I used to think, “I had COVID. I don’t need a vaccine… not for now at least, and maybe not ever.”

November 2020: I was a few hours into my 12-hour shift in the emergency department. I had been treating COVID at every shift for about 10 months at that point, and I knew what I was feeling now was more than just fatigue. I took a swab and went into the staff bathroom to use the mirror.

I waited for about 45 minutes for the results, looking at the schedule to see who would be available to cover for me if my test came back positive, knowing my already tired colleagues were going to have to pick up my slack.

It was positive.

I went into the breakroom with my mind whirling. Honestly, I almost started to cry. But it wasn’t out of fear or anxiety. It was a mix of emotions, but the strongest was probably relief. I had been fighting this beast for months, day after day, hour after hour, and I was tired. I was worn out. Physically and emotionally. A forced, 10-day reprieve seemed like a gift. Being sick seemed almost worth it.

But I also knew that my infection was, and likely already had, exposed my family, including my older parents and my son with asthma. I know I saw the sickest of the sick, those with all the risk factors; however, I also saw the exceptions to the rule, those with no risk factors. And I saw a lot of death. While most of my patients survived, I saw the worst results of this pandemic. I knew that while the odds were still in our favor, it was still a gamble as to who in my family could possibly be one of those exceptions.

Within a few days, my wife and kids all developed symptoms. My wife and I, following the statistics, had much worse symptoms than my kids, including my son with asthma, but in the end, we all had a relatively quick and uneventful recovery.

Back when I was an active-duty Air Force physician, one of my jobs was to manage the immunization clinic. We reported any adverse reaction into the Vaccine Adverse Event Reporting System (VAERS). Most of these adverse reactions were very mild, but we reported all of them. We had a few more serious reactions, but these were not severe. All this to say that I understand vaccines are not without risk. Any medicines, including lifesaving, beneficial ones, have the risk of side effects. And sometimes, these side effects are very significant.

With that experience and knowledge, considering what we were dealing with in my local emergency department and what was happening globally, back in November of 2020, I was thrilled that we had a COVID vaccine coming soon. I was planning on getting the vaccine as soon as I was eligible.

But then I got COVID.

And about two weeks after I was diagnosed, the first vaccine was released to the public. But by then, I didn’t think I needed the vaccine.

Based on the data, I knew I had a very good chance at being protected from this pandemic. In fact, when I write this in August of 2021, it appears that those who had moderate COVID symptoms likely have antibodies against SARS-CoV-2 that will last for at least 18 months, maybe longer still.

Remember that COVID-19 is the manifestation of symptoms from infection by the SARS-CoV-2 virus … sort of like HIV (Human Immunodeficiency Virus) causes symptomatic AIDS (AutoImmune Deficiency Syndrome). Those who had SARS-CoV-2 infections with very mild to no COVID symptoms seem to have shorter-lived antibodies. Those who had very bad symptoms also have shorter-lived antibodies. But those in the middle (like me), seem to create the strongest and longest-lived antibodies.

Also recall that vaccines work by making our body think it was infected by a bad virus or bacteria that causes disease (tetanus, rabies, polio, influenza, etc.). When our body is (or thinks it is) infected, it creates special cells called antibodies that remember what the bad virus or bacteria look like.

The next time the antibodies see the bad virus or bacteria, they recognize and attach themselves to that bad virus or bacteria. This prevents the virus or bacteria from entering cells to cause an infection, but it also calls in other immune cells to attack and kill the bad virus or bacteria.

If your body encounters the real virus or bacteria, the immune system attacks it. The result is that you typically get a very mild infection with very mild symptoms or even better, you don’t get the infection at all.

But viruses mutate, and other strains (variants) can develop.

The next question is: “If my body developed antibodies to one variant of COVID, will my immune system (antibodies) recognize the variant and appropriately respond to it?”

It depends on how much the virus mutates.

If the virus mutates a little bit, it’s likely that the virus will still be recognized by the antibodies. Kind of like if your best friend cut their hair… you would still recognize them.

But occasionally, a virus may mutate a lot, and then maybe the antibodies won’t recognize the virus. Sort of like if your best friend cut and dyed their hair, wore a big hat, and spoke in a foreign accent. You may still recognize them, but maybe you wouldn’t.

And this finally brings us to my decision to get vaccinated.

We are now seeing patients who are getting COVID a second time. This means that either their antibodies didn’t last long enough or the virus mutated enough to fool the antibodies of our immune system. And all evidence points to the latter. SARS-CoV-2 has finally mutated enough that the vaccine is needed.

Right now, almost all cases of COVID in the United States are caused by the Delta Variant – it is very contagious and seems to be affecting younger people more than the initial virus did.

Greater than 90 percent of the deaths from COVID-19 in the United States are occurring in unvaccinated individuals.

Even if you’ve had COVID previously, you are twice as likely to catch SARS-CoV-2 a second time if you are unvaccinated than if you had the vaccine.

To be clear, the vaccine doesn’t prevent you from getting COVID, but it increases your chance of staying out of the hospital and greatly increases your chance of surviving it.

The vaccine is like wearing a bullet-proof vest in a gunfight. You could still get shot in the head (and die) or get shot in the leg (and be seriously injured), but your chances of survival are greatly improved.

I would want a bullet-proof vest if I was in a gunfight. It’s why I’m vaccinated, and it’s why my wife and eligible children are vaccinated.

I encourage you to do the same.

John Kitsteiner is an emergency physician.

Image credit: Shutterstock.com