Bob writes:
Dr. Griffin, is it known whether the new RSV vaccine can be received concurrently with Covid-19 and/or influenza vaccines?
Bob
Jamie writes:
Dear Dr. Griffin,
I’ve listened to your weekly updates throughout the pandemic. I’ve used them to craft email blasts to my patients which (I think, I hope) have cut through some disinformation and helped people get vaccinated and treated. As a dermatologist, I have prescribed dozens of courses of Paxlovid when my patients could not reach their doctors or were told to “wait and see” even when they were high risk.
I wonder what you would advise me and people like me to do now that the PHE has ended.
I have a genetic immunodeficiency and secondary lymphoproliferative disorder. I’ve been on maintenance rituximab for 13 years, and despite holding it for 9 months from the start of the pandemic got no antibodies from any Covid vaccines (had to go back on when the LPD recurred). For 3 years I have worn a PAPR at work As a dermatologist and have to be right in people’s faces, even oropharnyx since I treat mucous membrane pemphigoid). I always wear an N95 at stores, never eat indoors and generally isolate BUT my daughter will be home from college and work at a summer camp this summer. I am left out of CME dinners and am not sure how safe I will be as the only masked person at conferences. My husband had Covid a month ago, and amazingly I did not get it. He isolated as soon as he developed symptoms (I think he got it on a plane 3 days prior)
There is no data on how people like me are faring with Covid. I have a plan, of course, and will get Paxlovid and likely convalescent plasma if I test positive. I don’t fight viral infections well, but IVIG has helped that area a lot, and I have survived influenza infections with a fairly normal course (and Tamiflu). The IVIG I get now was donated early 2022. No idea if that has protection.
Do I have to isolate forever? Do I have to make my daughter live in the basement? There is so little guidance for people like me. I’m not aware of any transparency on who is still dying of Covid – the thousand a week – the elderly elderly yes, but also transplant patients? B cell depleted patients?
I can’t help feeling like my life is considered an acceptable loss at this stage of the pandemic.
Thank you, as always, for your compassion, guidance and care.
Jamie Weisman, M.D.
Isabella writes:
Hello Dr. Griffin,
I tested positive for covid for the first time in December 2022 and have been dealing with long covid symptoms ever since, including fatigue, new onset of migraines, brain fog, upper chest tightness, worsening of previously controled asthma symptoms, chronic sinus infection, and gi upset. I am 23 year old women with asthma and was vaccinated and boosted prior to getting infected. I’d been diligent about wearing a mask throughout the pandemic, but had started to mask less in late 2022 when I got covid. Since getting covid and developing long covid, I’ve gone back to wearing a mask everywhere in public, but I see very few other people wearing masks now. I was wondering if having long covid puts me at a greater risk for complications if I get a second covid infection, and if you would recommend someone with long covid continue wearing a mask in public?
Thank you.
Best,
Isabella
Ellen writes:
Dear Daniel,
The CDC guidelines say 4-8 weeks, for the initial two shots.
The WHO guidelines say 8-12.
What in your opinion is the best interval to shoot for (sorry for the pun)? I thought I learned from TWIV that a longer interval gives better protection, but is that in terms of efficacy or durabilty?
My 7-month old grandson is up for the vaccine and I’m trying to advise his mom. I’m thinking either now and in 4 months when his 5 year-old brother goes to school for the first time, or wait until 2-3 weeks before school starts and then the second dose 4 months later when the winter season ramps up. My daughter’s concerned that their pediatrician will insist on following the CDC guidelines which allow an outer limit of 2 months between doses.
Thanks for your advice.
Ellen