There's been a long COVID-related rise in self-reported disability. Notice how the rise starting in mid-2020 mostly has to do with an increase in difficulty remembering things? That's the brain fog symptom everyone became aware of.

Importantly, in both the ACS—which lacks specific long COVID questions—and in the Household Pulse Survey—which added them in 2022—there's a curious demographic concentration of, first, new disability, and second, long COVID reports: Young, female, Hispanic, and poorly-educated.

The timeline for long COVID as a meme is basically: Spring/Summer 2020: Patient groups, the media mainstream the idea. Survivor Corps, Body Politic, NYT articles, Mount Sinai's dedicated post-COVID clinic, Ed Yong's Atlantic article.

Official recognition picked up from Summer/Fall 2020 CDC flagged prolonged illness in a late July 2020 MMWR release (69(30);993-998) In 2021, the CDC posted clinician guidance on post-COVID conditions, the NIH announced RECOVER, and HHS clarified long COVID can be a disability

At this point, self-diagnosis was way up. Women led the way on that. From mid-2020 on, women's reporting growth outpaced men's. It was only with mainstreaming that women stopped running away with it.

And this was a particularly common thing to report among the less educated. Just look at the scale of that relative increase!

Various sources agreed about the scale of these numbers. They also agreed about manifestations, demographics, and when possible, contributions to increased disability self-reporting.

The people suffering from long COVID did claim to be disabled, which led to a curious change in the employment rate of people with disabilities It took off! Compared to people disabled before COVID, long COVID sufferers were clearly different, generally not as severely disabled

That means that the nature of disability changed. And it did. If the pandemic's increase in disability was like existing disability, then it wouldn't have been so singularly about difficulties the media associated with long COVID.

Moreover, these disability sufferers likely didn't receive SSDI benefits as often as earlier disabled cohorts. Notice how active claims look in 2021:

Ultimately, what should be done to assess this increase in disability is 1. Lay out the demographic similarity with long COVID sufferers in long COVID surveys 2. Examine demographic changes in disability sufferers 3. Check for measurement invariance in the questions over time

That should all be pretty easy. Now, with that said, notice the timing: the long COVID meme progressed in survey data from when it was invented in 2020. It does not look vaccine-related. Looking at different subgroups (e.g., the old, men vs women, etc.) makes that even clearer.

It's likely that, if anything, vaccination helps to prevent people from reporting they're long COVID sufferers. It might even have therapeutic value for those currently suffering, whether for real or psychosomatic reasons—ultimately, the reason is irrelevant.

Across several large cohorts, there seems to be a consistent benefit to being vaccinated when it comes to long COVID risk. This is true the world over, from North America to Europe to Asia.

This protective effect could be a healthy vaccinee bias in some cases. But not all. For example, we have some target trial emulation studies that produced results like this, where remission of long COVID symptoms followed vaccination.

Given all of the results (more papers, some reviews linked below), we should have a strong prior that vaccination would reduce the extent and help with the recovery of these long COVID sufferers. Or at least, that it did.

And this makes sense: we know vaccination prevented serious symptoms, and we know that serious symptoms predict and can lead to post-acute sequelae, including things that would be classified as long COVID symptoms.

And that's really all I have to say on that. There was not a vaccine-related rise in disability, but there was a COVID-related one. Sources: More: (and better: Household Pulse Survey: Disability reports, 16-64 y/o women: Disability reports, 16-64 y/o men: