Robert writes:

I am 83 and recently came down with shingles, despite being fully vaccinated with Shingrix. It was a horrible experience, months of pain, fatigue, loss of appetite and weight, etc. I have not yet fully recovered.

In the news I have read that Senator Feinstein was also vaccinated against shingles:

and according to news reports, at 89 had a much worse outcome with shingles than I did.

Could you comment on these apparent failures of the vaccine to do much to mitigate shingles’ disease course?


Alex writes:


I am wondering what your thoughts are on the new outbreak of Mpox in Chicago? Specifically that a majority of the patients received both shots of the Mpox vaccine & that it seemed we largely were able to beat this virus back. How do you think we should interpret these events in terms of the potential for wider spread and what is responsible for this resurgence? 

Thanks so much for all you do, 


Clark writes:

Dear Daniel & Vince,

We are two physician spouses (~60 y/o and without other risk factors) who are traveling for two weeks in the Mediterranean.  We continue to wear N95s when indicated, eat meals only outdoors, and endeavor to be judicious regarding crowd density. 

One of us contracted our first case of COVID-19 and started Paxlovid after converting an initially negative result at symptom onset to positive at the 36-hour follow-up test.  The 2nd of us turned positive a day and a half later and began Paxlovid also.

Are there special precautions that we should take to protect one another’s full recovery as we pass the 5-day isolation period and make our way through the subsequent 5-day masking-only (or until two consecutive negative tests, separated by 24 hours) period?  

For instance, should one of us isolate from the other for a specific number of days as we pass through our post-infection calendar?  Or is there a reasonable chance that the one continuing Paxlovid (and still within the 5-day isolation period) could reinfect the other?

We have thoroughly appreciated the work that you’ve invested to educate us all through the pandemic and the work that you are continuing to do.  Please persevere.

Appreciatively & with best wishes,


Ann writes:

Just got my first COVID diagnosis, testing positive a day after symptoms started, and assumed getting Paxlovid would be pretty straightforward (60 years old, overweight, fine kidney function) but the covering doctor at my medical group flat-out refused.

His statements, justifying his decision:

He claims “Omnicron” (his term) doesn’t affect the lungs in the same way.

He claims Paxlovid triggers a rebound (not my understanding from your podcasts).

He also claimed that 5 days after my first positive test I could consider myself non-contagious, regardless of my covid tests, also not my understanding.

Has something changed recently (I no longer listen weekly the way I did the first few years of the pandemic), or am I talking to the wrong doctor?

Thanks in advance,


Mary writes:

Hello Daniel,

I’m a regular listener and thank you and Vincent for this podcast.  It has been helpful to me.

During TWiV 1008 you answered Roland’s question about using Symbicort (an inhaled steroid) during the first week of COVID infection by saying it is the systemic steroids that should be avoided during the first week, but inhaled should be fine and safe for controlling COVID cough.

This caught my attention because Paxlovid is in my plan should I contract COVID.  My  doctor agrees I should suspend use of my Flovent inhaled steroid for asthma as soon as I start taking Paxlovid, since it is on the list of conflicting medications with Paxlovid.  I am elderly and have suffered pneumonia several times in my life so I am super careful to avoid contracting COVID.  I want to be sure my plan is a sound one, as I am pretty sure I’ll be experiencing COVID cough if I do get it.  Thank you.

Warm regards,