Anonymous writes:

Hi Dr. Griffin!

I’m a 25 year-old queer person and qualify for the Monkeypox vaccine, so I just got my first dose of the JYNNEOS vaccine! WAHOO!

When I went to get the shot, I was asked whether I develop keloids. I mentioned I get hypertrophic scars (which are basically keloids), so they administered 0.5 mL of the vaccine subcutaneously instead of 0.1 mL intradermally.

My question is, what’s the biological reason for administering JYNNEOS subcutaneously, per its traditional administration, rather than intradermally at the lower dose to stretch out the vaccine supply for patients who develop keloids?

Is the concern cosmetic, is there a reduction in efficiency of vaccination if a keloid develops, or is the science on this unknown?

I love the pod, thank you and Dr. Racaniello for keeping us up to date on the latest science and policy!

Ellen writes:


I have MS and I believe that with each covid shot my symptoms have gotten worse.  Don’t know if it’s from my immune response to the injection or not. I had no reaction to the first one, but the second and the next two booster shots caused me to have a fever which exacerbated my MS symptoms.  Have you heard of any other MS patients having this problem?

Thanks for your reply.


Suzanne writes:

Hi Dr. Griffin,

I’ve been an avid TWiV listener since May 2020 (unlike a certain recent guest whose name rhymes with Sandy Tavitt) and have a question for you about COVID-19 treatment. My father and stepmother were diagnosed with COVID last month and immediately contacted me with questions because they know I’ve been listening to TWiV. Both are 70 years old, have heart problems, and are on blood thinners. Both are also quadruple-vaccinated and got all those shots as soon as they were eligible. When they tested positive, I advised them to talk to their primary care doc and try to get Paxlovid, in conjunction with speaking with their cardiologists about temporarily stopping their blood thinners.

They’ve both since fully recovered, but I was surprised by what was offered by their docs. My father ended up with Paxlovid plus also was given bebtelovimab by infusion (yes, infusion — not injection). My stepmother was given bebtelovimab only (again, by infusion). They were told that Paxlovid often doesn’t work but they could take it if they really wanted it. I insisted that it was what they should take, so my dad did take it (and temporarily stopped taking a conflicting med). The doctor, however, wouldn’t give him that alone, which is why he also had bebtelovimab. Due to what the doc said, my stepmother was concerned about the supposed “Paxlovid rebound”, despite what I told her about the facts. Neither were offered Remdesivir; both my dad and stepmother said it was never mentioned in their consults with their doctors.

The doctor and hospital where they went for treatment is a regional tertiary care medical center in New Jersey in the NYC suburbs, by the way. It’s not the same level of hospital at which I receive care here in Boston, but it’s certainly not out in the bush either.

I’m confused and somewhat concerned about several parts of this. First, Paxlovid was clearly not a preferred treatment (which seemed unrelated to concerns about heart conditions and other meds). Second, there was no mention of Remdesivir. Third, they given bebtelovimab by infusion. Fourth, my dad given two different treatments. I’m glad they’re fine now, but this type of care is confusing and concerning.

What do you think of this?

Many thanks to you, Vincent, and all the TWiV crew for everything you do! It’s helped me, my immediate family, and my extended family live safely since the pandemic started. I love learning, and you all have such an engaging style of speaking!

Thanks again, Suzanne