Monday, March 27, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 0.25 ABIM MOC points
Nurses - 0.25 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)
Pharmacists - 0.25 Knowledge-based ACPE (0.025 CEUs)
Physician Assistant - 0.25 AAPA hour(s) of Category I credit
IPCE - 0.25 Interprofessional Continuing Education (IPCE) credit
This activity is intended for primary care physicians, infectious disease specialists, internal medicine clinicians, nurses, physician assistants, pharmacists, and other members of the healthcare team who care for patients at risk of COVID-19.
The goal of this activity is that members of the healthcare team will be able to understand whether COVID-19 vaccination is protective against long COVID.
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CME / ABIM MOC / CE Released: 4/1/2022
Valid for credit through: 4/1/2023
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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. It is the policy of Medscape Education to avoid the mention of brand names or specific manufacturers in accredited educational activities. However, manufacturer names related to COVID-19 vaccines may be provided in this activity to promote clarity. The use of manufacturer names should not be viewed as an endorsement by Medscape of any specific product or manufacturer.
The world is still reeling from the most recent surge of COVID-19 related to the Omicron variant. Nonetheless, the global incidence rate of COVID-19 has declined substantially during February. At the same time, there is concern that the Omicron BA.2 subvariant will promote the next global surge in infections. A preprint study by Lyngse and colleagues[1] assessed the ability of the BA.2 subvariant to infect household contacts, as well as vaccine efficacy against BA.2.
The study was conducted in Denmark during late December 2021 and January 2022. Of 8541 cases of COVID-19, about one-quarter were due to the BA.2 subvariant. The secondary attack rate of infection associated with the Omicron BA.1 and BA.2 subvariants were 29% and 39%, respectively, indicating increased transmissibility associated with BA.2.
Moreover, BA.2 was associated with a higher risk for transmission among household contacts regardless of their vaccination status; however, BA.2 was not more transmissible than BA.1 in cases in which the primary case had been fully vaccinated or had received a COVID-19 booster vaccine.
One of the most common significant consequences of any SARS-CoV-2 infection is prolonged symptoms over months after the infection. There have been multiple studies that evaluated the effect of COVID-19 vaccination and the risk for long COVID, and the current review by the UK Health Security Agency summarizes the findings from this body of research. Long COVID, also known as post acute sequalae of a SARS-CoV-2 infection and post COVID-19 syndrome, has several definitions, but most often includes having persistent symptoms of COVID-19, usually for weeks but potentially for months or years . Symptoms commonly include fatigue, shortness of breath and a persistent cough, although many other symptoms have been reported.
Vaccination against COVID-19 reduces the risk of developing long COVID and improves long COVID symptoms among persons who were unvaccinated when infected, according to a new comprehensive review by the UK Health Security Agency.[2]In all studies, fully vaccinated is defined as 2 doses of any 2-dose vaccine or 1 dose or a single dose vaccine, and partially vaccinated is defined as a single dose of a 2-dose vaccine.
The review includes data from 15 UK and international studies, with 7 studies examining whether COVID-19 vaccination before infection protects against developing long COVID and 7 studies looking at the impact of vaccination among people who already had long COVID. One study examined both.
In 6 studies, persons who received 1 or 2 vaccine doses before SARS-CoV-2 infection were less likely to develop symptoms of long COVID after infection.
In 2 studies, fully vaccinated people were less likely than unvaccinated people to develop medium- or long-term symptoms, such as fatigue, headache, weakness in the arms and legs, persistent muscle pain, hair loss, dizziness, shortness of breath, loss of smell, or lung scarring.
In addition, 3 studies comparing long COVID symptoms before and after vaccination found that most people reported an improvement in symptoms after vaccination, either immediately or over several weeks. A few cases reported a worsening in symptoms after vaccination.
“There is also evidence that unvaccinated people with long COVID who were subsequently vaccinated had, on average, reduced long COVID symptoms, or fewer long COVID symptoms than those who remained unvaccinated,” the review said.
Scientists are not yet sure why vaccination leads to an improvement in symptoms for some people, according to The Guardian.[3] Additional research is being conducted.
“The term ‘long COVID’ covers a wide range of post-COVID conditions and so we don’t yet fully understand all the processes involved,” Deborah Dunn-Walters, chair of the British Society for Immunology’s COVID-19 Taskforce, told the Science Media Centre.[4]
“The immune system is thought to play a role in symptom development in a significant number of cases, likely as a result of an overreactive and/or slightly misdirected immune response during the acute COVID infection,” she said.
