Q. “I got a J&J shot back in March and I got my J&J booster in November in different places on my arm. My original injection spot STILL hurts! The booster (and flu shot) never hurt at all. I haven’t done a test yet, but hoping the first injection worked and wondering why it still hurts to the touch.” — Barbara
A. The pain is most likely related to the way the first injection was administered, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.
She said the soreness may indicate SIRVA, or “Shoulder Injury Related to Vaccine Administration.” The needle may have been placed too high, entering the shoulder joint instead of the deltoid muscle.
“Sometimes you can have just pain, and sometimes it can limit your range of motion,” she said. “The best course of action is to seek care from your physician, who may recommend imaging, physical therapy, and anti-inflammatory treatment, such as steroid injections.”
Look at the bright side, she said: Even when reactions such as this occur, the vaccine is still effective.
Q. “We are planning to fly to Europe and are being told that because we change planes, we need to present a QR code to get on the connecting flight. Where do we get QR codes to show our vax status and also a current negative test?” — Elise Herman
A. Check the websites for the U.S. embassies in the countries you’re going to. If you’re going to Spain, for example, the embassy provides directions for how to download the necessary QR code through the Spain Ministry of Health’s website or in the Google Play or iTunes App stores.
“Every country has its own requirements, so you have to check online to get that country’s info,” said Vicki Bean, a travel advisor at Luxe Travel Management in Boca Raton. “It can change anytime, so you have to keep your eye on it prior to departure to make sure you are meeting the most current requirements.”
Another important thing to remember is that when you re-enter the United States, you need a negative test for COVID-19 taken within 24 hours of your return flight or paperwork showing you have recently recovered. You’ll have to show these documents to the airline before you board.
Q. “Can I receive one COVID vaccination in Florida and the second in Colorado?” — Julia Feikert
Q. “In November I had stem cell shots for two severely damaged hips. Will obtaining a booster shot interfere with the stem cell therapy? If so, when will it be safe for me to have the booster shot?” — Nancy Trimble
A. This is actually one of the “frequently asked questions” on the American Society of Hematology’s website. In short, they say you should go ahead and get a booster. I also asked Dr. Jorge Galvez Silva, medical director for the KIDZ Bone Marrow Transplant Program at Nicklaus Children’s Hospital in Fort Lauderdale, for his view.
“Vaccines will not interfere with stem cell therapy,” he said. “We suggest giving flu and COVID vaccines to patients with immune systems whose numbers/values are in the normal range.”
He said some stem cell patients may have a weak response to the vaccines, but they should still get them.
“Patients undergoing stem cell therapies for inflammation could respond differently but it will depend on what type of immunosuppressive medications they are on,” he said. “Either way, COVID vaccination should not affect the stem cell infusion and it is better for the body to have an incomplete reaction than none at all.”
Q. “I got my booster and tested positive the next day for COVID. Was it a waste to get the booster? Is it still protecting me from the worst symptoms? Should I re-boost?” — Eric, Cooper City
A. No need to beat yourself up on this one. You did the right thing, said Dr. Andrea Klemes, chief medical officer at MDVIP, a national physicians’ network with headquarters in Boca Raton.
The Centers for Disease Control and Prevention recommends people with COVID wait until their symptoms have resolved before getting a booster. But even if you didn’t know you had the virus when you got vaccinated, you’ll still be fine, she said.
“It was not a waste,” Klemes said. “The CDC is recommending boosters for all adults. There is no reason to re-boost at this point. The COVID you have now is giving you natural immunity on top of your booster. Research has shown that being vaccinated does help minimize the severity of your disease.”
Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience, agreed.
“Now you have very strong immunity,” she said. “If you knew you had COVID, you could have canceled the booster and postponed it for a month later. But since you didn’t know that you were already infected (which happens to many people), there is no harm in receiving the booster.”
Q. “I am in my 80s and had my booster shot in August. My plan in February is to fly and visit my family in another state. As six months will have elapsed since my booster shot, should I get another booster before I travel?” — Ruth, Boca Raton
A. It depends whether you fall in the “immunocompromised” category. The Centers for Disease Control and Prevention has approved a fourth dose beginning in February for people with weakened immune systems, which includes cancer and HIV patients, and organ transplant recipients. Age is not an included category at the moment.
A fourth shot could become standard for almost all Americans in the coming year. Israel is already offering them to people age 60 and older and medical workers. Needless to say, Americans who are concerned about the omicron variant have started getting fourth shots anyway, whether they are compromised or not, and there are few safeguards in place to prevent this.
Q. “I tried to make an appointment for the antibody treatment and there are hardly any locations where they are available. Any ideas or recommendations if this is going to change anytime soon? Getting the treatment early is of critical importance for those who are at risk. I’m sure you already know that!” — P.L.
A. Treatment availability did slow down last month because federal officials said monoclonal antibodies are not effective against COVID’s omicron variant. However, the federal government has agreed to start shipping them out again. Gov. Ron DeSantis said on Monday U.S. health officials will send at least 30,000 monoclonal antibody treatments to Florida, with new public treatment sites to open as soon as the doses arrive.
The infusions prevent COVID from becoming severe, although they appear to be more successful against the delta variant.
When the doses arrive, you won’t need a doctor’s prescription. DeSantis said the state’s surgeon general is going to offer guidance on how to “explicitly target” the treatment to the elderly population and people with risk factors.
Q. “A few months ago President Biden stated that rapid testing kits would be sold to the American people for $14. However, Walmart is the only store that I know that lowered the price to $14. Walgreens and CVS are still selling these tests for $23.99. The poor cannot afford to buy these tests. If they are lucky they can find them at Walmart but that is becoming difficult because of the mass buying of these tests.” — Sean Cononie, Cosac Foundation for the homeless, Davie
Biden had announced earlier this month he wanted home tests to become free and widely available. I couldn’t find any reference he made to the $14 price you mentioned.
The president is making this announcement as the omicron variant of COVID-19 is spreading quickly. At-home tests are in high demand now and hard to find, although pharmacies say they are regularly restocking. Prices start at about $7 per test (or $14 for two, maybe that’s where you heard the $14 number) and go as high as $38.99. These costs could become prohibitive for a family that’s testing regularly, so hopefully the president’s plan will come to fruition.
Q. “My wife and I are fully vaccinated and received our booster shots in late September. If everything stays OK, we would like to visit New York City in May for a week. Would proof of our vaccination (and not a negative COVID test) be sufficient for our trip? And if we travel to Montreal and then on to Toronto from New York, would our full vaccination status still be sufficient? Would our full vaccination status be all that’s needed to return to Florida?” — David, Aventura
A. You don’t need a negative COVID test or proof of vaccination to travel in the United States, although there could be some venues, such as restaurants or museums or theaters you visit in New York, that will want to see your vaccination cards.
Canada is a different story; you will have to upload your vaccine info and COVID test results to an app called ArriveCAN. You may even have to undergo another test upon arrival: “The Government of Canada is increasing the number of fully vaccinated travelers being selected for testing to reach 100% of vaccinated travelers in the coming weeks,” according to a government website.
As for returning to Florida, you will not need to show any vaccine or testing documents to anyone. But you can feel good knowing you are fully vaccinated and boosted and unlikely to be spreading COVID or its variants.
Q. “I got my second Pfizer shot at the end of February 2021. Every month since then I have suffered facial swelling and vision problems. I am afraid of the booster. What should I do?” — Judith
A. This is one for your doctor. These symptoms may or may not be a reaction to your Pfizer shots, said Dr. Andrea Klemes, chief medical officer at MDVIP, a national physicians’ network with headquarters in Boca Raton.
“I would suggest she talk to her doctor,” Klemes said. “She may have medical conditions causing these symptoms or something new going on. She needs to be evaluated and not assume it is from the vaccine.”
Q. “Can I just walk in to my local pharmacy for my booster or do I need an appointment?” — John, Coconut Creek
A. Get in line; everyone wants a booster now that the omicron variant is looming among us. A record-breaking 308,217 people in Florida got their boosters last week.
You may get lucky and be able to walk right into a pharmacy without an appointment, but I would call ahead and see if they will take you. Publix, for example, prefers that you make an appointment.
“While our pharmacies do take walk-ins, appointments receive priority and a pharmacist and/or pharmacy technician may not be available to administer a vaccine that is not scheduled,” Publix spokeswoman Maria Brous said. “Some stores may have a vaccine check-in table that would allow customers to inquire if walk-in vaccinations are available on that particular day.”
Here’s a way to see where boosters are available in your ZIP code: Text 438829 to receive a list of nearby pharmacies with doses available.
Q. “I need a COVID test to get on an international flight but every place I look into wants to charge more than $100. Is there anywhere that is low-cost or no-cost?” — Jill, Coral Springs
A. There are many testing sites in South Florida that won’t charge you; the problem is they may not get your results back in time. There are 11 free sites run by the Florida Department of Health in Broward County. They don’t require an appointment, will take any age and will take you whether you are vaccinated or not. Results typically come back within two days, spokeswoman Nina Levine said.
Palm Beach County has a similar number of sites with similar rules. Then there are the commercial sites that will either bill your insurance or require you to pay out-of-pocket. They can cost as much as $350, but promise to get you results quickly, sometimes within a few hours. So you have to weigh how fast you need the results with whether and how much you’re willing to pay.
Q. “I am yet to get my COVID-19 booster. Should I go now, or should I wait until the pharma companies develop a new formulation that will combat the omicron variant?” — Martin, Hollywood
A. No need to wait; go now, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience. The booster likely will offer protection from this scary new variant of COVID-19.
“If it has been six to eight months since your second COVID vaccine and you have not contracted COVID since then, it is recommended that you receive your booster, regardless of omicron,” she said. “While vaccine manufacturers are currently testing the effectiveness of the vaccines against omicron as well as developing specific mRNA codes that target the omicron variant, there is no timeline as of yet as to when these new vaccines will be available.”
The current vaccines protected us from the delta variant, so there’s hope they also will shield us from whatever comes our way in the coming months, she said.
“Vaccine manufacturers are constantly chasing their tail when it comes to variants, so a new variant may be present by the time a vaccine against omicron and delta become available,” she said. “It’s best to protect yourself as best you can by getting whatever booster is available to you currently.”
Q. “My husband and I both had a mild case of COVID-19 in January 2021, then got the first shot of Moderna in March, followed by the second in April. I plan to get my booster in the next few days. How long will immunity last with this third shot?
Also, this may be too soon to ask, but my husband and I plan to take my dream trip to Italy the end of June 2022 immediately followed by a trip to England to visit family. That’s seven months from now, so we’ll need to renew our COVID-19 vaccines prior to our trip, right?” — Linda, Boca Raton
A. Immunity wanes approximately six months after you’ve gotten two shots of Pfizer or Moderna or one shot of the Johnson & Johnson vaccine, said Dr. Jorge Perez, founder of KIDZ Medical Services, which has offices throughout South Florida. That’s why boosters are now encouraged, although recommendations continue to evolve.
“Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently said that the stance on boosters could change in the future as more data on their efficacy becomes available,” Perez said. “Overall, I recommend that my patients — and my family — follow the CDC recommendations in effect four to six weeks before their scheduled travel date.”
There are no recommendations for a second booster, or a fourth shot, at the moment, although that could change as omicron and other variants continue to emerge in the coming months.
“At that time, they also need to reconsider traveling to a country that is in the middle of a surge, as several in Europe are experiencing right now,” Perez said.
Q. “I am a Type 2 diabetic. I received the Pfizer vaccine. Six months from my last dose would be Dec. 28. I’m planning a Christmas trip. Should I get my booster two weeks before my trip, so that I have increased resistance before I travel?” — Robert
A. Go for it, said Dr. Andrea Klemes, chief medical officer at MDVIP, a physicians’ network with headquarters in Boca Raton.
“The Centers for Disease Control and Prevention recommends six months between your second dose and your booster, but I think it makes sense to get it two weeks early to ensure you are protected on your trip,” Klemes said. “Personally, that is what I would do.”
Q. “I had to get a tetanus shot about a month ago. Walgreens only had DTaP. Can I get a COVID booster now or is it too soon? Will the tetanus shot fight the COVID antibodies?” — Krista, Fort Lauderdale
A. DTaP is a triple-whammy vaccine that prevents diphtheria, tetanus and pertussis. Your DTaP shot will get along just fine with a COVID booster, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.
“This is a very common question,” Beckerman said. “Each vaccine works by making antibodies to a specific protein found on that virus or bacteria. When you get the COVID vaccine, your body makes antibodies specifically against the spike protein on the outside of the COVID virus. Those antibodies don’t affect a different virus or bacteria. So if you get a DTaP vaccine, the antibodies you make as a result of that vaccine don’t affect other viruses or bacteria. Therefore, you can receive the COVID vaccine regardless of any other vaccine.”
Q. “I may be a rare case, but I received my first Moderna vaccination in late January and my second in late February. Then this summer, I caught COVID and became quite ill with it. Do I have any extra protection? Can I get it again? I work with someone in a small office who refuses to get vaccinated and wears a mask only sporadically. That’s troubling.” — Susan
A. It’s true that you’re in the minority, but vaccinated people do get COVID and can get it more than once. According to the Centers for Disease Control and Prevention, there were 91 cases per 100,000 vaccinated people in the United States who had COVID as of Oct. 2, compared with 452 cases per 100,000 among the unvaccinated.
Now that you’ve recovered, you have extra protection, but how much and for how long is unknown, said Dr. Andrea Klemes, chief medical officer at MDVIP, a physicians’ network with headquarters in Boca Raton.
“You can get COVID after being vaccinated and you can also get COVID again after having had it before,” she said. “I would discuss your particular case with your doctor, but you may consider a booster shot if it has been more than three months since you had COVID and you meet the criteria.”
Q. “I received my COVID-19 vaccinations in January and February and then went for the monoclonal antibody injection in August. Do I still need to get the COVID booster?” — Deb
A. Monoclonal antibodies are proteins that fight the virus and have been successful in treating mild to moderate COVID. According to the University of Pittsburgh Medical Center: “If you receive monoclonal antibod(ies), it remains important to be vaccinated to prevent serious illness in the future.”
The Centers for Disease Control and Prevention recommends that you wait 90 days after treatment with monoclonal antibodies before getting a COVID shot. Depending when in August you got your monoclonal injection, you can head over to a pharmacy now or in the coming weeks to get your booster.
Q. “I am an over-70 survivor of open heart surgery and living with well-controlled Type 2 diabetes. I have had all three Pfizer vaccinations. What is your advice on attending a family gathering with vaccinated adults but several children under 11 still unvaccinated?” — Patricia
A. Don’t cancel Thanksgiving! There are several things you can do to create a safe gathering. Here are some recommendations from the Centers for Disease Control and Prevention:
Stay outdoors as much as possible.
Make sure indoor spaces have good air circulation and are not too crowded.
I would add you should get tested for COVID-19 before you go and ask others who are attending to get tested, too. The Binax Now home tests are about $25 and known for their accuracy.
Since you have some pre-existing conditions, there’s extra advice from Dr. Joanna Drowos, an associate professor of family medicine at Florida Atlantic University in Boca Raton.
“As someone who is at higher risk of becoming ill from a COVID-19 infection, the recommendation would be to mask when indoors, and ask others to mask around you as well,” she said. “You can still enjoy an event with your family, but make sure to spend time outdoors, keep your distance and wash your hands.”
Q. “Do you know of anywhere that would give a Pfizer booster in the thigh for someone diagnosed with breast cancer in both breasts?” — Survivor
A. You do have to ask around when you want your shot anywhere beside your arm. One possibility is a doctor’s office, said Dr. Hila Beckerman, a pediatrician with extensive vaccine experience.
“When administering the Pfizer vaccine, the most important aspect is to give it in the muscle,” she said. “The upper arm is more easily accessible and has less fatty tissue covering the deltoid muscle, which is why it is most commonly administered there. The anterolateral thigh can absolutely be used as an alternative location. However, it is imperative to ensure that the vaccine is placed inside the muscle. Therefore, those receiving a vaccine in the thigh may need to use a longer needle (commonly 1.5 inch, as opposed to a 1 inch needle in the deltoid). This will obviously depend on your body type and weight.”
I asked a CVS pharmacist and she said they weren’t allowed to do this. But some Publix pharmacists do have the training and the right needles; you just need to confirm this before you go, Publix spokeswoman Maria Brous said.
“There is additional training that accompanies administering a vaccine at an alternative site, such as the thigh,” said Brous, who added that the customer would have to prove a medical need. “We would want to ensure that our pharmacist has the training to make it a seamless process for our customer.”
Q. “I had a mild to moderate COVID infection in July 2020, not requiring any hospitalization. I was vaccinated with the Pfizer shot in January and February of 2021. I am wondering whether it is appropriate to get a booster shot at this time, or do I have enough protection currently and is it wiser to postpone a booster until the one-year mark of my second vaccine?” — Susan
A. If you meet the age and health criteria, you can get your booster now, said Dr. Andrea Klemes, chief medical officer at MDVIP, a national physicians’ network with headquarters in Boca Raton.
“Per the CDC recommendation, you should get a booster if it has been six months since your last shot and if you are over 65 or between 18 and 64 with health conditions that put you at high risk,” she said. “The CDC recommends those that had COVID get vaccinated as long as they wait 90 days from the start of the infection.”
Q. “A person who was fully vaccinated against COVID-19 (two Pfizer doses) in January and February 2021 subsequently lost a great deal of blood over a short period of time (June to August 2021) and received over a dozen transfusions. Subsequent to that, an antibody test was administered and it revealed zero antibodies for COVID-19. Is the most likely explanation that the patient’s body did not respond to the vaccine, that the loss and replacement of the large quantity of blood eliminated the antibodies, a combination of both, or something else?” — Renee
A. The transfusions did not affect the patient’s antibody levels, said Dr. Guillermo De Angulo, a pediatric hematologist-oncologist at KIDZ Medical Services, which has offices throughout South Florida. There are several possible explanations for the antibody loss.
“The duration of antibodies seems to differ significantly among patients; that’s why the booster is recommended,” he said. “If the patient was vaccinated with one of the three approved vaccines, my best guess would be that her antibodies were short-lived. But the replacement of blood has no impact on the presence of antibodies.”
Q. “I’m booked on an MSC Divina cruise ship, which departs at 11 a.m. on a Sunday from Miami. They told me I need a COVID-19 test two days in advance, which would make that a Friday test. I have checked with all the people that give tests and they are telling me it takes three days, sometimes up to five days, to obtain your e-mail results and all labs are closed on Sundays! I have spoken to the representatives of MSC cruise lines and they’re telling me that is their policy. I’m willing to follow their policy but if I don’t get my results, I’m standing on the dock ready to board the ship without results of my test. I have received my two vaccines plus my booster shot and I have my documentation to verify that. We are four people trying to get an answer. Do we lose all our money because we didn’t follow their rules and regulations?” — Jerry, Tamarac
A. Although PCR (polymerase chain reaction) tests, which can take several days to come back, are considered the gold standard of COVID-19 tests, MSC accepts the results of rapid antigen tests, which are considered less accurate but come back much quicker.
“MSC accepts several types of COVID-19 testing in order to maximize flexibility for our guests while adhering to our comprehensive health and safety procedures,” spokesman Field Sutton said. “Rapid antigen testing is an option for anyone 12 and older prior to embarking on a cruise, so there’s no need to worry about missing a cruise over the testing requirements. There are numerous places throughout South Florida offering rapid antigen testing with results that arrive within an hour. It’s quick and easy to schedule a test — or just walk in at many locations — during the two days leading up to a sailing.”
Sutton gave an example of his own experience with a rapid test before a cruise.
“I departed on a cruise the afternoon of Friday, Oct. 29,” he said. “I went to a drive-thru testing facility the morning of Oct. 27, drove to work after being swabbed and had rapid antigen testing results waiting in my email by the time I got to work. I then used those results to satisfy proof of testing for boarding the cruise two days later.”
Q. “I received my Moderna booster a few months ago. I have COPD (chronic obstructive pulmonary disease) and have not found any answer as to what type or strength of vaccine I received for this third shot. Is the booster I received acceptable or must I sign up for Moderna’s new third shot booster?” — Gene, Boynton Beach
“You likely received a full dose, just like with your other two,” said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience. “The half dose wasn’t approved until this fall. The original Moderna concentration is 100mcg and the booster has shown to be just as efficacious at half that dose, which is 50mcg, and with decreased side effects. There is currently no recommendation for a fourth dose.”
Q. “I’m a yoga teacher in South Florida. I found out that a student who had been in one of my classes came down with COVID-19. The student with COVID told the yoga studio owner, but the owner did not tell me or anyone who was in that class. Was there a legal obligation for the studio owner to share this information with me or the people in the class? I feel like we all should have been told so we would know to get tested.” — Concerned instructor
A. There’s no legal requirement. It’s more of a moral responsibility, said attorney Peter Sachs, a founding partner and chairman emeritus of the law firm Sachs Sax Caplan in Boca Raton.
“The yoga studio owner has an obligation to maintain a safe environment for her customers,” Sachs said. “In my opinion, this responsibility would include an obligation to notify the other students in the class that one of the students (name should remain confidential) they participated in class with had come down with a contagious disease such as COVID-19. The yoga studio owner breached that duty by withholding this information either intentionally or negligently.”
There might have been a legal remedy if the teacher contracted COVID-19 from the student in her class, Sachs said. But I followed up with the teacher and she didn’t.
“There is no remedy for simply not notifying her,” Sachs said. “Her option without anything else would be to stop doing business with that studio.” The instructor told me that’s exactly what she’s done.
Q. “How many people have died from taking the COVID-19 vaccine?” — John Silberman
A. As of Nov. 8, 9,549 COVID vaccine-related deaths were submitted to the CDC’s Vaccine Adverse Event Reporting System (VAERS). That’s 0.0022% of the 423 million doses given out in the United States.
But VAERS has proven to be an imperfect source of information. Health care providers are required to report deaths after vaccination to VAERS even if there’s no direct link to a vaccine, and average citizens also can submit information. So it’s a jumble the CDC warns should be analyzed by statistical professionals.
Widely shared reports on social media have said 150,000 people have died from COVID vaccines. But Reuters Fact Check rated these statements as false.
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The only causal link that’s emerged so far between vaccines and deaths has occurred in some women who took the Johnson & Johnson vaccine. In April, the CDC reported three deaths from a rare blood-clotting disorder among women 18 to 49 who got the single-dose J&J. The CDC halted J&J shots April 13 but approved their resumption 10 days later, saying their advantages outweighed their potential dangers.
Q. “I am a Canadian who owns a condo in Coconut Creek. I am planning on flying to Florida Dec. 6. I have had my two Pfizer vaccines. The second one was on June 5. Will I be able to get the Pfizer booster? If yes, will I be charged for it?” — Rosa Rudick
A. You can get your shot here, and there’s no cost. COVID-19 vaccines in Florida are available to “full-time and seasonal residents,” according to the Florida Department of Health.
“Additionally, anyone in the state for the purpose of providing goods or services is also eligible to receive the COVID-19 vaccine in Florida,” according to the department.