Debbie writes:

Dr. Griffin,

Can you comment on the following story about resurgence of symptoms and positive test after testing negative in patients who have taken Paxlovid?

What do we know? Who will be studying this?

Debbie Cardell, MD

Katie writes:

Hi Dr. Griffin,

I’m a nurse in Austin, Texas and work at a cardiologist office.  Recently, I spoke with a patient over the age of 65 with coronary artery disease who was asking for a letter of exemption from the Covid-19 vaccine. 

He stated he gave the cardiologist a letter explaining that his brother had a heart attack after receiving the second vaccine.  That is why he did not wish to receive the vaccine, even though he is a believer that vaccines are effective.  Included were 7 articles, some from Yale, he said, with documentation that this is a proven side effect.

I know of the risk for myocarditis with both the virus and the vaccine, but I can’t find any articles on this scenario.  My question is: If someone is at risk for a heart attack before the vaccine, how could it be determined that it was the vaccine that caused it vs other pathophysiology?  That doesn’t seem possible, but I’m not a physician or in research.

Thanks for the show and your great updates! 

Katie H

Brian writes:

Hi Vincent,

I’m a primary care physician who has greatly benefited from the clinical updates since the pandemic started. Thank you!

I have a Paxlovid question for Dr. Griffin:

Minus renal dosing adjustments and drug interactions, would he have any hesitation about prescribing Paxlovid to someone with liver disease (cirrhosis, NASH, NAFLD) based on the listed potential adverse reactions (hepatitis, hepatotoxicity, jaundice). The FDA fact sheet simply says “use caution in patients with liver disease,” but I’m curious where Dr. Griffin would draw the line clinically.