Ellen writes:

Dear Daniel,

How soon after one has gotten over the flu should one get a flu vaccine? Do the same rules apply as after a Covid vaccination? Why or why not?

Hope you’re doing well,


Mark writes:

Hi Daniel:

I am an internist in primary care and hospital medicine for my patients. For several years, you have been saying that we should not repeat COVID antigen testing after we have a positive test because it is not very predictive of how contagious one may be. I have been repeating that recommendation to my patients, but I see you have changed your recommendation. I missed the discussion of the science behind it. As you said this week once one tests negative twice over consecutive days, after day five, you can go without a mask. I know the CDC has been saying this, but in the past you have suggested that there was not data to support it. I am confused. Can you please help straighten me out?

Thank you.


Janice writes:

Dear Dr. Griffin,

Greetings from Niagara On The Lake, Canada!

I’m a big fan of TWIV and also your clinical updates. I don’t think I’ve heard this question asked before but applies to me at this time. Perhaps it will apply to many others as COVID community spread is high at this time of year and we enter flu vaccine time.

I tested positive for COVID the day after I got my flu vaccine. I had no idea prior to my flu vaccine.

I normally get body aches, slight headache, low grade fever and a sore arm after my flu vaccine so didn’t really think twice about it when those symptoms emerged after my shot.  I decided to do a rapid test after the flu vaccine reaction just to be safe and to my amazement and disappointment I was positive!  I took 3 different tests from 2 different boxes just to be sure. Thankfully I was able to access paxlovid the next day from the pharmacy and have started that now.

Will my flu shot be compromised by my COVID infection? Any interactions with Paxlovid and flu shot? What are your recommendations for protection from flu going forward this season given my situation.

Thanks for all your data based scientific communication.

Kind regards,


Niagara On The Lake, Canada

Lani writes:

I am a big fan of TWIV and the weekly Clinical Update with Dr Griffin. I recently tested positive for Covid-19 and messaged my physician at the Orlando VA Hospital requesting a prescription for Paxlovid (I’m 63 and have hypertension and CAD), and I was told that “we don’t prescribe that any longer.” I asked for an explanation and was only told to take general measures to ease symptoms. I am attempting to escalate this issue with the VA Hospital here, but I doubt anything will come of it before my 5 days are up. I only wish Paxlovid were available over the counter or that more physicians were in the know. 

Thank you,


John writes:
I appreciate your program on TWIV, even though most of it goes over my head (I am not a Doc).

I am a male, 62 years old and previously very healthy and active living in Vancouver, Canada. But I have had Long Covid for about 16 months and have been off work for over a year with severe fatigue and “brain fog” as primary issues. I was vaccinated three times before March 2022 (when I initially contracted Covid). I have had follow up vaccinations in November, 2022 (got COvid 3 weeks later) and was vaccinated again in May, 2023.

Each time I have been vaccinated since contracting Covid (i.e. Nov. 2022 and May, 2023) I feel my Long Covid symptoms have gotten noticeably worse. More fatigue leading to more “brain fog” and more rest periods and breaks required to live my daily life. I have read that some L.C. patients get better with a new vaccination, some get worse and some stay the same.

I am due to get another shot (probably eligible in a month), but am leery about doing so given my past history of feeling worse after a vaccine. Can I skip the vaccine when offered to me and perhaps rely on Paxlovid if I get Covid again? I have had a total of 5 vaccinations and 2 Covid infections so far.

My Doc says “Ask the Long Covid Clinic” and the Long Covid clinic (where I am also a patient)  says “Ask your GP.” What should I consider in making this call?