Amanda writes:

Hi Dr. Griffin,

Thank-you for your incredible weekly updates, you’ve kept me and my colleagues well informed and no doubt have saved lives with the information you’ve shared on this podcast!!!

My questions relate to COVID-19 vaccine boosters and antivirals for international travel…

How much would you encourage someone to get a 2nd booster before international travel?

-travel in and of itself is a risk factor for acquiring COVID and while having had 1 booster dose is likely to protect someone from severe COVID, the inconveniences that come with having mild-moderate covid are even greater when someone is visiting another country (having to isolate in a hotel, delays in returning home, having to find a medical provider who will give you an “okay to travel” letter so you can get back to the US).  If another booster will provide some short term protection against infection is it worth factoring travel as the reason to get it and risk the vaccine side effects (which could be annoying and confused w/ infection just prior to travel)  and reduced protection later on when back at home (where covid cases might be higher than the country visited).

Also, would you give someone a 2nd booster dose if someone was on the cusp of the CDC recommendations and traveling internationally? (example-someone in their late 40’s w/ obesity and hypertension and traveling to a developing country with not the best health care)?  Would your opinion be different if they had received J&J as their first dose and 1 mRNA booster?

And what about access to antiviral treatments in other countries? Is there a good resource to see what is available in each country (or at least where Paxlovid has been approved)?

Lastly along these lines, if you had someone who was at high risk for severe COVID and traveling to a developing country with limited health care, would you be inclined to give that traveler stand-by treatment of Paxlovid to bring with them? (as is done with Tamiflu or treatment for other travel-related illnesses such as Malaria and travelers diarrhea–although the great debate over stand-by azithromycin is still ongoing).  

Thank-you so much and I look forward to hearing your feedback!! 

Amanda RN

(Certificate in Travel Medicine)

Marin County California

“travel, it leaves you speechless then turns you into a storyteller”

Noah writes:

Hey David, Hi Vincent,

I have been a devoted listener to TWiV for some time now and deeply have appreciated the timely and actionable information provided by the show.  The level of detail in your discussions is something that I find to be deeply reassuring to listen to as a lay listener, because it is so rare elsewhere to hear professionals discuss covid in the context of the struggle with uncertainty and proof that goes along with the scientific method.  

Being a dutiful listener, I knew to ask my provider (Kaiser) about paxalovid when my pregnant wife (8 weeks, 33 years old,  3x vaccinated, no other complicating factors) got a positive covid test today.  

Our provider said that they were approved to prescribe it as of yesterday(!) to pregnant women, but the doctor said she couldn’t tell us if it would impact a pregnancy or not.  She said it was up to us to take the risk if we wanted, but couldn’t advise us either way.  

Her fever is low and it looks like she will not have a severe case, but we are monitoring and isolating.  We ordered the paxalovid, but are still unsure if we should take it or not. Is there anything about the category of drugs that paxalovid is in that might impact a pregnancy? 



Ed writes:

Dear Dr Griffin

Was wondering if you knew anything about paxlovid effects on immunity from covid.

My wife and I (late 60’s but otherwise healthy) very recently contracted Covid and are taking paxlovid.  

We are both fully immunized as well as having 1 booster dose.

I would expect the covid infection to confer some degree of further immunity.  How much?

And is there anything known about how taking paxlovid might affect that covid immunity?

thanks for all you have done over this time.  I love your program.