| Several crucial studies came out in the last week, including a trio of papers from the Centers for Disease Control and Prevention that show boosters are essential for optimal protection against covid-19. As I wrote in my column this week, when the science changes, policies should, too. I believe that there should be a national effort to increase booster uptake, beginning with changing the definition of what it means to be fully vaccinated to include three doses of the Pfizer or Moderna vaccines (and two doses of the Johnson & Johnson shot). Another well-designed study released this week might help vaccine uptake. The paper, funded by the National Institutes of Health, addresses a common question raised by those who remain hesitant about vaccines: Do the coronavirus vaccines affect fertility? The answer is no. Vaccination of either partner does not affect the chances of conceiving. Researchers from Boston University followed more than 2,000 couples in the United States and Canada trying to become pregnant without fertility treatment. Study participants were women between 21 and 45 years old. They and their male partners answered questions about their reproductive and medical histories, including whether they had been vaccinated against covid-19. Receiving the coronavirus vaccine was not associated with a difference in rates of conception for either partner. Interestingly, though, male partners that had recovered from a covid-19 infection had lower rates of conception, suggesting that the coronavirus — not vaccination — could have a short-term impact on male fertility. This study provides a key counterpoint to those who cite concerns about fertility as the reason they are choosing to remain unvaccinated. Not only has there been no evidence that vaccination impedes fertility, this research demonstrates that the coronavirus vaccine is not related to fertility. In fact, we know from many studies that vaccines reduce the likelihood of contracting the coronavirus and lessens the severity of illness, which is particularly important for pregnant women who are at elevated risk for adverse outcomes from covid-19. While the vaccine in pregnancy has been found to be safe and effective, coronavirus infection is associated with an increased rate of stillbirth and maternal death. Last year, I wrote a column debunking the "vaccine causing infertility" myth in which I cited D'Angela Pitts, an obstetrician-gynecologist who specializes in maternal fetal medicine. Women looking to conceive "want to do everything you can to be healthy," she told me. Instead of shying away from the vaccine, couples planning to get pregnant should get vaccinated as part of their quest for better health. That's a message that we should all help to spread. |
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"My husband tested positive. He isolated for five days. His symptoms were those of a common cold. On the sixth day, he used a rapid test and did a PCR test. Both came back positive. The nurse with his insurance company told him he could keep up his doctor's appointments and he could end the isolation as long as he wore a mask at all times. We were both surprised at this recommendation, but based on that information, he went to the orthopedic doctor for a follow-up as he had fractured his wrist. Was this sound advice?" — Carmen from Washington, D.C. According to new guidelines from the CDC, your husband should have stayed in isolation and not gone out in public. To be fair to the nurse from the insurance company, the CDC guidelines are confusing and, in some ways, contradictory. They state that people diagnosed with covid-19 should isolate for the first five days; then, for the five next days, they can go out in public as long as they wear a well-fitting mask. But the guidelines also say that if someone tests positive after five days, they should keep isolating. (If it's negative, they can be out in public as long as they are masked until day 10). The guidelines seem to suggest that there's basically no purpose to testing. After all, if you can go out after five days without a test anyway, then why bother getting a test at all? As they read now, testing seems to be disincentivized, because someone who gets a positive antigen result after five days shouldn't be out in public, even with a mask, which is more restrictive than if they never got a test. (Note that PCR tests can stay positive for weeks or even months after an infection, so a PCR result is not recommended for the purposes of ending isolation.) Given the head-scratching CDC recommendations, my advice for the future is to ask the doctor's office you're visiting directly. Many offices will not allow people to visit who had covid-19 so recently for fear of infecting staff and other patients, especially if someone tested positive that same day. In the meantime, I hope the CDC will clarify their isolation guidance. "I am immunocompromised, vaccinated and boosted. My son-in-law is against vaccination and will not allow my grandchildren to be vaccinated (my daughter is vaccinated). How can I safely see my grandchildren again? I see them outdoors, masked, but I want to hug them and kiss them and have them spend the night with me and read them bedtime stories again. I miss them so much my heart aches, and they miss me, too. Both grandchildren want to be vaccinated, but this is not an option and I don't believe it ever will be. I am desperate to be with my grandchildren again. Is there any way I can see them safely besides outdoors?" — Kristina from Missouri Kristina, my heart aches for you. This is such a difficult situation for your family. You say your son-in-law will not relent on the vaccination front, but will he agree to other types of precautions? For example, could his household quarantine for three days, then have the grandkids be tested just before they come to see you? If you trust that your daughter's family truly will quarantine and you can administer a rapid test to the kids immediately prior to your visit (and, to be even safer, every day of your being together), then they can see you without restriction, at low risk to you. "My son, who doesn't believe in the vaccine, asked why should I be concerned about being around unvaccinated people in a room if I'm vaccinated. 'Vaccinated people can have the virus just as an unvaccinated person, and you can still get it, Mom, whether I'm vaccinated or not.' How should I answer this?" — Karen from California According to the CDC, vaccinated people are five times less likely to be infected by covid-19 compared to the unvaccinated. So yes, someone who is vaccinated could still have the coronavirus and be able to spread it, but they are five times less likely to be infected in the first place than an individual who's unvaccinated. That's why, if given a choice to be in the same room for prolonged periods with an unvaccinated or a vaccinated person, I would choose the vaccinated person every time. |
What I'm reading New York Times reporter Rebecca Robbins wrote about her harrowing journey to secure the antiviral pill paxlovid when her 73-year-old cancer survivor mother came down with covid-19. The barriers she encountered at doctors' offices, urgent clinics and pharmacies were astounding. It shouldn't be so hard to access a life-saving medication. This Post article details how it has become the norm in other countries such as Britain, Singapore and India to get rapid tests before gathering with friends and relatives. As one person told the Post, "It's become a social phenomena, something you do before going to the pub or going to see Granny." "Each person becomes a lab," another person said. "You don't need to delay treatment. It gives power to the people." We are a long way off from this reality in the United States, but it is something we should aim for. I loved this National Public Radio profile of Francis Collins, who just stepped down as the director of the National Institutes of Health. Collins is both an internationally renowned scientist and an evangelical Christian. He talks about his faith and science and how he wants to bridge the political divides and restore "our greatest calling … truth, goodness and beauty." |
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