Ileana writes:
Hello Dr. Griffin,
I am over 70 years old and recently had my updated COVID-19 vaccine at a large pharmacy chain (CVS). It was quite busy with lots of people scheduled for their seasonal vaccines, but I noticed that some of these large vaccination centers may not be properly training its staff.
Many people listen to your clinical update questions and I thought that perhaps you can give us some help here. The person who administered my vaccine, injected it not at the center of the deltoid muscle, but instead in the triceps. When I saw her swiping the alcohol below the deltoid I was tempted to alert her that she had the wrong location and should inject higher. But I was afraid to correct her, fearing that because I am older and lost muscle mass she would then inject it too high and hit my shoulder bone.
My question to you is: if an intramuscular injection is given too low in the arm, for instance, in the triceps, is it possible for the patient to not absorb enough vaccine content and thereby lessening its immunological effects?
Thanks,
Ileana
Roxanne writes:
Dear Dr. Griffin,
I’ve had the pleasure of interviewing three of the TWiV team (including you!) in my capacity as a science journalist. I’m writing to you now in my capacity as a longtime TWiV and TWiV Clinical Update listener. A couple of weeks ago, I heard you answer a question posed by a woman who was pregnant and unsure whether she could take Paxlovid if she were to contract COVID. I believe you said that this would be OK. I have a variation on this question — my son is exclusively breastfeeding, and has cow and goat milk intolerance, so if I were to contract Covid (I have not yet been infected during the pandemic to my knowledge), would it be safe to continue breastfeeding him? A quick search online turns up a link to the NHS which mentions “The manufacturers advise that breastfeeding is not recommended during treatment with Paxlovid and for 7 days after the last dose.” I’m hoping that the “hypoallergenic” formula will be OK for my son, but in case not, I feel like I may have to choose between breastfeeding him or taking Paxlovid and giving him formula that doesn’t sit well with him. Has the thinking changed on Paxlovid and breastfeeding, and if so, why?
Thanks! And P.S. my baby is also a TWiV Clinical Update listener now, too!
WIth best wishes,
Roxanne
P.S. Bonus question (if there is time): My son’s vaccine appointment for his COVID booster got moved 2 days after my own COVID booster appointment due to staffing issues. Will antibodies he receives via nursing (presumably from my boost) interfere with his own booster shot?
I appreciate these are very niche questions, so I totally understand if they don’t make the TWiV Clinical update cut!
_____________
Roxanne Khamsi
Science journalist
Jen writes:
Hi Dr. Griffin,
In past years, parents of adolescent boys have been steered away from the Moderna vaccine. I believe this was based on the data from the original 2-dose series when the shots were separated by only 3 weeks and there was a statistically significant difference in adverse effects, especially myocarditis, for adolescent males who got the Moderna shots. If memory serves, this group had to get the Pfizer for the bivalent last fall, too.
I haven’t seen anything about this for the 23-24 formulations. It is 6 to one, half a dozen the other in terms of whether adolescent boys get the 50 microgram Moderna or the 30 microgram Pfizer this year? I’d love to get my son his shot soon and most places around us only offer Moderna.
Thank you!
Jen
Will writes:
Dear Dr Griffin
I recently saw reports of a new study from British Columbia that stated that the only group which were being protected from severe disease or death were the most vulnerable elderly.
I’ve also seen tweets that studies in BC have limitations because the use of Paxlovid was extremely limited in that province to the very most vulnerable groups.
Can you address this since the general understanding is that Paxlovid works for pretty well all groups that are taking it?
Thanks
Will