I am an orthopedic surgeon in New Orleans and have a friend who is an internist who treats Covid patients. He is on regular zoom call clinical updates. He told me that dexamethasone is no longer recommended to treat Covid. This seems to contradict everything I’ve learned so far about how dexamethasone is one of the best therapeutics we have. What do you think?
Dear Dr. Griffin,
I write from Manchester, UK, partly about my father in Australia. It’s 1C/33F, and as a metric native I’m grateful to Twiv for inadvertently demystifying Fahrenheit for me.
I should probably start by saying that I am vehemently pro vaccine for everyone who does not have a medical reason not to take them. I am fully vaccinated.
30 years ago my father received a flu vaccine and was hospitalised with Guillain-Barré syndrome as a consequence. He survived, but has been medically fragile (including permanent muscle weakness) since then. I know that this is vanishingly rare – but my dad got the short straw. I don’t know the details or remember this: I was four.
My question is twofold. One, is there a reason for my dad, or someone like him, to worry about any of the vaccines or candidates? (I do know he no longer receives flu shots)
Secondly, I really want to help and have registered my interest for vaccine trials through the National Health Service. I’ve passed the online survey for both Novavax and Johnson and Johnson and am waiting to hear back. Is my father’s experience a reason for me to worry in general, or not to take part in a clinical trial?
I desperately want to help, and I know better than most lay people that vaccines carry some risk. I’m prepared to take that small risk, but I don’t want to be reckless. And after nearly losing my dad (again) earlier this year, I want to do everything in my power to protect him, too. (Or, from the other side of the world, someone like him, in the hope that someone in his community returns me the favour)
Thank you for your time, and for everything that the team at Microbe TV do (have listened to every release since mid-March). I hope all of you and your loved ones stay safe and well.
Anon (because I’ll catch hell from my dad if he finds out I’ve signed up for trials!)
Hi! I appreciate what you all do so much – it has been my greatest source of hope throughout this crazy year.
So the situation is this – I have been trying to get pregnant for some months now. I am hopeful (as I always am) that this could be our month BUT as a nurse in a NYC hospital I understand the vaccine is so close for me.
Do I hold off until I’m fully vaccinated since it should be soon? If I find out that I have become pregnant, is the vaccine safe? I have it stuck in my head that my body will be triggered to produce some protein that is harmful to a fetus.
I understand studies leave pregnant women out for safety reasons but facing this question I do feel as though that they actually leave out pregnant women to our detriment.
I hope that wasn’t a dumb question! Please leave my name out (don’t need the whole TWIV world knowing my pregnancy plans)
I have a question for Daniel, could he discuss whether immune compromised individuals can take the mRNA vaccines?
Thanks for all you do!
Hi Dr. Griffin,
I am a high-risk individual for severe disease from infection with SARS-CoV-2: White female, 65 years old with mild hypertension controlled by an angiotensin-receptor blocker, Irbesartan; and a BMI on the high side of the overweight range.
In addition, exactly a year ago I was diagnosed with a hematologic cancer, chronic lymphocytic leukemia (CLL). My genetic tests indicate only one marker — mutated IGVH — so my prognosis is for a slow disease progression, and my CLL is considered indolent with a WBC count hovering around 20K and all other relevant blood tests in the normal range. I remain in watch-and-wait mode and have not yet been in active treatment.
Other than the conditions described above, my overall health is very good.
Since the pandemic hit, I have been 100 percent following all public health guidelines, including some enhanced individual efforts to mitigate my risks.
My pandemic fatigue is real, but fear of covid-19 keeps me motivated. I have maintained personal hope with the promise of vaccines. Now I recently learned that none of the vaccine trials have enrolled immune-deficient or immunocompromised individuals, so there are no data on efficacy or safety for these subsets of the population.
So my questions are as follows:
1) As the vaccines are rolled out in the next 6-12 months, do you have any idea yet when (or if) immune-deficient and immunocompromised individuals will be offered vaccines in the rollout prioritization?
2) If immune-deficient and immunocompromised individuals never become candidates for the vaccine, will vaccine-mediated herd immunity be sufficient for us to resume our pre-pandemic lifestyles? The prospect of sheltering in place for the rest of my life is too much to bear.
3) When and via what mechanism do you expect to see some useful data on the ability of these vaccines to confer sterilizing immunity on vaccinated individuals?
Okay, thank you and kind regards,
Litchfield, New Hampshire
P.S. I have an excellent oncologist-hematologist, who has been following up with me since 2014 after my non-metastatic Er+/Pr+ breast cancer diagnosis that only required lumpectomy, radiation and a daily 1-mg aromatase inhibitor. No recurrence to date.
I know I can ask my oncologist these questions as well. But he is super busy right now, and my next appointment is not until January. Meanwhile my anxiety is growing as the pandemic resurges and the anti-vaxxers proclaim that they will never take a covid-19 vaccine.
P.P.S. I have been following TWIV since March of this year after I found you online. I think the first podcast I listened to was with Christian Drosten. You have all been a lifeline to me during some difficult months as I have tried to navigate decisions about my life. I just want to thank you again, and in closing, today, Tuesday, December 1st, 2020, here in my little slice of southern New Hampshire, the temperature is 60 degrees Fahrenheit (15.5 degrees Celsius) and mostly cloudy!