Ellen writes:

Thank you for keeping me informed about covid. Even though to my knowledge I haven’t gotten covid yet, I got my doctor to prescribe me a course of Paxlovid before I go to a large indoor conference in a state where I don’t know that doctors believe in the effectiveness of Paxlovid – just in case. 

I’m startled to see on the package that it expires in only a month! Really? Now I feel like, what a waste, if I don’t get covid. 

Ellen in New Mexico

Louis writes:

Hello from Baltimore! Hope you do more events in Baltimore!

Question: I am 61 years old, history of asthma all my life. No other co-morbidities. I want to take the RSV vaccine but I got scared off by the reports of Guillaume Barre. I had no problems with any other vaccines including Shingrix. Planned to get it at CVS and use the Glaxo. Any more updates on this after over 2 million vaccines? Do you advise people in similar positions to go for the shot? (I know I have to consult my physician but just wanted to know your general take)



Larry writes:

I am 70 years old and have received the Zostavax vaccine and one dose of Shingrix.  I had an uncomfortable reaction from the 1st dose of Shingrix and, let’s be blunt about it, chickened out from getting the second dose.  

It has been over a year since my first Shingrix shot.  A few questions:

1.  Did I get any positive benefit from the single Shingrix shot?

2.  Does receiving both Zostavax + 1 Shingrix shots provide me with decent prevention?

3.  Can I safely get the 2nd Shingrix shot and will it be effective or do I need to restart the series?

Thanks for your help.


Cecily writes:

In 1988, at the age of 3 1/2, my son contracted chicken pox from his school-age siblings, and then went on to develop viral encephalitis with cerebellar ataxia. It took him two years to fully recover his muscular coordination and speech. Then when he was 19 he contracted shingles. He is now 39. Is he a candidate for the 2-dose Shingles vaccine, and would you recommend it in his case?

Jim writes:

Good day. Thanks for giving of your time and expertise to do these clinical updates.

I’m a community pediatrician practicing in Nashville TN.  We have found it very difficult to obtain nirsevimab for our patients this season. Best estimates from the company who we are obtaining the medication from indicate that we’ll only really be getting enough doses to give to 40 of our patients.  We are an 11 person group who tends to get about 40-60 newborns per month. This means that we’ll have about 280 kids who should be getting nirsevimab, but are only going to be able to protect 40 of them. That estimate doesn’t count children in their second season who also would benefit from the monoclonal.

But it gets even better. We are only getting the 50mg dosage which means we can only offer help to those kids we have who are weight less than 11 pounds. I know you only care for adults in your ID practice, but this essentially means that we can only offer protection to the very youngest of our kids. 

This situation has been frustrating for us and our families, as most parents have kids who weight at least 11 pounds and are quite concerned about them being hospitalized for RSV. We also have families whose kids have already been hospitalized for RSV twice this season.  Speaking to other practices in our community, the situation is the same.

I only bring this situation to your attention in order to ask that you not say that ‘we have beyfortus to protect young children against RSV disease” because we essentially do NOT have it.

I’m hopeful that enough Nirsevimab will be available 2024-2025 RSV season to really make a difference.

Thanks again for participating in these podcasts. I think I’ve learned a lot from you and Vincent.

Jim Keffer


Nashville TN