[talkingtab]

My experience was odd. And this is just a description with no science.

I was vaccinated, got COVID. At no point were my symptoms serious. Because of age and past heart issues I was given paxlovid. Two weeks after the paxlovid (or something like that) I became sick again, more seriously. With COVID. The symptoms I experienced were much worse but not life threatening and I recovered fully. However, it was odd that the COVID came roaring back. My conjecture is that the paxlovid suppressed COVID, but that caused my body to falter in terms of building immunity. So when the paxlovid wore off, I was actually worse off. In the same situation I would NOT take the paxlovid again unless it was clear I had serious symptoms - like I was going to end up hospitialized. I acknowledge there is no science here, but on the other hand none of the doctors were able to suggest why I had a second episode so quickly and why it was more severe.

My conclusion is that there was a lot of guessing, placebo, reassuring, best guessing going on. I think that is the take away if we face such a thing again.

[tehjoker]

If you take Paxlovid for 5 days, there is a risk of rebound. It's not guaranteed that the rebound will be "mild". Basically, if you take it early, the virus is suppressed before your immune system ramps, so if it recovers, you get potentially a regular course of COVID....

There's some talk that maybe the course should really be for 10 days, but the pharma companies are charging insane prices for it far beyond their costs.

[thenerdhead]

there are a number of computational/modeling studies suggesting paxlovid needs to be given for at least 7+ days to slow the viral load and prevent rebound.

Pfizer did a preliminary study(the FDA asked them) and quietly published their results on the topic. their data implies a second treatment might shorten the overall duration of the infection consistent with the studies i allude to above. but you probably haven't heard about this news!

https://clinicaltrials.gov/study/NCT05567952?tab=results

[jerlam]

The Paxlovid dosing guidelines probably need to be changed, but given the current climate and cost it's unlikely to ever happen.

Similarly, the initial two-shot vaccine guidelines probably needed more time in between the doses for more effectiveness, but that's what was tested so that's the official recommendation.

[thenerdhead]

agreed on changing guidelines, disagree its unlikely to happen.

the study is done and just needs to be formally published. then recommendations can "officially" change although the science has been clear about this for quite some time now with this specific drug.

other antivirals dont have this problem because they are actually effective for 10+ days even if you take it for 5 days (Ensitrelvir).

there's countless candidates in the pipeline as well for vaccines, antivirals, and monoclonal antibodies. as they keep getting better, the guidelines will shift slowly but surely.

i personally wish we did this with more urgency.

[CaliforniaKarl]

Research "Paxlovid rebound". It sounds like that is what hit you.

[nanodeath]

To add to the anecdata here, I had covid for a week (bedridden but otherwise not that bad), then had a single day in which I tested negative, and then it rebounded for a week, due to Paxlovid. Sounded like it was pretty common. So that was a waste of 15 days. On the plus side, my second week was much the same as the first week as far as symptoms go.

[cavisne]

Another example is Joe Biden, who had this exact thing happen (covid twice in a row with paxlovid).

Notable because while the chance of him just catching it again from someone are not 0, but about as low as it can go (an elderly POTUS under intense medical supervision and quarantine procedures).

[cameldrv]

There was a study out about a year ago that showed that you were pretty likely to rebound if you took it on the first day of symptoms, and very unlikely (it was something like 0/30 people) to rebound if you waited until the third day.

[gwervc]

> I was vaccinated, got COVID

How is this possible?

[boroboro4]

Just like it's possible to get COVID again and again. Neither your immune system nor COVID variant are stay the same over time.

[MrVandemar]

Several ways.

To start with, I'm pretty sure it was established early on that the various vaccines don't prevent infection necessarily, but rather reduce the severity of the symptoms.

Vaccines are always one step behind, like they are for Influenza. You can get vaccinated against last years, and still catch this years.

Maybe the vaccine that was given was not given or stored correctly. There were also stories of anti-vaxxer medical staff giving fake vaccinations to people.

And biology is weird and complicated. Given the large human population and diversity, at some point there'll be an exception.

[terribleperson]

Vaccines aren't total protection. Notably, you can get chicken pox as a child despite having been vaccinated for it, it simply reduces the severity.