Welcome to COVID Questions, TIME’s advice column. We’re trying to make living through the pandemic a little easier, with expert-backed answers to your toughest coronavirus-related dilemmas. While we can’t and don’t offer medical advice—those questions should go to your doctor—we hope this column will help you sort through this stressful and confusing time. Got a question? We are here to help. firstname.lastname@example.org.
Today, A.B. asks:
“I’m fully vaccinated, boosted and have recently recovered from a breakthrough infection. Can I go back to normal now?”
Certain pathogens are difficult to stop for the immune system. Others, such as coronaviruses, which cause common colds, can make a person sick for years.
Like other coronaviruses it is possible to infect multiple people with the COVID-19 virus. The body gets better at fighting it after each exposure or vaccine dose, meaning future brushes with the virus will likely be milder, but there doesn’t seem to be a point at which the risk of infection completely disappears.
“There’s probably always a level of exposure to the virus that could overcome the level of immunity you have,” says Dr. Rachel Presti, an infectious disease researcher at the Washington University School of Medicine in St. Louis. That’s especially true if you’re elderly, have underlying medical conditions or are immunocompromised.
Even with those caveats, there’s a lot of good news for fully vaccinated and boosted people who have recovered from a recent COVID-19 infection. This group has multiple defenses against the virus. And, assuming you’re generally healthy, experts say that leaves you with a grace period of at least three to six months during which you’re unlikely to get sick again.
According to the latest federal analysis, which included data from fall 2021, a fully vaccinated and boosted person in the U.S. was 10 times less likely to test positive for COVID-19—and 20 times less likely to die from it—compared to an unvaccinated adult. Data from the Omicron swarm in the U.K. has shown that fully vaccinated, boosted individuals are still significantly less susceptible to contracting the disease than those who were not. But, it is possible to get a breakthrough infection. The majority of cases in boosted adults are mild.
COVID-19 is not something you should try and catch, however there are some silver linings to it. An immune response is activated, which provides an additional layer of protection.
Presti states the body will mount a broad-ranging immune reaction when it is exposed to the virus, and not a vaccine. You will probably have a more powerful and robust immune profile after a (hopefully mild!) infection.
One small study of fully vaccinated health care workers who had breakthrough infections before the Omicron surge found that they experienced “substantial” jumps in antibodies after their illnesses, even though most were mild. Research has also shown that Omicron-related infections can be overcome by people with immunity to both Omicron variants and Delta variants. And a recent report from the U.S. Centers for Disease Control and Prevention found that case rates during the Delta wave—which was before Omicron and widespread boosters—were lower among people who were previously diagnosed with COVID-19 than people who were just vaccinated.
Why get vaccinated if you can protect yourself from infection? Immunization is safer than vaccination. Presti also says that vaccine-derived immunity is less reliable than post-infection immunity. Some people generate many antibodies after an infection while others are left with few, and the average person won’t know how many they have.
Infection-derived immunity also wanes over time, so you can’t count on it forever. According to a December 2021 study, reinfection may occur from 3 months to several years following a COVID-19 infection. This could be due to variations in person’s health and age.
Immunity from vaccines wanes over time too. But early evidence shows that booster shots can provide more protection than initial shots.
Virk believes that a person fully vaccinated and boosted who has recovered from COVID-19 may feel quite safe during the first few months. “We don’t know” exactly how long protection lasts, Virk says. “But we think you will be protected for at least three to six months after your infection.”
During this window of time, when your immunity is strongest and you’re unlikely to get sick, you can also be fairly confident that you aren’t spreading the virus to anyone else. Indoor dining, visiting relatives and other activities are safer, but not necessarily risk-free. “If somebody just recently had Omicron after they already got boosted, maybe [they can be] a little bit more cavalier about wearing a mask and social distancing,” Virk says.
But you shouldn’t ignore COVID-19 completely. While you may be well protected—at least for a few months—others in your community are more vulnerable, which makes it important to slow COVID-19’s spread as much as possible. It’s always smart to limit your exposure to sick people, stay home if you develop respiratory symptoms and keep an eye on hospitalization trends in your area. Authorities might request that everyone temporarily resume indoor mask wear if the health system is in crisis. This will help to prevent a catastrophic collapse.
There’s also no predicting if or when there will be another new variant that challenges your hard-won immunity. Long-term complications of the virus, such as Long COVID, are being discovered by researchers.
Vaccinations and previous exposure to the virus mean that many Americans are much safer than in 2020, or last year. If you’re generally healthy, fully vaccinated and boosted and have recently recovered from a breakthrough infection, you are currently about as safe from COVID-19 as you can be.
“For a lot of people, the risk is kind of the same as the risk of getting a cold or a mild flu,” Presti says. “We used to live with that.” And before too long, we will again.