I realize you have addressed nearly every variation on the theme of “should this patient get Evusheld?” but my father in law is 83 years old and had a splenectomy 8 years ago. Our family has been very cautious in managing potential exposure to SARS-CoV2 throughout the pandemic, and my father-in-law is current with vaccination (Moderna, 2 boosters).
There is a family memorial service this fall that my in-laws plan to attend in person, and because he has no spleen, he has inquired about Evusheld with his PCP and a local (Tucson, AZ) infusion clinic and has been told that having asplenia but otherwise being in good health (mobile, hx of mild stroke-resolved, history of afib—on warfarin) for his age does not qualify him for Evusheld unless an IgG test found that he had produced no antibodies.
Because he demonstrated some SARS-CoV2 antibodies, the infusion clinic has said that he does not “qualify” for Evusheld. Physicians I’ve discussed this with (I’m in NC) have universally said they’d recommend Evusheld for a patient like my father-in-law. What would you recommend?
Thanks for the weekly clinical updates; they have been an important part of keeping me informed throughout the last couple of years.
Dear Daniel and Vincent,
I have heard Daniel say a million times, never miss an opportunity to vaccinate, so I was hoping Daniel would comment on this tweet from Shane Crotty.
” In my opinion if you had COVID a month ago then a booster is pointless, and potentially disruptive to the ongoing antibody education the body is still doing. We know from multiple labs that the immune system is doing a brilliant job of improving antibodies for at least 6 months…”
Ann R. Beaton, Ph.D
I remember participating in a mass vaccination program for polio about 1964 or 1965. This was the Sabin OPV series: for each dose we were handed a cup with a sugar cube to suck on. I have no written record of this vaccination, but I dimly recall having received only two of the three doses in the series. I was eight or nine years old.
A year or so later I was hospitalized for appendicitis. For a few days I was moved to a ward next to a boy my age who was in an iron lung. This is an experience I will never forget. Most people have seen pictures of iron lungs. However I doubt many of you have experienced one in operation. Iron lung machines in the ’60s were big, noisy contraptions. My neighbor’s iron lung made an incessant clunk-whoosh sound as the machine’s valves and pumps worked to provide pressure changes to assist his breathing. He lay on his back with a mirror over his head at a 45 degree angle so that he could look around the room. We talked for hours about the stuff that 10 year old boys talk about, but we never talked about the iron lung, or how long he might have to stay in it.
So I know what a terrifying disease polio was, and I will never resist getting necessary vaccinations, so long as they have been proven safe.
I’m 66 now and here is my question: Do I need an IPV shot?
New York City
Can an individual receiving their first Jynneos shot subcutaneously receive the second intradermally? Or should the entire series follow the same administration method?