Susan writes:

Dr Griffin

I have a patient with IBD who is eligible for the third Moderna vaccine booster.

She is on remicade every eight weeks.  When is the best time to give her the booster?

Thanks for your help,  I appreciate your efforts and I have been listening to TWIV and your updates throughout the pandemic.  It is greatly appreciated.

Susan Lasker M.D.
Saint Elizabeth University
Morristown, NJ

Chris writes:

Hello Vincent and Daniel,

As a 56 year old recipient of the single shot J&J back in March I’m curious/conflicted about the need for a booster.  After listening to this week’s Q&A with A&V I’ve found myself conflicted even more.  I’m only an engineer but I deal with data and statistical analysis every day and typically the better data wins the argument, or at least moves the conversation in a better direction. 

My confusion is this, recently I’ve been hearing on TWIV, or weekly clinical updates, or Q&As how the single shot J&J “isn’t good enough” to quote Vincent in last night’s Q&A with A&V.  However, the article, “Durable Humoral and Cellular Immune Responses 8 Months after Ad26.COV2.S Vaccination”, attached, published in NEJM on September 2, 2021, which I believe was discussed on at least one TWIV, suggests that the durability of the AD26.COV2.S is very good.  This leads this engineer to the conclusion that in an effort to get us through a pandemic and assuming the goal remains to be preventing hospitalization and death, both I fully support by the way, the single dose J&J meets the goal with flying colors even 8 months out.  Please correct me if I’m wrong, bring data though.  I’m all ears. 

We have found ourselves, as a world population and especially here in the US, discussing the less necessary in times of emergent need for life saving vaccines around the world.  Our priorities are not aligned with the problem at hand.  I understand, maybe, that the “more is better” philosophy is what’s behind the CDC’s booster recommendation but to quote Amy from last night’s Q&A this “philosophy” makes us in the US look incredibly selfish and self-centered to the world. If we all agree that the only way out of this pandemic is to get everyone vaccinated and that the first shot of any of the approved vaccines is magnitudes more important than the second or third, yes there are exceptions, then the only responsible message from any of the experts should always be “Get vaccinated and send the surplus where ever it is needed most” period.  That’s it, simple.  The more the experts waver on this subject and talk about boosting the more the American people, who just want to know what to do in simple terms, waver and debate boosting and in the meantime the death toll goes up.  How does the most advanced country in history, with the knowledge and resources let this happen?

Thanks for your time. 

PS, don’t let my racanyelling fool you.  All the podcasts in the TWIX family are my all-time favorite ways to spend my commute time. 

BTW it’s 57F (14C) and pouring down rain here in South West Michigan. 

Best regards


Ingrid writes:

Dear Dr. Griffin,

My dermatologist prescribed Tacrolimus cream for me for a rash. Could the immune-suppressing features of that cream interfere with my COVID vaccine and/or make it more likely I will contract COVID?


Holly writes:

Dear Dr. Griffin,

I greatly enjoy and appreciate your weekly clinical updates on TWiV.  I have searched for an answer to a question about COVID-19 boosters for a specific kind of patient, but have not found an adequate answer.  I suspect that you may be able to provide such information.

I have a couple, ages 84 and 90, both vaccinated in February with Pfizer.  In September, they were each diagnosed with COVID-19.  Neither experienced severe symptoms and they were able to isolate at home.  Because of shortages (Denver, Colorado), neither received monoclonal antibodies.  Now, we face the question of boosters.  While they both qualify, is there any reason to consider their September infections as a type of booster on its own?  Any reason in folks of such advanced age NOT to proceed with a booster?  If they should receive boosters, any advice on the best timing?

Thank you for your time and expertise,


Holly Lemons, MD