Billy Culbertson got COVID-19 almost exactly a year ago and spent two days in the hospital.

When he recovered, he said, he figured COVID was a worry of the past.

“That was basically my exact mentality,” he told FOX10 News in a text message. “I’m healthy, I work out every day, I eat mostly healthy, take vitamins, I figured I had the antibodies and I was in the clear.”

But the 43-year-old Spanish Fort man got a surprise last week when he tested positive again. He indicated that his breathing became so labored that he went to the emergency room at Thomas Hospital on Monday. He has been there ever since.

Culbertson, an aspiring actor, told FOX10 News that breathing difficulties made it hard for him to talk. But he communicated through text messages.

“At first I just thought it was a cold, sinus infection, basically anything other than COVID-19 again,” he wrote.

He added that on Tuesday and Wednesday of last week, he lost his sense of taste and experienced an “overwhelming gut feeling” that convinced him he did, indeed, have the disease again.

Culbertson is not alone. State health officials say it is rare for someone to contract the virus twice, but they add that the number is rising, especially with new, more-contagious variants circulating.

The Alabama Department of Public Health estimates more than 4,800 residents have had the virus more than once.

“Now we have Delta variant,” said Rendi Murphree, the top epidemiologist at the Mobile County Health Department. “I mean, people could get COVID, you know, two, three, four times, you know, depending on how this thing plays out.”

Murphree, director of the department’s Bureau of Disease Surveillance and Environmental Services, told FOX10 News that a COVID-19 infection typically confers at least 90 days of natural immunity.

“But beyond that, very little is known, and we’ve been, you know, trying to remind people that, you know, you don’t have full immunity just because you had COVID last year or four months ago,” she said.

Murphree said researchers are trying to figure out if having COVID previously makes someone less likely to have a severe case the second time.

Alabama Assistant State Health Officer Dr. Karen Landers said early experience has been all over the map.

“We’ve actually seen a range in re-infection from not so severe to very severe illness and even death. So, this is something that I want to remind people, COVID is a severe and deadly disease.”

Culbertson told FOX10 News that the second time has been worse.

“It hit harder this time,” he wrote. “The headaches and body aches have been way worse this time. The not being able to breathe and constantly coughing is considerably worse.”

Culbertson told FOX10 News that his doctor told him the current infection is from a variant but did not specify which one.

Landers said natural immunity is not as “durable’ as vaccine-induced immunity. Confusion over that has contributed to low vaccination rates, she added.

“It absolutely is a factor and regrettably, this is part of misinformation that is circulating that’s not based upon science,” she said. “And this information is hurting people.”

Murphree said many factors can determine how long natural immunity lasts. It could depend on how much virus someone took on when he or she got infected and how the immune system reacted to that dose.

“And so, it's really just a gamble if you are relying on natural infection and natural immunity from a COVID infection to protect you,” she said.

Murphree acknowledged that the same sort of uncertainties over how long natural immunity lasts also apply to the vaccine. Manufacturers can only guess at how long they will offer protection.

“But that we can look at clinical data, right?” she said. “There are clinical trials ongoing. … We’ve learned those.”

When demand for vaccine was high and supply was scarce, health officials asked people not to get vaccinated if they had been infected in the previous 90 days. But there was no medical reason for that. Instead, Murphree said, it was an effort to conserve limited vaccine for the most vulnerable.

With more than enough vaccine, all that advice has changed.

“We don’t tell anybody to wait,” Murphree said. “And, in fact, if you come into our clinic and you test positive for COVID, we’ll vaccinate you before you go.”

Murphree said the vaccine will not do anything to help that infection. But she said it will help reduce chances of a second illness.

The only exception, according to officials, is for people who have had monoclonal antibody or convalescent plasma treatments. They should still wait 90 days.

“We’ll give it with flu shots in the fall,” Murphree said. “We’re giving it now for other, you know, childhood vaccines, adolescent vaccines, adult vaccines.”

Culbertson, meanwhile, told FOX10 News that he had a good talk with his doctor and believes the vaccine will slow the spread of the virus and reduce the intensity of the infection should he get COVID a third time.  

“I am definitely going to get it (the vaccine9 when it’s time now,” he wrote.

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