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Monday, September 27, 2021

The latest recommendations on masks and booster shots

Dr. Gabe Mirkin

Federal health officials are recommending that fully vaccinated people should get booster shots eight months after their second shot. A final determination from the Food and Drug Administration (FDA) on boosters for everyone is expected in a few weeks. The U.S. now has nearly 169 million people fully vaccinated. An Israeli study found that a third dose of Pfizer COVID-19 vaccine helped to block the highly-contagious Delta variant and was 86 percent effective in people aged over 60 (Reuters, August 18, 2021).

Studies from Massachusetts, India and Finland have shown that the Delta variant of COVID-19 can grow in the noses of both vaccinated people and unvaccinated people, so both vaccinated and unvaccinated people can transmit the virus to others, even if they have no symptoms. The CDC Director, Dr. Rochelle Walensky, said this explains why the CDC is once again recommending that even vaccinated people wear masks indoors.

The FDA has already authorized a third dose of the mRNA (Pfizer or Moderna) vaccines for immunocompromised patients. These booster shots are now available at many pharmacy chains by appointment or walk-in. According to the U.S. Centers for Disease Control and Prevention (CDC), individuals will need to self-attest that they are severely to moderately immunocompromised but do not need to show proof of their condition to receive a booster.

Should you be vaccinated if you have already had COVID-19? Having had COVID-19 in the past offers some protection from reinfection, but the CDC reports that vaccination offers better protection against COVID-19 than a prior infection. Having had both an infection plus vaccinations gives you more and higher levels of antibodies. Reactions to the vaccine are more common in people who have had COVID-19 (JAMA Intern Med, published online August 16, 2021). People who have a reaction to their first injection of Moderna or Pfizer vaccines are likely to have had previous exposure to COVID-19 and thus have a high antibody response to the vaccine.

A study from Stockholm found that patients infected with COVID-19 can have an elevated heart rate for many months after they develop symptoms (The American Journal of Medicine, August 11, 2021). This is very important because COVID-19 increases risk for clotting that can cause heart attacks, strokes, and swollen legs. The researchers note that 25-50 percent of the patients had a rapid heart rate and/or chest palpitations that lasted 12 weeks or longer, and nine percent still had palpitations six months later. Palpitations are a feeling of having a fast-beating, fluttering or pounding heart. The authors recommend a basic heart workup for people with COVID-19 and palpitations or a resting heart rate greater than 80.

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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