Can you be reinfected with COVID? What we know and don’t

Since the beginning of the coronavirus pandemic, experts have grappled with the question of whether or not a patient who recovers from COVID-19 can contract the disease again. Although coronavirus reinfections are rare, there are several documented cases where it appears to have happened. Scientists are particularly interested in these cases because they could teach us a lot about how the coronavirus makes people sick, as well as how vaccines might be able to help end the pandemic.

There are also practical considerations. For example, if you’ve recovered from COVID-19, do you still need to wear a mask when you go out in public? Should you get a vaccine when one becomes available or will you not need one now?

Like many questions surrounding the coronavirus, there’s still much we don’t know. That’s why experts almost always recommend an abundance of caution when making decisions that could affect your health or the wellbeing of others.

Here, we walk you through what doctors know and, just as importantly, what they don’t know about COVID-19 reinfection, including what to look out for and steps you can take to help protect yourself. This article is intended to be a general overview and not a source of medical advice. If you think you might have COVID-19, here’s how to find a nearby testing site.

Is getting reinfected with COVID-19 something I should worry about?

In most confirmed cases of reinfection, the patient first tested positive for SARS-Cov-2, the virus that causes COVID-19 disease, then at some point tested negative before testing positive for a second time. Although several dozen cases have been reported, they represent a very small percentage of the over 45 million total confirmed cases worldwide, according to Johns Hopkins University. 

In other words, while reinfection can happen in very limited circumstances, it’s not a common occurrence. “Real-world experience suggests reinfections are very rare, but would be interesting to see if there is a seasonality to the virus with waning immunity next year,” Dr. Onyema Ogbuagu, a Yale Medicine infectious disease specialist, told Heathline.

Translation: It’s really not anything you need to worry about right now.

How do I know if I’ve been reinfected or if COVID just never went away?

Some people who feel sick weeks or even months after testing positive for COVID-19 may still be experiencing symptoms as a result of the initial infection, aka “long-haulers.” 

In other instances, doctors have run genetic analyses on samples of the virus taken from patients during the first infection and then again during the second. In cases where those samples showed genetically significant differences, scientists have concluded they were separate, unrelated infections.

Unless you get extensive testing, you probably won’t know for certain whether a recurrence of COVID-19 is a bona fide reinfection or an example of a long-hauler coronavirus infection.

Are you better or worse the second time you get COVID-19?

Again, you will need COVID test results to determine if your symptoms are connected to your initial infection or if they’re new.

With most viruses, a second infection is usually milder than the first because the body has built antibodies against it. However, that’s not always the case, and there’s still much about SARS-CoV-2 doctors are continuing to reveal. With some viruses, already having antibodies for the virus can actually make a second infection worse. Dengue fever and Zika virus are familiar examples. 

For most patients who’ve had COVID-19 more than once, symptoms have typically been mild or absent entirely with a second bout with the virus. But some patients’ second illnesses have actually been worse compared to their first infection. It’s too soon to know for sure which reaction is more typical, plus there are too few cases to study.

Am I immune from COVID-19 if I’ve already had it once?

The immune system is a complicated network of organs, tissues and cells that work together to protect the body against disease. It doesn’t have an on/off switch. Rather, there are varying degrees of immunity one may have against a particular pathogen or germ.

Doctors and scientists have so far avoided making any strong claims about lasting immunity to COVID-19. According to epidemiologists, reinfection is unlikely for the first three months after testing positive for the virus.

How does COVID-19 reinfection affect a potential vaccine?

We won’t really know until one or more vaccines are approved and widely distributed, but doctors are hopeful that coronavirus vaccines will give people at least enough immunity to be able to resume normal life once enough people have been vaccinated. That’s because in the vast majority of cases, COVID-19 patients have so far not appeared to contract the virus a second time, which gives scientists some hope that a vaccine will work.

In fact, cases of coronavirus reinfection could help researchers better understand how to best distribute and administer a vaccine. For example, it may be necessary to give people regular booster shots, which reinforce immunity, until the virus is completely contained.

Do I still have to wear a mask or social distance if I’ve had COVID-19?

Every public health organization, including the US Centers for Disease Control and Prevention and the World Health Organization, recommends the same set of safety precautions for everyone regardless of whether or not they’ve had COVID-19 in the past. (The only exceptions are for cases of active infections, which call for even more stringent protocols.) That means masks, social distancing, hand washing, regular surface cleaning — everything experts have been telling us to do since the beginning of the pandemic.

For specific details on that and more, here’s how to sanitize your home and car, where to buy the most popular face mask styles and how to more safely enjoy a restaurant meal during the pandemic.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.