Should You Still Get a Booster Shot After a Breakthrough COVID Case?

People who get vaccinated against COVID-19 develop strong protection against severe illness, hospitalization, and death from the disease. But they can still get infected and have what is called a breakthrough case.

If you get a breakthrough infection will you need a booster shot down the line? Although current evidence shows that breakthrough cases can greatly enhance the degree of COVID-19 immunity, experts say you should still get the booster dose if you are recommended for it.

How Do Vaccines Compare to Natural Immunity?

Immunity to COVID-19 can be acquired in two different ways, either through natural infection or vaccination. Both will allow the body's immune system to produce antibodies that are necessary to fight the disease, but they are not entirely the same.

“Natural immunity confers some short-term protection against infection, but data now clearly shows protection from natural immunity is not as long-lasting as from vaccination,” Amber D'Souza, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, tells Verywell. “Among those who have had COVID, the risk of getting COVID again is higher among those who did not get vaccinated than those who got vaccinated.”

A recent Centers for Disease Control and Prevention (CDC) study shows that unvaccinated people who were previously infected are more than twice as likely to get COVID-19 again compared to those who are fully vaccinated. This suggests that vaccine-induced immunity may be greater than natural immunity.

However, Albert Shaw, MD, PhD, Yale Medicine infectious diseases specialist and professor of medicine at Yale School of Medicine, tells Verywell that there is a lot of variation in the immune response from infection to vaccination. It can be difficult to compare the two.

“Factors such as how much virus someone was exposed to and infected with, whether their course of COVID-19 was mild, moderate, or severe, as well as factors such as age and pre-existing medical conditions—which affect the function of the immune system—all play a role,” he adds.

Because of these factors, even the immune response from natural infection alone will not be the same across all individuals. However, with a vaccine, most people are administered the same dose, reducing the variability of the elicited immune response, to some extent. 

Compared to vaccination, getting COVID-19 is, by far, the more dangerous option.

Does a Breakthrough Case Increase Your Immunity?

For a while, there had been speculation about whether immunity from a breakthrough case would boost the current protection conferred by vaccines. Emerging evidence shows that breakthrough infections can significantly enhance the immune response to variants of the virus.

“A young, healthy fully vaccinated individual could have a breakthrough case and activate their immune system—especially the memory response of the immune system—and possibly have an increased immune response from re-exposure to SARS-CoV-2,” Shaw says.

More rigorous clinical studies are needed to understand the degree and duration of immunity from both natural infection and vaccines, but keep in mind that breakthrough infections are not recommended as a means to “boost” immunity.

Breakthrough cases are mild about 90% of the time, but the risk of hospitalization or death is still present, according to the American Medical Association.

Do You Still Need a Booster After a Breakthrough Infection?

The CDC recommends a booster dose for all eligible individuals—including persons who get a breakthrough infection. In fact, those who recently had a SARS-CoV-2 infection may consider delaying their primary series dose or booster shot by three months after the onset of symptoms or a positive test.

At this time, a COVID-19 booster dose is recommended for everyone 5 years and older who:

• Completed the Pfizer or Moderna primary vaccine series at least five months ago.
• Received the Johnson & Johnson vaccine at least two months ago.

A second booster dose is recommended for persons 12 years and older with certain kinds of immunocompromise and all adults 50 and older who have received an initial booster dose at least four months prior.

"Immunity after a breakthrough case is imperfect," David Dowdy, MD, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, tells Verywell. "People who have been infected should wait until after they have gotten better—and they may want to wait even longer after that—but it is suggested that they get a booster, if they are recommended for it.”

Ultimately, many factors have an impact on the degree of immunity that the body develops against infection, and “there is no ‘one-size-fits-all’ immune response to COVID-19,” Shaw says.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.