Issue: November 2022
Fact checked byShenaz Bagha

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October 07, 2022
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COVID-19 boosters reduce symptom severity and duration

Issue: November 2022
Fact checked byShenaz Bagha
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People who received a booster dose of the COVID-19 vaccine had reduced symptom severity and duration across delta and omicron variant predominance, according to data from the COVID-Out trial.

“The manuscript on the effect of vaccination versus COVID-19 symptom severity and duration was a substudy of the COVID-Out trial data,” David R. Boulware MD, MPH, CTropMed, FIDSA, a professor of medicine in the department of medicine at the University of Minnesota Medical School, told Healio. “As none of the medicines studied in the trial — metformin, ivermectin, or low-dose fluvoxamine — reduced COVID-19 symptom duration, we wondered if the FDA-recommended symptom severity scale was just insensitive to detect any differences in symptoms. Thus, we decided to look at vaccination status versus symptom severity over time.”

IDN1022Boulware_Graphic_01_WEB

Boulware and colleagues used patient data from the COVID-Out trial on early outpatient COVID-19 therapy testing metformin, ivermectin and/or fluvoxamine. According to the study, participants were given a paper symptom diary which allowed them to rate the severity of symptoms as none, mild, moderate or severe.

The researchers then used generalized estimating equations and compared those data between unvaccinated, vaccinated with primary vaccine series only, or vaccine-boosted study participants to provide a secondary analysis of clinical trial data on symptom severity over time.

Overall, the parent clinical trial prospectively enrolled 1,323 people, of whom 1,062 (80%) prospectively recorded daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with their primary series only and 52 (5%) were vaccine-boosted.

The study showed that overall symptoms were the least severe for the vaccine-boosted group and most severe for participants who were unvaccinated at baseline and over 14 days. According to the data, average symptom severity was 1.2 points lower (95% CI, 0.6-1.8 points) among vaccinated participants compared with unvaccinated participants, and three points lower (95% CI, 2.1-3.9 points) among boosted participants compared with unvaccinated participants.

The researchers added that individual symptoms including cough, chills, fever, nausea, fatigue, myalgia, headache and diarrhea, as well as changes in smell and taste, were also the least severe in the vaccine-boosted group. The authors added that these results were consistent across delta and omicron variant predominance.

“This is a somewhat obvious clinical observation in practice, but no one had actually published quantitative data on this issue,” Boulware said.

He also clarified that these data were true with the original booster — meaning a third dose — but said they would also be true of the current booster as well from the basics of immunology principles.

“Even if you are at low risk for developing severe COVID-19 and requiring hospitalization, getting a COVID vaccine booster will lessen symptom severity and duration if you acquire COVID-19,” Boulware said. “No one likes to be sick. Getting a COVID booster is the best way to shorten duration of illness.”

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