Welcome to the November newsletter. This newsletter aims to provide information and analysis of timely topics from recent articles published in the medical literature. I hope you find this information useful and helpful in your health journey. If you have comments or questions, please let us know!
The news is now being dominated by the Omicron variant, first described in South Africa. Many countries are rushing to close their borders but it is certainly too late for this action to do any good. The variant has been identified in Canada already and is undoubtedly already here in the United States as well. What does this mean? We don't know for sure but the reports out of South Africa, which has an excellent viral identification system, is that the symptoms are a bit different, it seems to be highly transmissible but does not appear to be causing more severe outcomes. Vaccines and previous infections still look to be quite beneficial. Similar to Delta, the biggest risk is to those who do not have previous immunity (vaccine or naturally acquired).
My recommendations have not changed as far as vaccines. The CDC has now authorized a third dose (booster) for all individuals 6 months after their initial series. A second dose of any of the three available vaccines is recommended for those who received the Janssen/J&J vaccine two months after the initial vaccination. If you got the single-dose vaccine and choose to get a second dose, I am recommending a single dose of one of the mRNA vaccines be considered as the immune response appears to be excellent.
Should people who had the virus get a second (J&J) or third dose (Pfizer/Moderna) of the vaccine? We don't know for sure but "hybrid" immunity looks to be excellent protection. Our memory B cells are able to produce high levels of antibodies if we see it again and these memory B cells will produce antibodies adapted against the variants! Memory B cells are like blueprints for making antibodies but can be modified on the fly. Additionally, as I mentioned previously, exposure to the virus generated T-cell memory even without a detectable viral infection. At this time I am not recommending third doses for people who have normal immune systems and previously had the virus. As we move forward, the combination of vaccination, previous infection, and hybrid immunity will continue to lower the number of people susceptible to severe outcomes. Certain groups such as the elderly and immunocompromised will still continue to have increased risk.
I would be happy to assist you in finding sites giving boosters and you can check locations at https://www.vaccines.gov/search/. If you have questions regarding the vaccinations, please let me know.
I am getting a lot of questions about vaccinating teens and children. The Pfizer vaccine is approved for children ages 5-11. For people who are considering vaccinating their children, I would recommend waiting longer than recommended between doses (6-12 weeks rather than 3 weeks) as this could boost antibody responses after the second inoculation more than threefold (shown in those older than 80, so children would likely have an even more robust response).
I am happy to announce that I have one of the newest diagnostic tests available. The Galleri test is a blood test that can detect over 50 types of cancer before they are apparent through regular screening testing (and many cancers don't have a screening test). The test detects methylation patterns of cell-free DNA which can indicate cancer and thus has the potential to detect cancers at the earliest stages. If you are interested in learning more about this test please let us know. I'm constantly on the lookout for cutting-edge tests and procedures for my patients and I have a few more things on the horizon that I am evaluating.