Pamela writes:

Weeks ago in response to a question from a young mother Dr. Griffin responded that his wife should breast feed their child. What I was hoping to hear was if there is research that addresses how a nursing mother’s milk is impacted by getting a vaccination. Our daughter believes she should not get vaccinated until she stops nursing.

I know that they are saying pregnant women should get vaccinated but this is about the next stage of motherhood.

Pamela

Mark writes:

Dear Dr. Griffin,

I fear that by the time this question reaches you, it will be too late for any response you might have to help in this particular case. Even in that event, however, I wonder whether your answer might be helpful to others.

My fully vaccinated 31-year-old brother tested positive twice for SARS-Cov-2 by Rapid Antigen Test yesterday after developing COVID-like symptoms (headache, sore throat, and congestion) and went to the ER (at a Kaiser hospital in Oakland, CA) last night after experiencing what he described as “chest tightness.” At my advice, because he has chronic kidney disease, he asked about monoclonal antibody therapy. They began administering the Regeneron cocktail, but they had to stop because he had what he described to me as an “anaphylactic response.” Eventually they sent him home because they deemed his symptoms mild or moderate and his blood oxygen levels were fine. He’s due to follow up with an ID specialist. 

My questions for you are several. First, how often does this sort of reaction occur in response to monoclonals? Second, and more important, would it be worth trying a different cocktail, if one were available, or would he be likely to have the same reaction? Would it be too late for him to receive another infusion, say, tomorrow, three or four days after symptom onset, if that were possible? And finally, if monoclonals are out of the question because of his response to the first treatment, are there any alternatives available for someone in his situation?

I’m confident that my brother’s clinicians at Kaiser will have answers to these questions, but like so many others I’ve grown to rely on your clinical updates as a critical source of information. Thanks so much for your time and all that you do.

Sincerely,

Mark

Sleepless in the suburbs writes:

Dear Daniel,

I live in a suburban area in a red county. Our town’s conservative school board has made masking and post exposure quarantines optional this school year. My 10 year old son was exposed to CoVID at school a little over two weeks ago. I wanted to quarantine him at home for two weeks post exposure but my employer would not allow me to work remotely to stay home with him because his quarantine was optional. I reluctantly continued to send my son to school. On his 14th day post exposure he told me that he had a sore throat and stuffy nose all day at school. I gave him a Binax Now home test which was negative. I thought he might be faking his illness to get out of school but because of his somewhat recent exposure I kept him home and got him PCR tested at the local drug store. His test came back positive and he’s since developed a cough. He definitely has CoVID so I’ve lost my faith a little in rapid antigen tests. I got a Pfizer booster a month ago so I’m hoping I’ll be protected. However his dad/my husband is unvaccinated and extremely opposed to getting our son vaccinated. Once my son recovers from CoVID how long will his immunity likely last? If I got our son vaccinated it would likely destroy my marriage and result in divorce. Now that my son will have some natural immunity I’m wondering if it’s worth blowing up my marriage to get him vaccinated? Any advice would be greatly appreciated. 

Thanks,

Sleepless in the suburbs

Jamie writes:

As another ‘lowly lay person’ (72 with sarcoidosis in my lungs), I REALLY appreciate the (generally) clear explanation of COVID issues that Daniel provides. That said, I still ‘lose the thread’ sometimes. Case-in-point was the discussion about the use of CT values and various test results in assessing COVID status. 

I heard the following:

* PCR tests do not distinguish between dead, remnant pieces of virus and active ones, so a large proportion of positive PR tests are actually measuring residual dead virus particles in people who are no longer a risk to others.

* Rapid tests are 96% effective in detecting active virus

* Only (about) 1 in 1000 viral replications results in a viable virus so what does a CT value actually mean?

I am completely confused about what conclusions can be drawn in regards to the actual meaning of a positive test (of either kind). Could Daniel explain (probably again) in detail the differences between PCR and rapid tests with a particular focus on false positives? 

Jamie