Larry writes:

Hi Dr. Griffin, 

I heard you on Brian Lehrer last week and I tuned into the latest TWIV podcast. Thank you for what you do. 

I thought that you said on WNYC that it is actually preferable to get the flu vaccine and the new Covid bivalent booster at the same time. Is that what you said? If yes, you never got the chance to explain why that is. My partner said she read an article saying the opposite: that you should wait a week between the two. Can you clear this up for me? 

Which leads to my second reason for writing. You make a very good point about not using twitter or what your partner read online to determine your health decisions. But I feel that the way you advise people to consult with their primary care doctor does not reflect the current state of medicine. I just turned 63, am very healthy and live in New York City. I would love to have a 30-minute sit down with my PCP to discuss a covid plan. But doctors these days are limited to 15-minute visits with patients. And that is if you can find a doctor. You say that if your PCP is not up on the latest info, or doesn’t return your calls, go out and find another. I have been on Obamacare plans in recent years. Maybe the NYC market is unique but none of my regular doctors will accept an Obamacare insurance plan. They feel that if they accept Obamacare plans, they will be inundated with patients for which the reimbursement rate is very low and it will prevent them from having time to see other, higher-paying patients. When I have had to search for a doctor, it is hard to find one who will accept new patients. 

    Again, maybe this is different in other parts of the country where doctors have little choice but to join the one or two networks in their smaller market. But I urge you to take this into account when you advise people to simply phone their doctor or go in for a long consultation. It doesn’t happen very often that a doctor returns a call much less sits down with you for 30 minutes. It reminds me of the routine advice given about picking health insurance. Everyone says to make sure that your doctors are in the network you choose. But in reality there is no way to find out whether your doctor is in network. I have called doctors’s offices and the receptionist had no idea which of the multitude of plans her boss accepts. (One receptionist told me during open enrollment that they were waiting for “the government” to tell them which plans they accept. Huh?)  Trying to find out from the insurer which doctors are in-network is even more difficult. They tell you to call the doctor and their online directories are hopelessly out of date so you can see that your doctor is listed as being in-network and then discover that he or she is actually not. And doctors have the right to withdraw from a network at any time so you might start out in-network with a doctor only to see them exit. 

     All of which is to say that when I hear authorities advise listeners on the radio to check to see if their doctor is in-network, it is like being told that the check is in the mail. I believe that if you acknowledged some of these difficulties in your remarks, they would be more effective because they would better reflect what listeners are dealing with daily. 

Thanks again for being such a clear and reliable communicator. 

Best wishes, 


Robert writes:


Thank you so much for your excellent weekly COVID reviews – please keep them coming. 

My question involves Paxlovid and potential drug-drug interactions. Because ritonavir’s inhibition of CYP3A4, its reported that after its discontinuation (at 5 days for Paxlovid), 80-90% of this CYP3A4 inhibition resolves within 3 days. Because of this, I was under the impression and have been recommending to my patients to hold drugs that require CYP3A4 for elimination, such as apixaban, cholesterol meds, etc… for a total of 8 days. I hear some of my Pharm D colleagues note this, however, I do not hear this recommendation expressed by many of my clinical colleagues or experts. 

Can you set us straight on this? Thank you. 

Robert Dachs, MD, FAAFP 
Director of Graduate Medical Education
Dept. of Emergency Medicine, Ellis Hospital 
Schenectady, NY
Clinical Associate Professor
Ellis Hospital Family Medicine Residency Program 
Albany Medical College

Harry writes:

Dr. Griffin

Greetings from Auburn CA

My wife, Shirley, is post-polio from her September, 1948 illness.  Our GP doctor states there is no risk factor from post-polio regarding COVID.  They also state they know of no association.

Is there any known post-polio risk factor for COVID, that you know of?

Hoping to get your input.



Retired science teacher

Anna writes:

Hello Daniel and Vincent,

I have been listening to your updates (and other TWIV podcasts) since I discovered you during the first year of the pandemic. You are an incredible resource. Thank you for keeping us sane and informed.

My 10 year old daughter had 2 dozes of Pfizer, spaced at 3 weeks apart, the 2nd in December 2021. In May this year, we unfortunately all got Covid. My question is, how necessary is it for her to get a booster, since now she has both vaccine and infection derived immunity?

Thank you!

Mad respect to the two of you, and all the rest of the TWIVers.