Efthimis writes:

Hi Daniel and Vincent!

What an enjoyable 1000th episode! This is so exciting that twiv has been this successful. Congratulations on this huge milestone!

Dr. Griffin, during this episode you mentioned you got infected with Dengue virus twice before you became extremely curious about virology. 

I am fascinated with Dengue virus above all other viruses and I would love to learn more. 

-Could you go more in depth about your experiences during both infections?

-Which serotypes did you get infected with?

-What symptoms do you expect the disease to give you if you were to get a third Dengue infection?

-About how deadly is Dengue for every subsequent infection? Is the third Dengue infection much deadlier than the second? The data for this seems to be inconsistent so I am not sure what to believe.

Thank you so much! Go twiv!



Matthew writes:

Dear Dr Griffin,

I am a healthy 45-year-old man who received the second dose of the Pfizer covid vaccine in 2021, three weeks after the first dose. I have not tested positive for covid at any time and have not had any symptomatic respiratory infection for at least five years. I lead a normal life and don’t usually wear a mask, so it strikes me as unlikely (although not impossible) that I have not had an asymptomatic infection. I eat a healthy plant-based diet and exercise at least 30 minutes a day. I am a healthy weight with no medical conditions. I’ve heard you mention several times that the three-week gap was too short and that the vaccine should really be considered a three-dose vaccine. However, isn’t it likely that as almost two years have passed since my second dose, the memory B-cells have already matured in this time with or without asymptomatic infection? I don’t really see much value in a booster and in some countries like the UK would not even be entitled to one. The bivalent booster is available to me but I’m not inclined to get it as the risk of serious disease seems so low. Do you see any flaws in my analysis?

Kind regards,


Louise writes:

I am a family physician in suburban Pennsylvania, and in March my nephew brought home a cold, and his eight-month-old daughter ended up having a seizure and was diagnosed with human meta-Pneumovirus. I have not taken care of adults or children with this and  I am curious if Daniel has seen much of this in his adult population in addition to the RSV which you have discussed. Thank you-I love the podcast. I try to encourage my anti-VAX patients to listen to you.


JB writes:

I am a primary care physician actively caring for Covid patients who recently contracted Covid for the first time. Fully vaccinated but based on risk factors, took Paxlovid on the day that it tested positive. Initially felt good but day 3 felt extremely fatigued. By day 5 felt better and by antigen test negative. Returned to work while masking and on day 10 started feeling URI symptoms again. Tested positive for the next 5 days on antigen tests. SaO2 totally normal through the second week. Mike Osterholm said he took a second course of Paxlovid. For folks that get ill again after Paxlovid treatment  that clearly aren’t hypoxic, is there a role for retreating with an antiviral?

As a follow up, is it possible that we may be treating too early with antivirals (as in my case where I could test ad lib and initiate antiviral immediately) and not allowing the immune system to get fully “engaged” leading to recrudescence of symptoms?

I have followed TWIV since early on and value all of the information for those of us in primary care.

J.B. Ketner, MD

Seward, NE