Katherine writes:
Good evening,
I am a pediatrician in Waco, Tx who has a patient who was diagnosed with severe MIS-C in October of 2021. He thankfully has had a full recovery and been released to play sports again by cardiology. His father is concerned because the entire family including this 11 year old came down with SARS CoV2 infection earlier this month. His case was again mild, but that was true of his last episode which resulted in MIS-C. Dad is wondering about recurrence risk of MIS-C with repeat infections with the virus. The child is not vaccinated, although I have encouraged them to get him vaccinated for SARS CoV2 as soon as possible. We don’t have the vaccine in our clinic, but the local health department does. (That is a whole other concern as we have asked to have vaccine in our clinic for over a year with no movement from the corporate hospital system to allow this. Very frustrating for my partners and me.) I appreciate your help in this matter as I have not been able to find any recurrence risk data for MIS-C. Keep up the great work! I listen to TWIV and the clinical update weekly to assist me in my pediatric practice.
Katherine Thaller, MD
Emily writes:
Hi Dr. Griffin,
Thank you so much for continuing to produce this content. As a microbiology/virology Ph.D. candidate, many friends and family have been asking me for COVID medical advice that I’m of course, not comfortable giving. I find myself often saying “I’m not an MD” and then recommending your TWiV episodes as an alternative.
I share in your frustration with some providers being hesitant to prescribe paxlovid and instead defaulting to antibiotics, which brings me to my question. A relative tested positive for SARS-CoV-2, and, per my advice, called his primary care to ask about paxlovid. Instead, he was given a prescription for prednisone and azithromycin along with a warning of the potential side effects of paxlovid. What would you recommend a patient in this situation does, other than not fill the prescription? I feel awful disagreeing with his primary care, but taking immunosuppressive steroids < 24 hrs post positive test and subjecting yourself to those side effects seems questionable at best.
I understand that this is part of a larger informed consent and patient advocacy conversation, but you keep mentioning some sub-optimal treatment plans that people are being subjected to. I think it would be useful if you touch on what a patient in this type of situation can do to advocate for themselves.
Thank you again,
Emily Ivey
Ph.D. Candidate
Jacobs School of Biomedical Sciences
State University of New York at Buffalo
Department of Microbiology and Immunology
Tara writes:
Hi Daniel,
On the latest episode 912 you say Pfizer vaccine for children under 5 years is 5 months between the 2nd and 3rd. This is incorrect, it is 8 weeks between the 2nd and 3rd dose.
Just wanted to be sure the correct information is out there!
Tara Monday DO
Pediatric Care of KY
Carlos writes:
Hi Dr. Griffin,
First, thank you for all of your help with all things covid-19 related. I am a general internist in the community and I truly appreciate your expertise.
My question is related to vaccination and pregnancy status. Does the recommendation for a fourth mRNA dose (booster) differ in pregnancy? Specifically should a pregnant woman who has received 3 doses of mRNA vaccines receive a 4th dose at this time? I recognize a covid-19 infection in pregnancy can be considered higher risk but I also don’t typically think of pregnancy as a reason to obtain a fourth dose and I just wanted to make sure I was thinking about this correctly.
I look forward to next week’s update. Stay safe
Respectfully,
Carlos