These numbers are alarming. Most older individuals and people with chronic medical conditions should not delay getting the vaccine. As I’ve discussed before, this is because immunity wanes and the updated version better targets circulating strains. People vulnerable to severe illness should seek all the protection they can ahead of the anticipated rise in coronavirus cases this winter.
Readers who are holding off voice specific reservations. “I was diagnosed with Stage 3 ovarian cancer and began chemotherapy just before this fall’s vaccines became available,” wrote Judith from California. “I’m feeling vulnerable to covid, RSV and flu and am taking precautions to minimize exposures. I get mixed messages about getting vaccinations while immunosuppressed. The sooner the better, or waste of time?”
Anne from Oregon has a similar question: “My 80-year-old husband was diagnosed with polymyalgia rheumatica in the spring and is currently tapering off prednisone. He is now taking 1 mg daily. Can he safely get the new covid vaccine? We would both like to be vaccinated before an airline flight.”
It’s very important for both Judith and for Anne’s husband to receive the shot. Both are at high risk for severe illness from covid-19. Judith is immunocompromised because of her chemotherapy. Anne’s husband is vulnerable because of his age; he also has an autoimmune disease for which he is taking a low dose of steroids.
For some immunocompromised individuals, the vaccine might not be as protective as they are for immunocompetent individuals. But that does mean it doesn’t work and or that it’s unsafe; rather, the possible reduced efficacy combined with higher vulnerability should prompt immunocompromised people to take additional precautions to protect themselves.
Of course, Judith and Anne’s husband should speak with their physicians in case there is something unique in their medical circumstances that would change this recommendation. In general, though, immunocompromised people are among those most in need of the coronavirus vaccine (and the flu and RSV shots, too).
Linda from Michigan writes that she is scheduled to have knee replacement surgery soon. “I want to get the newest booster shot, as a grandchild will be joining our family before the end of the year. Since I suffered joint pain after the last booster, I was thinking of getting the booster after my surgery when I may still be on painkillers. Are there any guidelines about scheduling boosters around elective surgery?”
Linda can receive the updated vaccine right after her knee surgery if she wishes. There is no requirement to wait to get the vaccination after an elective surgery.
Interestingly, there were guidelines that instructed patients to wait at least seven weeks to have surgery after a covid infection, but some studies have since shown that there is no increased risk of post-surgical complications among who recently had the virus. There is also no prohibition on waiting between vaccination and surgery, or vice versa.
The one situation where someone could wait to get the vaccine is if they just recovered from the coronavirus. That’s the case with Lynne from New York, a 76-year-old who just recently got covid. “I’ve read I should wait about three months to get the covid vaccine. Do you agree?”
Yes, waiting three months is what the Centers for Disease Control and Prevention recommends. If Lynne recovers in early November, she could wait until at least early February to receive another shot. The chance of reinfection during this time is very low.
Karen from Iowa has not received the shot for another reason: “We are in our early 70s and healthy,” she wrote. “Normally we get a flu vaccination in October and would do the same with the new covid vaccination. However, I wonder if we should wait until December or January this year because we plan to go on a European cruise next April and will have much more chance of exposure at that time than we do in our normal activities.”
Given the high likelihood of a winter covid spike, I would not advise waiting until February or March to get the updated vaccine unless Karen and her partner both recently recovered from covid. They could get the coronavirus shot now, recognizing that the protection against infection will have largely waned by the time of the cruise, which Karen has accurately identified as a high-risk venue for virus transmission. They should prepare in case they contract covid while on the cruise and make sure they have Paxlovid or can access antivirals if they test positive during the trip.
Here’s a final question courtesy of Ginger from Maryland: “I live in a senior community which recently offered a vaccine clinic. I overheard two residents say they were not getting the covid booster because they have O-positive blood and that protects them. My research says the correlation between blood type and covid infection is thin, at best, not a reason to avoid the shot. If you think this rumor is a serious problem, please write about it.”
I don’t know if the rumor is a serious problem, but Ginger is right and the other two residents are wrong. The genesis of the misconception is rooted in some facts. A recent study did find that the coronavirus preferentially infects type A blood cells compared with type O cells. Another concluded that people with type O blood were less susceptible than other groups. But the difference was small, and people with type O blood can and do contract the coronavirus, and some can become very ill and die as a result.
If possible, Ginger should try to speak with these holdouts about why they should consider getting the updated coronavirus vaccine. Such peer-to-peer and friend-to-friend conversations can help to boost lagging vaccination rates.
“I am 66 and fully vaccinated, including the latest shot, but just got covid for the first time. I took Paxlovid and am feeling well now. I still test positive and am concerned about transmitting covid to my cat. I have tried to remain masked in his presence and keep him out of my room at night. Am I being ridiculous, or should I continue to avoid close contact with him until I test negative?” — Gilbert from New York
The CDC recommends that if you are sick with covid, “You should avoid contact with your pets and other animals, just like you would with people. Contact includes petting, snuggling, kissing, licking, sharing food, and sleeping in the same bed.” In short, you are right to continue to be careful around your cat until you test negative.
“I take Silver Sneakers classes at a gym that has good air quality overall, but this class is in a small windowless studio. New ceiling fans were just installed in a room that has air-conditioning or heat available. I’ve requested that the fans be turned on even though the room may be on the cool side already because I think that keeps us safer from any germs circulating in the room. I think the instructor agrees, and she’s been good about turning the fans on. But many in the class are annoyed by it getting even colder in the room. If the fans aren’t helping us germ-wise, I don’t want to make others uncomfortable. But if they offer protection, then maybe folks bothered by cold air just need to put on a sweatshirt. What do you recommend — fans or no fans?” — Valerie from N.Y.
This is an interesting question. We know that the coronavirus is airborne, and ventilation is key to reducing risk. But if the space is an enclosed room, a fan might not help.
The World Health Organization reports, “Using a fan in an enclosed space can increase the spread of the virus that causes covid-19. This is why it is important to open windows and doors whenever using a fan to replace indoor air without outdoor air.”
In the case of your studio, which you describe as being small and windowless, the fan probably won’t make things safer unless the door is open.
If that’s not possible, there are two more things you can ask the gym. Check to see if they have an industrial-grade HVAC system and make sure it is set to “on” instead of “auto.” They could also invest in a portable air cleaner with a high-quality HEPA filter.
Of course, people engaging in activities around others are still at risk for contracting covid. All those in your gym class, who are higher risk because of age, should be up-to-date with their vaccines and have a plan for accessing antiviral treatment if they contract the coronavirus.
“I don’t have a question but want to share a tip. I’ve taken Paxlovid twice for covid and both times experienced the terrible metallic taste side effect. Chewing cinnamon flavored gum and candies really helped. Big Red gum, Hot Tamales candies, those little red cinnamon hearts and so forth.” — Beth from North Carolina
Thanks for sharing, Beth. I hope this tip helps some readers.
The Post has also compiled coronavirus Q&As from my previous newsletters. You can read them here.
When are children with covid most likely to be contagious to others? New research in JAMA Pediatrics sheds light on this important question with practical and policy implications. The median duration of infectivity among 7-to-18-year-olds was three days. Most were not infectious by day 5. The duration did not change depending on vaccination status. These data can help inform return-to-school policies as well as precautions taken by children living in households with vulnerable family members.
A study in Clinical Infectious Diseases found that coronavirus viral loads peaked around the fourth day of symptoms. In addition, on the first day of symptoms, the likelihood of rapid antigen testing picking up a positive result was just 30 to 60 percent. On the fourth day, it was 80 to 93 percent. My takeaway is that one negative home test might not be enough. If someone needs to be certain they don’t have covid, they need to test not only when they first develop symptoms but also a few days after.
I loved this study, published in the journal Frontiers in Sports and Active Living, which found that a middle school cycling program improved mental health and well-being among adolescents. Researchers used surveys to assess well-being before and after 11-to-14-year-olds went through a program called Riding for Focus, which teaches basic cycling skills and instills the lifelong habit of physical activity. There are so many studies that have highlighted the mental health crisis among teens; it’s refreshing to see interventions that can be part of the solution.
https://www.washingtonpost.com/health/2023/10/24/rsv-monoclonal-shortage-cdc-update/
https://www.washingtonpost.com/health/2023/10/29/seniors-mental-health-medicare-expansion/
https://www.washingtonpost.com/health/2023/10/26/pepfar-funding-delays-hiv-abortion/
https://www.washingtonpost.com/dc-md-va/2023/10/26/opioids-dc-public-emergency-fentanyl/
https://www.washingtonpost.com/opinions/2023/10/25/hamas-war-israel-equality-suffering/
https://www.washingtonpost.com/opinions/2023/10/30/its-lonely-time-be-jew-america/
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