to achieve peak immunity. “

Q. “The day after I was vaccinated I had mild tinnitus, pressure in my head, tingling and numbness in the left side of my face. Over the coming days I would also have twitching in my face, hands and feet. These effects lasted for three months. The worst part was having an episode of severe vertigo with nausea that lasted for nine days. Intervention with vestibular therapy helped to resolve that.

My doctor had suggested that I hold off on getting the second shot, and I still haven’t gotten it. I searched for answers to figure out what happened to me. I discovered a website, Vestibular.org, and looked at their forum on COVID-19 vaccine side effects, and found over 60 pages of comments from people who had similar issues.

I desperately want to get the second shot, but I am afraid to do so, fearing that I could have another reaction. Why doesn’t the media acknowledge these adverse effects, and why are we not hearing anything from the medical professionals?” — Diann Hasseman, Orlando

A. It’s been really hard for researchers to understand individuals’ adverse reactions after the COVID-19 vaccine. Tests on large populations have determined the vaccines are safe, but then there are people who have had experiences such as yours.

“With additional time and vaccine experience, what we know about your particular situation may change,” said Dr. Joanna Drowos, an associate professor of family medicine at Florida Atlantic University’s Charles E. Schmidt College of Medicine. “The challenge becomes that just because something is reported, it doesn’t mean that it was caused by receiving the vaccine, and if it happens rarely it is even harder to determine whether there is a link to the vaccine.”

There have been case reports where individual physicians describe neurologic symptoms following the vaccine, and some of these same symptoms have also occurred in patients who are infected with COVID-19. But Drowos said researchers are not seeing unfavorable responses commonly enough to attribute them to the vaccine, or to even determine the best approach forward for an individual patient.

“This doesn’t take away from what you and others are experiencing,” she said. “There just isn’t enough data or experience with these types of events yet in order to identify whether there is an increased risk of them occurring over what would occur in the general population,andhowtohandlesubsequent immunization.”

Q. “I am 55 with no underlying conditions and finished my two Pfizer shots six months ago. My wife is a high school teacher, teaching in an overcrowded classroom of 30-plus students all day. She just got her Pfizer booster shot. I am effectively exposed to whatever my wife is when she gets home each day. Can I get the booster?”

A. You are advised to get a booster only if you meet the criteria, and you don’t meet them at the moment. Federal health officials recommend the booster for people 65 and older; nursing home residents; adults 18 and older with chronic health problems; and frontline employees who work in health care, schools, grocery stores, nursing homes and other risky settings.

However, most vaccination sites in Florida are giving out boosters on the honor system and won’t question whether you fall into one of these categories. Talk with your doctor about whether your situation merits a third dose now.

Q. “Among those who were vaccinated and got COVID, were there any antibody tests given to determine if the vaccine was effective for those individuals? Why isn’t there a suggestion/requirement to have antibody tests first to determine if a booster would be necessary or helpful ?”— Fred Eng

A. The problem is each person produces a different amount and requires a different amount of antibodies to fight infections. There is no standardized quantity a test could show that would say, “You are protected.” Also it would be quite a challenge to test every American to see if each had enough antibodies to fight COVID. Does everyone then go back each week to see if their antibodies are still working? That would become expensive.

“Antibody testing is complicated,” said Dr. Andrea Klemes, chief medical officer at MDVIP, a physicians’ network with headquarters in Boca Raton. “The tests that are routinely run may not show if you have an antibody to the spike protein that you got from the vaccine. Research studies have been done though, with tests that can detect those antibodies, to show that those who are immunocompromised may not have had an effective response and that is why boosters have been recommended for those people.”

Federal health officials have issued blanket recommendations for certain groups to get the Pfizer booster, no matter their antibody levels, as it would be almost impossible to test individuals on a massive scale. This group includes the immunocompromised, people over 65 and people who are exposed because of their jobs. “There is not a current recommendation to test someone for antibodies before getting the booster,” she said.