the HAS issues the following recommendations:
- Immunocompetent people who have had a dated SARS-CoV-2 infection (symptomatic or not) proven by a PCR or antigenic test should be considered as protected for at least 3 months, but more probably 6 months, against infection by SARS-CoV-2 by post-infectious immunity. It is therefore recommended to carry out their vaccination beyond this period of 3 months after infection, preferably with a period close to 6 months. It appears reasonable that people at risk of severe disease should be vaccinated as a priority, as defined in the vaccination strategy developed by the HAS.
- In the event of prolonged symptoms after Covid-19, an appropriate medical consultation is necessary before the vaccination to judge the benefit of the vaccination on a case-by-case basis.
- Performing a pre-vaccine serology is not relevant and therefore not recommended, however, in the event of positive serology performed previously, without the infection being dated, the period from 3 months to 6 months begins on the date of the serology.
- Considering the currently available evidence, the immune response to vaccination of people who have already been infected is of anamnestic type. Therefore, the HAS recommends offering only a single dose to immunocompetent people who have had an infection with SARS-CoV-2 because they have already developed an immune memory during the infection. The single dose of vaccine will thus act as a booster. If the second dose of vaccine has already been administered to people with a history of infection with SARS-Cov-2, the data available to date do not show any difference in the safety profile apart from the occurrence of reactogenicity effects.
- People with proven immunosuppression (especially receiving immunosuppressive therapy) should, within 3 months of the onset of SARS-CoV-2 infection, be vaccinated using the 2-dose schedule. In situations of prolonged infection, specialist advice is required for vaccination.
- People with a PCR-positive SARS-CoV-2 infection after the 1st dose of vaccine and who have not yet received the 2nd dose should not receive this 2nd dose within the usual timeframe, but within 6 months and not until 3 months after infection.
These recommendations reflect the analysis of the literature as of February 10, 2021. They may therefore be updated according to new evidence on the infection by SARS-CoV-2, in particular in view of the data on the immunological response to vaccination of persons previously infected with SARS-CoV-2 and knowledge on the variants.