Hello again, dear readers, and welcome to our monthly letters column. Virtually all of the mail we received in the last month concerned the coronavirus vaccine. In fact, we heard from so many of you, we need two columns to cover it all. Onward to part one:
-- A reader shared that she is using an over-the-counter nasal antiseptic so that she will be less likely to spread the coronavirus should she become infected. "I read that killing germs in the nose can reduce your risk of bacterial infections such as MRSA and staph," she wrote. "And some experts believe it can help fight COVID-19." It's true that some patients use an antiseptic nasal spray to "decolonize" the bacterium Methicillin-resistant Staphylococcus aureus, also known as MRSA. However, these nasal sprays target bacteria, and not viruses. It's a crucial distinction, because COVID-19 is caused by a virus, and it doesn't respond to antibacterials. We're not familiar with data supporting this practice for COVID-19, and we would not recommend it to our patients.
-- A reader who tested positive for COVID-19 in August asked about antibodies and immunity. "Do I need to get tested for antibody levels?" she wrote. "Should I get the vaccine? When will my immunity run out?" At this time, it's believed that antibodies persist for about 90 days after COVID-19 infection. The degree of immunity that they confer is not yet known, so the only reason to get the test would be out of curiosity. And, yes, we recommend that everyone get the vaccine. This includes those who have tested positive for the coronavirus in the past and don't currently have COVID-19 symptoms.
-- A reader wondered whether the anti-inflammatory she takes for a type of arthritis known as pseudogout presents a problem regarding the vaccine. "Does it affect the efficacy of the COVID-19 vaccine?" she asked. "Is one vaccine manufacturer better than another?" We are not aware of any data about decreased efficacy of the vaccine in individuals using either NSAIDs (non-steroidal anti-inflammatories) or steroids. As for the vaccines, they are equally effective. We strongly recommend that our patients get the first one available to them.
-- We heard from a number of readers asking if the vaccine is safe for people with disorders such as multiple sclerosis and Parkinson's disease. Both the Parkinson's Foundation and the National MS Foundation convened panels of experts to research this question. Their conclusions are that, yes, individuals with these diseases should get vaccinated. It's important to note that these recommendations apply only to the Pfizer and Moderna mRNA vaccines.
-- A reader with Type O blood, which has been linked to a lower risk of serious illness with COVID-19, wondered about her need for a vaccine. "Do I need to get the vaccine since I have a low risk of getting COVID-19? If so, which one is best for me to get?" Yes, we recommend that our patients with Type O blood get vaccinated with either the Moderna or Pfizer vaccine, whichever is available.
Please come back later this week for part two of the vaccine letters column.