Laura & Kip write:
Hello Dr. Griffin,
We wanted to re-send this document that we had created a few months ago which explains why Paxlovid tablets should not be crushed. Hope you will find it helpful. Thank you for your very informative clinical updates!
Laura and Kip Potter
Hi Dr. Griffin,
My name is Efthimis (Ef-thee-mees).
I appreciate all the time and effort Vincent and you put into Twiv and the clinical updates.
My grandfather is 87, has diabetes, has high cholesterol, has issues with too high or low blood pressure leading to brain bleeds and strokes in the past, and is generally a fragile and skinny individual. He is also fully vaccinated with two booster shots.
He is taking a myriad of medicines daily including Eliquis, Atorvastatin, Metoprolol, Metformin, and others.
I followed your advice and I contacted his doctor to set up a plan for COVID-19 therapies in the case that he would get sick. To my surprise, my doctor’s front desk told me that it would be better to wait until he tests positive before deciding which COVID-19 therapy is best for him.
Do you agree with this approach of waiting until symptom onset to decide which therapy to be used? If not, which therapy would you recommend for him? From my unprofessional investigation, Paxlovid might not be an option because of the drug-drug interactions. If this is the case, is Remdesivir the best option for him? Would an IV drug like Remdesivir have any complications for someone like my grandfather?
Regarding TWIV 974 Q&A, and the parent asking if a toddler should receive a second dose of MMR:
All children are recommended for 2 doses of MMR, especially for protection against mumps and measles. The standard age for the second of MMR is 4-6 years before starting primary school, but it instead may be administered before the 4th birthday, at a minimum of 4 weeks after the first dose.
https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/A/age-interval-table.pdf page 2
Thanks to TWIV and your ongoing dedication!
Robert Schechter MD
California Department of Public Health
Confused pregnant lady writes:
Dear Dr. Griffin,
Thank you for all the information you provide to the public, your service is invaluable!
I am in my late 30s. I had a 3-dose Covid vaccine series, then got Covid 4 months ago (very mild, almost asymptomatic). Listening to your and Paul Offit’s reasoning, I was in no hurry to get the bivalent booster, and wanted to wait for more science to emerge (as well as give my germinal centers time to do their thing after the infection). I then got pregnant and am now at 11 weeks. The question of whether or not to boost became more urgent due to increased risk for the fetus.
I am stuck in my risk-benefit analysis: on the one hand, I can get the shot now and somewhat decrease the risk of infection for most of the pregnancy. On the other hand, I would like to pass on maternal antibodies to the baby, so there is rationale to wait till 3rd trimester, at the cost of somewhat increased risk of infection earlier.
I raised this question with my OB nurse and she suggested getting a booster now, and another in 6 months – seems excessive. What would your recommendation be?
With much gratitude,
Confused pregnant lady