Stephen writes:
Dear Daniel:
A friend about 70, who lives with Lupus, was hospitalized with anaphylactic shock after receiving her first Moderna COVID vaccine dose. She has not received any other COVID vaccine, and though she has been sick and a cancer patient, she has not had COVID as far as she is aware.
What do you recommend? While I don’t think she’s inclined to pursue COVID vaccination in light of her first experience I wonder, were she to consider, say, Novavax, is there a test an allergist / immunologist could do to know whether she’s likely to have an allergic reaction?
Also, would you recommend she have serology done? Too bad Evusheld is no longer effective.
Sincerely,
Stephen
Kevin writes:
Hi —
Does severity of the “Early Viral Upper Respiratory Non-hypoxic Phase” predict the “Early Inflammatory Lower Respiratory Hypoxic Phase”?
I was seeing a patient with a history of heart failure, on amiodarone and eliquis. Got primary vax series plus booster. His family member was covid positive, so he took a covid test and it was positive. He has no symptoms other than perhaps some increased sneezing. No fever, sore throat, cough, etc. Vitals normal. He previously got antibodies with his last covid infection (but obviously can’t now). Ended up with molnupiravir as outpatient remdisivir isn’t a thing where I am.
Got me to thinking though, what is his real chance of him ending up admitted on oxygen one week later? It seems that lack of symptoms/signs (cough, sore throat, fever, tachycardia) in the URI phase would make it unlikely that he progresses to a hypoxic phase, but I’m unsure.
And would Plaxlovid prevent progression in someone like him (if he didn’t have med contraindications)? I think the EUA for Paxlovid is for treatment of “mild-to-moderate” disease, but how about asymptomatic disease (ie less than mild)?
Thanks for any thoughts,
kevin.
James writes:
Dear Dr Griffin,
I have been listening to your Podcast for a couple of years now and every week you reiterate that young people are also at risk from Covid. I live in Australia and have two children of ages 2 and 5. As of right now my 5 year old is only legally allowed to have 2 doses of mRNA vaccine and my 2 year old is still not legally allowed to be vaccinated at all for Covid19. The governing body in Australia (ATAGI) has deemed that vaccines in the under 5 year old population is only available for extremely immunocompromised kids.
Here is the current guidance: https://www.health.gov.au/news/atagi-recommendations-on-covid-19-vaccine-use-in-children-aged-6-months-to
It’s been about 6 months since this guidance was originally given (which was also months after approval was granted in the US) and a lack of safety data seems to be the continued line that ATAGI has taken on not allowing these vaccinations. As a parent of a 2 year old (and an under vaccinated 5 year old with no booster yet available), my family has been desperate for any kind of protection that we can get for our child. Would you also agree that giving parents the choice to vaccinate their under 5 year olds at this stage to be both the safest and wisest option for the powers that be in Australia (taking into account the possibility of severe disease, hospitalisation, long covid, long term effects on a child’s immune system)?
I would be more than happy if this question was to make it on the air as to raise the profile of this issue within the medical establishment in Australia.
Thanks you so much for all that you do,
James.