The Omicron Variant wreaked havoc from December through much of February in the US, case numbers then dropped quickly, and now, the numbers are up again.
-International travel still needs to be carefully considered, even if you are fully vaccinated.
-Unpredictable border-closings, testing positive before a return-home flight (forcing you to isolate in a destination country!), and severe limitations of medical resources outside the US if you should become ill are only some of the current issues involved with international travel during this pandemic.
–All international travelers arriving in the US are now required to have a COVID-19 test ONE CALENDAR DAY before they begin travel to the US. For more detailed information, visit the CDC site: International Traveler’s Testing Requirements.
-Please check for updated specific information regarding entrance requirements (testing and COVID vaccination) through your destination country’s official website. You may also go to the US Department of State for country-specific travel advisories related to COVID. Some countries are relaxing vaccine and testing requirements, others are not.
(Dr. Klapowitz will review COVID information with you further on your travel medicine consultation visit.)
-Multiple countries have developed vaccinations. Moderna, Pfizer/Biontech, and Johnson & Johnson have all received authorization by the FDA in the United States. An excellent review of the components (“ingredients”) of these three COVID-19 vaccinations can be found here: Vaccine Ingredients.
-BOOSTERS: For people vaccinated with Pfizer or Moderna, a 4th booster vaccine with either shot is recommended four months after your first booster age 18+. For immunocompromised people, this booster is recommended age 12 and over. (CDC Recommendations for Immunocompromised Patients).
-Life-threatening allergic reactions, called anaphylaxis, are rare (about 5 in a million vaccines administered), but still several times more frequent than the flu vaccine. A history of anaphylaxis to vaccines, bee stings, or other medications/substances increases the likelihood of anaphylaxis to the COVID-19 vaccine.
-Moderna and Pfizer shots appear to be over 80% effective at preventing hospitalization and death from COVID-19. “Breakthrough” cases (COVID-19 disease in vaccinated people) can occur, but are usually mildly symptomatic (cold-like or flu-like symptoms).
-Antibody levels seem to decrease within weeks to a few months after vaccination/boosters HOWEVER, it appears that cellular immunity may last far longer, preventing severe disease, hospitalization, and death. Having the disease but not having any vaccinations may not provide as much of this long-lasting immunity.
-If you have not had one of the US FDA-approved COVID vaccinations but had vaccines abroad (SINOVAC, SPUTNIK, and others), you likely will benefit from receiving one of the US vaccinations.
Treatments for COVID are constantly evolving (and availability is often an issue). You can find updated information in the NYT website. (NYT Treatment Tracker). In our Internal Medicine practice, we prescribe Paxlovid. Paxlovid may be the correct medication for you if you have:
- A positive COVID test result
- An elevated risk of progressing to severe disease
- No medical reasons to avoid Paxlovid
Paxlovid interacts with MANY medications (by inhibiting medication breakdown in the liver). It should also not be prescribed for patients who are at very low risk of progression to severe disease, since it has short term side effects (such as diarrhea and rarely liver effects) and unknown long-term side effects.
- Regardless of your vaccination status: If you are positive for COVID, isolate yourself for 5 days. You may end your isolation after 5 days if you have had no fever for >24 hours and your COVID symptoms have improved (if you had symptoms). Finally, masking for at least 5 days after ending isolation when around other people is recommended.
- If you have had a significant exposure and you are vaccinated AND boosted, no quarantine is needed. However, you should wear a mask around others for 10 days and test on day #5, if possible.
- If you have had a significant exposure and you are not boosted or not vaccinated at all, you should quarantine for 5 days then wear a mask around others for 5 days. Also, test on day #5, if possible.
- Health care worker guidelines, back-to-work guidelines, and other specific recommendations can be found at www.cdc.gov.