How can vaccination status change Covid symptoms? ER doctor explains what to look for

A New York emergency room doctor has explained which symptoms his Covid patients typically get, depending on which – and how many – vaccine shots they’ve received. Unsurprisingly, the unvaccinated patients fare the worst.

“I’ve seen a lot of Covid in the ER recently,” tweeted Dr Craig Spencer, director of global health in emergency medicine at Columbia University Irving Medical Center. “With so many people getting infected recently, some folks may wonder what’s the point of getting vaccinated at all? And is there really any value to a booster dose if I’ve had two Pfizer/Moderna or a shot of J&J?”

According to Dr Spencer, the answer to that second question is definitely yes.

“​​Every patient I’ve seen with Covid that’s had a 3rd ‘booster’ dose has had mild symptoms,” he wrote. “By mild I mean mostly sore throat. Lots of sore throat. Also some fatigue, maybe some muscle pain. No difficulty breathing. No shortness of breath. All a little uncomfortable, but fine.”

As the Omicron variant spreads rapidly through the US population, hospitals are finding that huge proportions of their patients test positive for Covid-19 – even the ones who were hospitalized for something else. With so many Covid cases to observe, including mild and asymptomatic ones, Dr Spencer has noticed some patterns.

One of those patterns, he says, is that three shots is better than two.

“Most patients I’ve seen that had 2 doses of Pfizer/Moderna still had ‘mild’ symptoms, but more than those who had received a third dose,” Dr Spencer wrote. “More fatigued. More fever. More coughing. A little more miserable overall. But no shortness of breath. No difficulty breathing. Mostly fine.”

And two shots is better than one, in the form of the single-dose Johnson & Johnson vaccine.

“Most patients I’ve seen that had one dose of J&J and had Covid were worse overall,” Dr Spencer tweeted. “Felt horrible. Fever for a few days (or more). Weak, tired. Some shortness of breath and cough. But not one needing hospitalization. Not one needing oxygen. Not great. But not life-threatening.”

The ER doctor urged anyone who’d only received the Johnson & Johnson shot to get a booster of the Pfizer or Moderna vaccine – “ASAP!”

But even those patients, he said, suffered much less than those who hadn’t been vaccinated at all.

“Almost every single patient that I’ve taken care of that needed to be admitted for Covid has been unvaccinated,” Dr Spencer wrote. “Everyone with profound shortness of breath. Everyone whose oxygen dropped when they walked. Everyone needing oxygen to breathe regularly…”

“They’re the most likely to have complications,” he went on. “They’re the most likely to get admitted. And the most likely to stay in the hospital for days or longer with severe Covid.”

Dr Spencer noted that these were only his personal observations, not a scientific study – but his conclusions largely match the national data. In October 2021, according to the CDC, unvaccinated Americans died of Covid at 14 times the rate of the fully vaccinated, and 20 times the rate of those who’d received both a vaccine and a booster shot.

“So no matter your political affiliation, or thoughts on masks, or where you live in this country, as an ER doctor you’d trust with your life if you rolled into my emergency room at 3am, I promise you that you’d rather face the oncoming Omicron wave vaccinated,” Dr Spencer said. “Please be safe.”