Long Vax is delayed onset Long COVID

Abstract

Long COVID is a common chronic health condition that impairs daily functioning and social connection. It affects multiple organs and is marked by fatigue, post-exertional malaise, cognitive impairment, and many autonomic dysfunctions. Post COVID-19 Vaccination Syndrome (PCVS), Post Acute Covid Vaccination Syndrome (PACVS), or simply ‘Long Vax’ is a large set of similar symptoms that first manifest hours, days or weeks following a COVID-19 vaccination. Perhaps because of the pandemic’s public health imperative to vaccinate populations and prevent acute COVID-19 deaths, the Long Vax phenomenon has been slow to be acknowledged and to the frustrated patient community post-vaccine issues seem like a taboo medical topic. Meanwhile, evidence is accumulating that low-level persistence of SARS-CoV-2 virus in a variety of cell types and tissues may be the root cause of Long COVID symptoms. We propose that based on the similarity of patient-reported symptoms, symptom prevalence, and patient demographics that Long COVID and Long Vax are the same medical condition. Furthermore, we propose that both have the same underlying pathobiology; viral persistence of SARS-CoV-2. This hypothesis implies that the same treatments that help Long COVID patients will also help Long Vax patients. It is important that Long Vax patients be identified in Long COVID cohorts and included for subgroup analyses in Long COVID clinical trials. As biomarkers and diagnostic tests for Long COVID are developed and validated, this hypothesis becomes easily testable as it predicts that the same measures will also be useful for characterizing Long Vax patients.