David writes:

You two suggested that the apparent persistence of SARS-CoV-2 as detected by PCR could be either viral remnants or ongoing replication. Could these be distinguished by sequencing the PCR products over time? Continuing replication should result in a progression of accumulated mutations while viral remnants’ sequences would be unchanged.

David

Sharon writes:

Dr. Griffin…the latest Covid vaccine guidance from the CDC seems to focus on older folks and the immune compromised continuing to be vaccinated with the most updated  shots.  Are there some circumstances where younger people should get the latest Covid vaccine? My nephew and his wife, ages 36 & 40, are traveling to Peru for vacation this June. Both have had Covid twice and have 3 previous vaccines. My nephews wife takes a biologic for RA, but other than that no major health issues.  Would you recommend they receive an updated covid vaccine b4 traveling…or should they ride the wave of hybrid immunity? Thank you! 

sharon

Lisa writes:

Hello, Dr. Griffin,

I am hoping very much that you will take my question. Have had it for a long time.

47-y/o healthy healthcare worker, no risk factors for severe Covid. I had original 2-vaccine series with Moderna in 2/2021, and one booster in 12/2021, original strain. I work in an outpatient setting and see mostly well patients. 

I am confident that I have not had Covid. I am still masking in public almost all the time, and have only been ill once since 3/2020, with a cold I got from my son- myself and household all Covid-negative at that time with repeated testing through day 5. 

My question is: Is 3 doses of the original-strain mRNA vaccine still effective against severe Covid- Specifically, for people who have NOT had Covid infection? Do we have data on this? What about effectiveness against Covid-related effects like myocarditis, VTE, etc.?

Because all vaccines and medications have potential side effects, although rare, I prefer not to vaccinate for Covid again without proof that it is needed for me. I am trying to weigh benefits vs. risks, and I do not know what the benefit is. I do know that my personal risk from Covid WAS low, at least, after my first 3 doses. I don’t personally feel the benefit of avoiding infection for a few months is sufficient, alone, for me to get more booster doses. I will, however, get another dose if there is data that the protection of the original 3 doses against severe disease has waned significantly. 

I have been unable to find this data. It seems it is assumed everyone has been exposed to post-Omicron strains. With the vast majority of the population having probably been infected by now, it seems that whole-population data on vaccine effectiveness may not apply to “Novids” necessarily… for me to weigh my own personal risk here, I feel I really need data on those who have had neither Covid nor updated vaccine doses. Does it exist?? If you are not sure, is there anywhere you may be able to direct me to find this information? And what might you, as a physician, recommend for a patient like me? 

Thanks very much!

Lisa

Ellen writes:

Dear Daniel,

You and others have cautioned against consuming raw milk due to the presence on H5N1 in dairy cows. However, not many Americans have access to raw milk while many are consuming raw cheeses. Should the same caution apply?

Thanks again for sharing your knowledge and critical thinking,

Ellen

Nikki writes:
Our point of care Cepheid PCR machines are set up to detect influenza A, influenza B, RSV and Covid. They do not reveal the subtype. If a patient walks in with H5N1, would we have any way of knowing? Also, we don’t swab patients who present solely with conjunctivitis. How was Avian influenza diagnosed in the TX rancher?

Thank you!

Nikki