Kayla writes:

Hi Daniel,

I’m a clinical pharmacist currently involved with COVID treatment through the VA. My role involves assessing patients for early outpatient treatment with either Paxlovid or molnupiravir. As you might expect I often run into issues with drug-drug interactions and Paxlovid so I have to consider alternatives. I rarely am able to offer IV Remdesivir due to logistical constraints, but can sometimes offer IV bebtelovimab if the patient is willing to come in to the ER for an infusion. I’m curious why you rank molnupiravir as a last line option when it is my understanding that it’s a similar level of recommendation compared to IV bebtelovimab. I deal with many patients who live in rural locations and are unable to come in for IV treatment in a lot of cases. How can I talk about the effectiveness of molnupiravir compared to IV bebtelovimab to better help my patients decide between these two treatment options? Appreciate your insight.

Thank you for all that you do!

Kayla Ward, PharmD

Bryan writes:

Is there a recommended amount of time to wait after recovery from Covid before getting a monkeypox vaccine?

Aaron writes:

Hello Daniel, 

Let me start by saying thank you for all the time and effort you put into not only treating people but working hard to answer all of these clinical questions as well. I deeply appreciate it. 

I was thinking about monkeypox and wondered how much of a transmission risk public swimming pools represent if someone who’s infected visits one. 



Selvi writes:

Hi Daniel,

I am a 34 year old, healthy woman who is currently 29 weeks pregnant with an overall uncomplicated pregnancy.  Also I am fully vaccinated (2 doses of Moderna and a Pfizer booster in December 2021).  About a week after the 4th of July weekend, I became symptomatic and tested positive for SARS-COVI-2.  My illness was fairly “mild”, I was only sick for about a week with a lingering cough that lasted another week or so.  I was not prescribed Paxlovid (although it sounds like I should have been), was just told to rest and drink lots of water.  I had an ultrasound appointment last week and everything looked fine with the baby, so I felt like I was “out of the woods”.

A couple nights ago, I went to a large stadium concert in Los Angeles (where COVID rates are very high), not really considering the risk of getting COVID again, having just had it.  However now I’m starting to worry about the possibility of a reinfection :/ What is the likelihood of being reinfected so soon after having just recovered from COVID?  Have you heard of any such cases in people who are pregnant (and therefore somewhat immuno-compromised).  Could a second SARS-COVI-2 infection at this stage in pregnancy have more severe negative consequences for the baby (or perhaps less) than the first infection? Basically, how worried should I be about this?  Would pushing for a Paxlovid prescription if I were to be reinfected at any point during pregnancy help curtail any potential negative outcomes of a second infection?

Thank you! 

-Selvi (a very anxious pregnant woman)