In a new study in Health Services Research, US researchers from the University of Georgia report that the cost of long COVID is making it harder for people to pay their bills, buy groceries, and pay for utilities. And those in the lower-income brackets are hardest hit by the chronic condition.
Related findings, meanwhile, show that the two-dose booster vaccine appears to cut the risk of long COVID by more than a third over and above the protection provided by the first three vaccine doses.
Study involved almost 10,000 with long COVID
The first study is based on findings from 271,076 adults who participated in the 2022 Behavioral Risk Factor Surveillance System (BRFSS). In total 9,998 participants said they had long COVID.
The study authors measured financial hardship caused by long COVID through three indicators: food insecurity, inability to pay bills, or the threat of losing utility services. Participants were asked to rate each indicator on a binary scale.
The people in lower income groups and those without college degrees were disproportionately affected by the condition. Food insecurity was the most prevalent indicator among adults with long COVID in all income and education groups other than the top income group. Long COVID was associated with an increase in the probability of experiencing food insecurity by 2 to 10 percentage points above what it would have been without long COVID.
Lower-income participants worked from home less
Participants in the lowest income group also reported being at risk of losing utilities and unable to pay bills. Only the two highest-income groups did not report these economic challenges, and the authors suggested that wealthy people with long COVID had sufficient resources to mitigate the short-term impacts of long COVID and had job flexibility to work from home if needed.
"Lower income groups probably have less savings and less to fall back on if something happens with their job," study author Ishtiaque Fazlul, PhD, said in a press release from the University of Georgia. "Lower socioeconomic groups also tend to have more hands-on jobs that have less opportunity to work from home. If their income decreases even by a little bit, they may cross a threshold that makes them food insecure and makes it difficult to pay bills."
Currently about 17.6 million Americans are thought to have long COVID, or persistent symptoms of COVID-19 infection lasting at least 3 months past initial infection. Long COVID is a growing source of disability.
People's financial well-being is being affected by long COVID.
"People's financial well-being is being affected by long COVID," Fazlul said. "That's something we should care about."
Bivalent booster reduces long COVID risk
In the second long-COVID study, published yesterday in Clinical Infectious Diseases, researchers found the bivalent (two-strain) COVID booster is associated with a 38% lower risk of long COVID over and above that provided by the original two-dose monovalent (single-strain) ancestral vaccine plus monovalent ancestral booster. The study was based on nearly 1 million people in Singapore.
This is one of the first studies to look at associations between bivalent boosters and long COVID following Omicron-variant infection.
The study compared outcomes after 1,080,348 vaccine-breakthrough infections after an ancestral mRNA booster, compared to 9,824 vaccine-breakthrough infections following a bivalent mRNA booster.
Overall, those who were infected after a bivalent booster had an estimated 37.8% lower risk of developing long COVID than those who only had an original vaccination series. Moreover, there was reduced risk of thrombotic disorders (hazard ratio [HR], 0.54), episodic neurologic disorders (HR, 0.55) movement disorders (HR, 0.57), and autoimmune vasculitis (HR, 0.54) 31 to 365 days post-infection amongst who received prior bivalent boosters, versus those boosted with ancestral mRNA vaccines, the authors said.
