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Experts answer your COVID-19 questions: ‘Are people who haven’t been vaccinated by have had COVID carriers?’ | Coronavirus

Have a question about COVID-19? We will ask the experts.

Note: Due to the volume of questions submitted, we will not be able to answer them all. Any questions of an urgent nature should be directed immediately to your primary care physician.

Readers of The Tribune-Democrat asked the following questions:

“I saw that fully vaccinated persons are not COVID carriers. How about those that are not vaccinated, but have had COVID? What about reinfections from more virulent strains as it pertains to those that have had the virus, but are not vaccinated, especially those who are under 30?”

The answer:

I am not sure where you saw this, but there has been no scientific study completed to determine this claim.

Individuals who have been vaccinated may still be able to transmit the virus. A study done in monkeys shows that the virus may be in the nose one to three days after exposure. This equates with no clinical infection, as the immune response will destroy the virus, but it does not assume that those individuals are incapable of spreading the virus in that time frame.

A study is being conducted now to answer that very question. The study is using 18-22-year-olds. Half have been vaccinated. These people will be swabbed daily to determine if an exposure resulted in possible transmission. The results are expected in December.

Anyone who is symptomatic for COVID-19 is contagious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My sister got her second dose of Moderna and has chills/fever and body ache. I haven’t had my vaccine yet. Is she contagious?

“Should I wear a mask?”

The answer:

I am so happy to hear your sister chose vaccination.

No, she is not contagious. The vaccine is doing its job, and your sister’s body is mounting an immune response to the virus that causes COVID-19. She should be feeling better within 36 hours of her vaccine.

I do recommend that you continue to wear your mask in public.

Once you are fully vaccinated, you will be able to gather in small groups with other vaccinated individuals.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“We live in a multi-generational home – my husband, my father (63 years old with COPD and diabetes), sister, brother-in-law, nephew and me. My husband will be fully vaccinated, and he intends to visit with his fully vaccinated friends from different households before there has been two weeks passed for the rest of the family after their second dose. Actually, on the same day, my father will be getting his second dose. I advised him against it because the rest of our family will not yet be fully vaccinated and, while he could be safe, there is the chance he can transmit the virus to us before we are fully vaccinated.

“Can you help with guidance? Is my assumption correct that it is better for him to wait until the rest of the household is fully vaccinated?”

The answer:

Science is working to answer the very question you are asking.

If you husband can wait a few more days, it will be safe for all.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had my second vaccination shot on March 16, and then had an allergic reaction to touching shellfish on March 26. Is this anything to do with the vaccine? I’ve been eating shellfish all my life.”

The answer:

Your reaction was 10 days later.

Allergic reactions occur, for the most part, within seconds to minutes of exposure to the substance. I would venture to guess that you are allergic to something that was on the shellfish.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband and I contracted COVID on Feb. 26. We were both sick for 10 days; low-grade fever, chills, brain fog, loss of taste/smell and extreme fatigue. After isolation and experiencing no more symptoms, we received the first Moderna shot on March 17. Within 18 hours, we felt like we were hit by a truck. Fever, chills, nausea, headache, rash and severe exhaustion for four days.

“Naturally, we are hesitant and scared for the second shot. Will it be as bad, or worse, than the first shot? I don’t think I can handle being that sick, or sicker, so soon again.”

The answer:

The most common side effects reported are headache, low grade fever and tiredness with the Moderna vaccine. You may experience those symptoms again.

I recommend that you drink plenty of water the day of your vaccine and take acetaminophen to help alleviate the symptoms.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My mother-in-law has tested positive twice. She was supposed to have a hip replacement, and they have postponed twice.

“She has no signs of COVID and has had both shots. What can she do? She is in so much pain.”

The answer:

When was her initial infection? Sometimes the virus is persistent in detectable levels up to 12 weeks or longer after infection, but likely isn’t infectious.

For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within 3 months after the date of symptom onset for the initial infection.

Your mother-in-law is fully vaccinated two weeks after her second dose of the vaccine.

I recommend your mother-in-law consult an infectious disease specialist who can clear her for the planned hip surgery.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If a person tested positive for COVID and had to quarantine for 14 days, is it safe for that person to get their vaccine shot now?”

The answer:

If you are not symptomatic for COVID-19, or any other infectious illness, you can get your vaccine. If you have had another vaccination in the past two weeks (like the shingles shot or pneumonia vaccine), you should wait 14 days before getting the COVID-19 vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My spouse received his first vaccine and I haven’t gotten mine. Are we safe to sleep in the same room together? Do I need to wear a mask around him? It gives me a lot of anxiety that he is vaccinated and I am not. I want to be safe, but I want to be comfortable living in my own home, too.”

The answer:

Studies of the mRNA vaccines (Pfizer and Moderna) suggest that one dose may offer between 50-80% protection. The Pfizer and Moderna vaccines are 94-95% effective two weeks after the second dose.

I understand your anxiety associated with you not being vaccinated. I recommend you get vaccinated as soon as vaccination is offered to you.

If there is no known exposure to another person with COVID-19, masking with your spouse in your home is not required in my opinion.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had my second Pfizer vaccine on March 22 and was exposed to COVID on March 24 by my son’s girlfriend. She started showing symptoms on March 25 and she got tested that day and my son started getting symptoms on March 28. He got tested on March 30 and they both got their results on March 31, and tested positive. I went for a test on March 30 and my results came back negative and I have no symptoms. The question is: did I test too soon? Also am I at risk of spreading it to unvaccinated people even though I tested negative? Do I need to quarantine?”

The answer:

Yes, you need to quarantine separately since your exposure was before you were fully vaccinated. People are considered fully vaccinated two weeks after the second dose in a two-dose series (Pfizer and Moderna).

Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Another option is your quarantine may end after Day 7 if a diagnostic specimen done on Day 7 tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I got my first Pfizer shot three weeks ago and I’m in Antigua. They gave me a rapid test and they said it came out positive. I’m flying back to the United States in three days. Could this be a false positive and what do I have to do?”

The answer:

Did you have a known exposure?

The rapid test is good for individuals who are experiencing symptoms of COVID-19. It tests for viral proteins. If you are not actively making virus, it is difficult for the test to show positivity.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have had both COVID shots a month ago. Today, my sister informs me that she has tested positive for COVID. She did have symptoms. We were all together for a family gathering on March 23 – wore masks, etc. Those of us who have had our shots, do we need to self-quarantine? If so how many days?”

The answer:

People who are vaccinated against COVID-19 do not need to quarantine after an exposure to another person with COVID-19 if they meet all of the following criteria:

• They are fully vaccinated (greater than 2 weeks after the second dose in a 2-dose series, or greater than 2 weeks after 1 dose of a single dose vaccine);

• They are within 3 months after the last dose in the series; and

• They have no symptoms since the current COVID-19 exposure.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am scheduled for surgery next week. I have an appointment for my COVID vaccine this week. Is it safe to take the vaccine?”

The answer:

In my opinion, yes. Please inform your surgeon.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am getting my first COVID shot April 19, and on April 22 I am having a cardiac CT and will be injected with contrast to highlight my vessels. Is this OK?”

The answer:

Yes.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my second Pfizer shot on March 16. I am still getting pain in my right arm where the shot was given.

“There is no rash or other signs of side effect. The pain is now radiating to my shoulder and neck but mostly in the arm.

“At times when it is severe I have trouble raising my arm. Any ideas?”

The answer:

Perhaps you’re dealing with a shoulder injury (shoulder bursitis or tendinopathy) related to vaccine administration.

I recommend you contact your physician for an evaluation and consider a trial of physical therapy.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My boyfriend has a 102.7-degree fever. He was exposed to COVID and has been in bed the past two days – today puking and high fever, hasn’t eaten anything; nonstop sleeping. He was exposed last Sunday. He has the chills. His last two blood works from his doctor came back elevated. He went for the third time. If elevated he has to see his cancer doctor. Help. What do I do?”

The answer:

It sounds like your boyfriend has severe illness, and I advise transporting him as soon as possible to a medical center emergency department for urgent evaluation and treatment.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter’s boyfriend is in hospital for stomach issues, but he tested negative. Then they sent him to another hospital, and he tested positive. My question is, we were eating at a restaurant where my daughter works, and her boyfriend showed up and sat at our table.

“We drove him home, and that was five days ago. Do my fiancé and I need to get tested now that he’s positive?”

The answer:

Considering the time frame, and if there were no symptoms since the last contact at the restaurant, no testing is needed at this time.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I live in Canada. I received my first dose of Pfizer on March 4. My second one is scheduled for June 23; this is how they’re doing it here. How protected will I be with the doses so far apart?”

The answer:

Recent research into the Pfizer and Moderna shots show that individuals will have 80% protection from infection within 14 days of the first dose.

I can understand how it is confusing and frustrating to have to wait so long to receive your second dose. Your country, Canada, is choosing to vaccinate everyone before they give second shots.

This is one public health strategy that is being employed to combat COVID-19.

If you continue to wear your mask, wash your hands and maintain physical distance from others outside your pod, this will also help you to reduce your risk of COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had my first Moderna vaccination on March 8. Right after the shot, I experience a short wave of flushing. It made me a little nervous, but it went away as quickly as it came. I am due for my second vaccine on April 8, and I am a little nervous that it could be worse. I have never had a reaction to any vaccines or flu shots.”

The answer:

Most people experience mild cold-like symptoms upon the second shot.

Our bodies have a response called the sympathetic response. It is our fight-or-flight response. When we are startled, scared or encounter anxiety, this response kicks in. Since the flushing you described went away quickly, I am hypothesizing that it was due to the sympathetic response and not the vaccination.

However, it is best for you to wait the required 15 minutes in the presence of medical personnel after your second shot to be as safe as possible.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“How does a senior citizen (over age 85) get a second dose when the provider of the first dose states they have no idea when they will receive their allotment? Online sign-ups do not allow us to register for second-dose only.”

The answer:

This is a good question. I am sure you are frustrated by the unknown. Vaccine distribution to providers can be challenging. Some providers only know a few days before they receive the doses how many they will get.

I am certain that your provider will contact you when doses become available. You can delay the second dose up to six weeks.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am due for a my second Moderna vaccine and was informed my friend tested positive five days ago, and I was at their house. Can I get the second vaccine? Also, is it safe or do I have to be tested before I get the vaccine?”

The answer:

I recommend you self-quarantine separately.

Persons with known exposure should wait to seek or complete vaccination until after their quarantine has ended.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive for COVID on March 25 using the rapid test. I was told to quarantine for 10 days.

“I alerted my mom, whom is my next-door neighbor and is experiencing the same symptoms I am – allergy-like symptoms. She went the next day, and they would not give her a rapid test because they said she did not have enough symptoms and a two-day test is more accurate. Her results came back negative. What are the chances my test was a false positive? I called my doctor and requested a two-day test but was denied. I was put on a steroid and antibiotic because I have interstitial lung disease due to a toxic reaction to chemotherapy.

“I feel like I am at my baseline.

“I typically get a sinus infection at the change of every season and am allergic to mold.”

The answer:

The chances of your rapid test being a false positive are 50/50.

Out of an abundance of caution, I recommend you self-isolate separately 20 days since you were treated with a steroid.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I got my first COVID vaccine and my son tested positive do I still have to quarantine?”

The answer:

Yes, you should quarantine separately.

Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Another option is your quarantine may end after Day 7 if a diagnostic specimen done on Day 7 tests negative, and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband had a liver transplant 14 years ago and has been on immunosuppressants since. He also is going through chemotherapy for multiple myeloma. He will be doing this once a month for the next two years. He has had both his vaccines (Moderna). How protected is he with the vaccines? We want to go see our newborn great-grandson.”

The answer:

Although data are not currently available to establish vaccine efficacy in these patients, the Centers for Disease Control and Prevention (CDC) recommends vaccination of immunocompromised patients.

I’m glad your husband was vaccinated, and I also recommend you get vaccinated if you are not. You are considered fully vaccinated two weeks after the second dose of a two-dose series. I’m very optimistic that you and your husband will see your new great-grandson.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I got both Moderna shots, and then traveled to Las Vegas to visit my son. How long should I quarantine now that I am back? I was very careful. I wore my mask all the time.”

The answer:

Individuals who are fully vaccinated do not need to quarantine from exposure to someone with COVID-19.

You do need to keep wearing your mask in public and when around individuals who have not been vaccinated. There is a chance that you could spread the virus to them before your body eliminates it (if you happen to have an exposure).

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife took her second COVID-19 shot (Pfizer) 12 days ago and is experiencing a cough and headaches. What do you recommend?”

The answer:

Your wife should be fully vaccinated now. Headache is a known symptom after Pfizer vaccination, but cough is unusual and may not be related to the vaccination.

Therefore, I recommend she be evaluated by her primary care physician as soon as possible.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received the Johnson & Johnson vaccine, and 48 hours later my young daughter tested positive. I am waiting on the results of my COVID test, but would like to know if I need to be vaccinated again if I test positive?”

The answer:

Our immune systems take 14 days to reach full potential for protection against any pathogen after vaccination. Your body is working to make that protection for you.

What this means is that you may be infected with SARS-CoV-2, the virus that causes COVID-19, from your exposure, because your body has not reached full protection from the vaccine.

I hope your daughter has a mild case of COVID-19 and that all in your home are well soon.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Neither myself nor my adult daughter have had COVID. We have had both shots. Do we have to wait two weeks to be in the same house without wearing masks? I’m 82 and she is 61. She works in an office. My last shot was mid-February. Her last shot was a week ago.”

The answer:

People are fully vaccinated two weeks after the second dose in a two-dose series. You are fully vaccinated, and your daughter will be in one week.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My friend in Florida, who is 87, got her second dose of Pfizer vaccination six weeks ago and now has developed COVID. How is this possible? I thought you are protected.”

The answer:

The Pfizer COVID-19 vaccine is very effective (95%), but it is still possible you can get COVID-19. If you are vaccinated and test positive for COVID-19, your symptoms are expected to be milder and you’re less likely to be hospitalized.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have leukemia and will be getting the COVID vaccine. My wife does not want to get it. Is that a problem?”

The answer:

The available COVID-19 vaccines are safe, very effective, and will decrease COVID-19 related severe illness and deaths. Therefore, COVID-19 vaccination is strongly encouraged, and it is safest if she is also vaccinated.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Why, after having COVID-19 and having been vaccinated, am I still required to swab test for COVID at my place of employment? A little ridiculous.”

The answer:

Thank you for choosing vaccination.

Each work place may have varying rules for returning to work. I know it can be frustrating in your situation, but what may be the case is that they are setting rules for everyone, regardless of COVID-19 recovery or vaccination status. I sympathize with your frustration.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I just had blood work, and my IGG levels are below 300, so I get monthly IGG infusions to help. My second Pfizer vaccine is soon. Can I get my IGG infusion, or should I wait until after my vaccine to get it?”

The answer:

The CDC says COVID-19 vaccines may be given to patients who receive passive antibody treatment not specific to COVID-19.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I have been vaccinated and am exposed to someone with COVID-19 (close contact) do I still need to quarantine?”

The answer:

If you are fully vaccinated, meaning you have had both shots of the mRNA vaccines and are two weeks out from the last shot or you are two weeks out from the single-shot Johnson & Johnson, you do not have to quarantine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My friend got her first COVID vaccine two weeks ago. She is now in the hospital with COVID and pneumonia. I went with her when she got her first shot. Should I now get a COVID test to make sure I don’t have it?”

The answer:

In my opinion, COVID-19 testing is not necessary if you had no symptoms during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Would my siblings be safe for a get-together? One lives out of town. We have all had the COVID vaccine. Should we be safe?”

The answer:

Yes, you should be safe. The risk should be minimal – less than 5% if everyone is asymptomatic and fully vaccinated (more than two weeks after the second dose of either the Pfizer or Moderna vaccine).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am 65-plus and I got my first shot of Pfizer on March 17. I got absolutely no reaction. Could that mean they forgot to inject the Pfizer vaccine in me? Sorry, but that’s what I feel.”

The answer:

Thank you for choosing vaccination. Most people do not experience any issue with vaccination. I am sure that the medical professional who gave you the injection did so correctly.

You may experience tiredness, pain at the injection site and mild body aches upon your next dose of the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had tested positive back in November. I had my first shot in the beginning of March, and my second one is due soon. My son-in-law that lives with us has tested positive. Do I still have to quarantine?”

The answer:

Yes, you should quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.

Another option is that your quarantine may end after Day 7 if a diagnostic specimen tests negative on Day 7 and if no symptoms were reported during daily monitoring.

Persons with known exposure should wait to seek vaccination until after their quarantine period has ended.

According to updated CDC quarantine recommendations, people who are vaccinated against COVID-19 do not need to quarantine after an exposure to another person with COVID-19 if they meet all of the following criteria:

• They are fully vaccinated (greater than two weeks after the second dose in a two-dose series, or greater than two weeks after one dose of a single-dose vaccine);

• They are within three months following the last dose in the series; and

• They have remained asymptomatic since the current COVID-19 exposure.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am male, 69 years old, and in September, I had a severe bout of COVID-19 and dengue at the same time while in the Caribbean. I am well now and came out after 12 days of hospitalization and treatment.

“On March 9, I took my first shot of the Pfizer vaccine while staying at my son’s house in Florida. On March 14, my son and I started having symptoms of a cold. He tested positive on March 16. My wife, who is much younger than I (35 years) and who has no symptoms, and I tested negative on March 18, or five days from my first symptoms. We have isolated together from my son.

“I feel that with antibodies from both having COVID and my first shot, I am keeping severe onset of COVID at bay. On March 22, I continued with mild cold symptoms and retest with rapid antigen test and still test negative. My wife tested positive and she still has no symptoms. My cold symptoms improved slightly. Although I tested negative, I feel that we both have COVID and are isolating together; it’s just not manifested in my rapid test. Since she shows no symptoms, I also feel that it would be safe to stop isolating 10 days after her positive test, or March 31. We isolate together from my son, who is recovering, as I am.

“I am due for my second shot. If I am well, I believe I should take the second Pfizer shot. My wife does not qualify at the moment for a vaccine. Our vitals are good, no fever, no shortness of breath, oxygenating 98-99, no fatigue. For me, runny nose and mild cough with mucus. Getting better. My son is also recovering the same.”

The answer:

The current recommendation for persons with current COVID-19 or asymptomatic SARS-CoV-2 infection is: Defer vaccination in persons with known current COVID-19 infection until the person has recovered from acute illness and no longer requires isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my second Pfizer vaccine on Feb. 12. My husband just received his second Moderna dose on March 16. My husband sings with a five-man vocal group, and they have been rehearsing three nights a week for a few months, to my dismay. After rehearsing, one of the members was hospitalized with a fever. While they rehearse, he said, they social distanced (which I can’t see) but couldn’t sing with masks on, of course. If the hospitalized member is found to have COVID, is there danger of my husband getting it or bringing to me, or of us passing it to others even if we do not contract it? I am a Type 1 diabetic.”

The answer:

I am happy to hear that both you and your husband chose vaccination. Thank you!

It takes our bodies 14 days to be fully vaccinated after the last dose of the vaccine. In your case, you are fully protected. The Pfizer vaccine affords 95% protection from infection (with recent studies showing it provides 80% protection against the UK variant).

Your husband was not considered fully protected until March 30. In this case, your husband needs to quarantine, if it is found that he was exposed to someone with COVID-19, for at least 10 days (14 if he does not test negative on Day 7 or 8).

You do have a 5% chance of becoming sick. I urge you to wear your mask when sharing space with anyone who is not fully vaccinated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am 67 years old and received the Moderna first dose on Feb. 27. I am very healthy and had very little reaction, a sore arm. I took a mandatory test for volunteer work on March 16 which was presumptive positive, retested on the 18th and received a positive result. I have no symptoms. I am self-quarantining to be safe for others until my apointment for the second Moderna shot. Should I go in for the second dose?”

The answer:

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“How early can you get the second shot of Moderna?”

The answer:

The earliest you can receive the second dose of the Moderna vaccine is 28 days.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I received the Johnson & Johnson vaccine exactly two weeks ago with no major side effects except the usual sore arm. Would it be possible in a few months to get the Pfizer or Moderna as a booster to help prime the immune system?”

The answer:

I know that there is much information circulating about the virus and variants and what vaccines are most effective. This can make your head spin!

The Johnson & Johnson vaccine is highly effective at preventing serious COVID-19 infections. This means that you may get sick, but it will be a mild, cold-like illness.

There are booster shots in development for the new strains of COVID-19. When they are out, you may want to consider getting one. For now, I see no reason for you to get the Pfizer or Moderna vaccines in addition to the Johnson & Johnson vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had the first vaccine on Monday and had to do a CA (cancer antigen) 125 test two days later, it came back abnormal. Is that possibly the result of having received the vaccine? My oncologist did not know I had the vaccine and ordered a CT scan. Next dose is in three weeks. How long should I wait for a second CA 125 test?”

The answer:

I’m not aware of any currently available COVID-19 vaccine causing an abnormal CA 125 test result. I recommend you follow up with your oncologist.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I wanted to ask if I have been fully vaccinated but my husband has not been, I know it is 95% effective, but do I still need to continue to wear a mask around my husband? We have not slept in the same room for months. I wear a mask whenever he comes home. Is it necessary for me to continue.

“I’m overweight with Type 2 diabetes. I have mild CHF and an arrhythmia from chemo and radiation. I have been treated for asthma in the past and chronic bronchitis. So I have a lot of risk factors. I have had breast cancer with a recurrence in lymph nodes four years later, but I’m five years out from treatment, so can I stop wearing a mask around my husband? He refuses to vaccinate. I will continue to wear a mask in public, but it would be nice to not wear one around him and to be in the same room to sleep.”

The answer:

Since you have a history of medical issues that increase your risk of complications associated with COVID-19, I suggest that you continue to wear your mask around your husband.

I know conversations around vaccination can

be difficult. I suggest that you speak frankly and from the heart to your husband and attempt to determine why he is against vaccination. There

are some great resources on the website:

www.inthistogethercambria.com. Together you can look at the information and help alleviate any fears or misconceptions your husband may have about vaccination.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My granddaughter went to her father’s for a weekend visit, spending time with four step-siblings and stepmother. She left Sunday and the dad came down with COVID on Thursday. I am high-risk, COPD and diabetic on oxygen 24/7. We are to meet Sunday for a family day. Is it safe for me to be with her.”

The answer:

Your granddaughter is a close contact with exposure to another person (her dad) with COVID-19. She should quarantine. Ideally, people should quarantine separately. Her quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Another option is her quarantine may end after Day 7 if a diagnostic specimen done on Day 7 tests negative and if no symptoms were reported during daily monitoring.

I recommend you get vaccinated for COVID-19 considering your high risk and medical history.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my second Pfizer vaccine on Feb. 12. My husband just received his second Moderna dose on March 16. My husband sings with a man vocal group and they have been rehearsing three nights a week for a few months – to my dismay. On March 19, after rehearsing the previous night, one of the members was hospitalized with a fever. While they rehearse he said they social distanced (which I can’t see) but couldn’t sing with masks on, of course. If the hospitalized member is found to have COVID, is there danger of my husband getting it or bringing to me? I am a Type 1 diabetic. Or of us passing it to others even if we do not contract it?”

The answer:

I am happy to hear that both you and your husband chose vaccination. Thank you!

Your husband is not considered fully protected until March 30. In this case, your husband needs to quarantine, if it is found that he was exposed to someone with COVID-19, for at least 10 days (14 if he is does not test negative on Day 7 or 8).

You do have a 5% chance of becoming sick. I urge you to wear your mask when sharing space with anyone who is not fully vaccinated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“We have a trip to Florida planned on March 26.

We just found out that my son’s friend tested positive a couple of days ago. My son sits next to him in one of his classes. The school told us my son has to quarantine for 10 days as a safety precaution.

“Should we cancel the trip? We were told by the airline that as long as my son has no symptoms, he can still fly. We plan on getting him tested in a few days as well. If he tests negative and has no symptoms can we still fly to Florida? We would hate to cancel the trip if he is negative and has no symptoms.”

The answer:

Your son is a close contact with exposure to another person with COVID-19.

I recommend your son quarantine. Ideally, people should quarantine separately. His quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Another option is your son’s quarantine may end after Day 7 if a diagnostic specimen done on Day 7 tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am 8 months out from my COVID infection and am a long-hauler. Though my symptoms have gotten much better, I still randomly get a low-grade fever and struggle with fatigue. I recently got an antibody test and it showed I had IgG antibodies, which is great this far past initial infection but it also showed I tested positive for IgM antibodies.

“To be on the safe side I got a COVID test and it was negative. Is it safe for me to get the vaccine or should I wait until the IgM antibodies drop off?”

The answer:

An excellent question.

A positive SARS-CoV-2 (COVID-19) IgG antibody test indicates you had a previous infection, but it doesn’t give the exact date. Positive IgM and positive IgG antibodies indicates you may be in either the active phase of infection, or the late or recovery stages of infection.

If the negative COVID-19 test was a Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), then in my opinion, you are in the late or recovery stages of infection and it is OK to be vaccinated. However if the negative COVID-19 test was a rapid SARS antigen test, then I do not recommend vaccination now, and instead I advise you to get a RT-PCR swab test as soon as possible.

If the PCR test is positive, then that indicates you are in the active phase of reinfection, and you should self-isolate at least 10 days if you are not immunocompromised and 20 days if you are immunocompromised. In this case, defer vaccination until you have recovered from the acute illness and no longer require isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If a periodic booster vaccination is found to be necessary, will you have to be vaccinated with the same vaccine that you were initially administered?”

The answer:

What a great question.

It is looking as if a COVID-19 booster may be necessary due to the variants that have been emerging and will likely to continue to emerge.

These boosters will be modified to match the various variants associated with the changing virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband and I got the Moderna vaccine on March 2. His only side effect was tiredness. I had severe chills and headache for a couple days, but Tylenol helped tremendously.

“My husband tested positive for COVID on March 10, after being ill with chills, fever and headache for a day or so. He is 83 and has heart conditions and leukemia. He was in the hospital for 13 days before he tested negative, but was very weak and still tired. He was transferred to a skilled nursing facility for rehab, which is going slowly. He has no appetite and has lost 15 pounds or more since being ill. He is scheduled to stay in the nursing facility for a total of 10-14 days.

“My question is, should he get the second dose of Moderna vaccine on schedule, March 30, even if he is still very weak and tired? The nursing facility said he could go with me to get the vaccine, but then would need to return to rehab to finish up until he feels stronger. Do you think he should still get the second dose on time or put it off until he feels stronger?”

The answer:

Due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, my opinion is your husband should receive his second dose of the Moderna vaccine as scheduled on March 30.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Can a person who had COVID on Jan. 13 and has recovered, but was not vaccinated, now be in the same household with a fully vaccinated person three weeks after vaccine? They are a couple, but had been separated since she had COVID.”

The answer:

COVID-19 reinfection is possible, but is uncommon within 90 days following initial infection.

The safest option is for the person who had COVID-19 on Jan. 13 to be fully vaccinated before sharing the same household. Fully vaccinated is greater than two weeks after the second dose in a two-dose series (Pfizer or Moderna) or greater than two weeks following one dose of a single-dose vaccine (Johnson & Johnson).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 39-year-old spouse received his second dose of Pfizer COVID-19 vaccine the first week of January. Early last week, our son who attends elementary school where there are no requirements to wear masks (our son does however, and is the only one of two or three in the entire school) became sick with fever, cough, congestion, fatigue and aches for days. Last night, my spouse became sick with scratchy throat, headache, congestion, fever, chills, body aches and loss of smell and taste. He went to be tested, only because of the smell and taste issue. He had a PCR test that we were told was positive after three hours. I was shocked.

“I, too, have received both vaccinations and have not had symptoms. I guess my question is, how often is this happening? I know it is supposedly 96% effective and my spouse could just be in that unlucky 4% category or possibly infected with a variant. Just wanting to report this or find out how many others have been so unlucky or unfortunate.”

The answer:

I am so sorry to hear that your husband and son are sick. The Pfizer vaccine is 95% effective at preventing COVID-19 from the original strain. A recent study out of India showed that it is 80% effective against the UK variant.

Without knowing the specific genome of the virus your husband had, it is difficult to say if he was infected with a variant or the original.

What has been documented is that those who are vaccinated have a milder case of COVID-19 if they become infected. I sure hope this is the case with your husband.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had my first and second doses of the Pfizer vaccine on Jan. 7 and 28, respectively. On March 17, at a doctor visit at a Mount Sinai clinic, I asked my doctor if an antibody test could be run (given that blood was to be drawn for other assays). She agreed and I just got my results March 19. I really was shocked to see that I tested negative on the Abbott SARS-CoV-2ab, lgG test.

“The results indicated ‘no detectable antibodies.’ Is that possible? I am really devastated, thinking that I was protected, but I am just as vulnerable as before getting the vaccine. And now what do I do? Get revaccinated?”

The answer:

An excellent question.

First, I do not advise repeat vaccination. You are fully vaccinated, and the Pfizer vaccine is 94-95% effective.

Antibody tests indicate you had a previous infection. Experts are currently looking at how a COVID-19 vaccination may affect antibody testing results.

Antibody testing is not currently recommended to assess for immunity to COVID-19 following vaccination or to assess the need for vaccination in an unvaccinated person. Since vaccines induce antibodies to specific viral protein targets, post-vaccination serologic test results will be negative in persons without history of previous natural infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mom got the Johnson & Johnson vaccine. Five days later, she got COVID-19. Will the shot help her at all in recovery?”

The answer:

Vaccination following exposure is not likely to be effective for preventing the disease; however, being fully vaccinated limits severe illness.

It typically takes a few weeks after vaccination for the body to build protection (immunity) against the virus that causes COVID-19. That means it is possible a person could still get COVID-19 just after vaccination. This is because the vaccine has not had enough time to provide protection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’ve not been tested for COVID, but have been sick with several symptoms for a week as of today. My husband received the first of his two-part vaccine four to five days ago. I’m struggling with, ‘Should I get tested?’

“Explain why or why not please. My main concern is this: Is my husband in danger? And if I do have COVID, how long should I wait/quarantine before getting my own vaccine?”

The answer:

Regarding you, I recommend getting tested as soon as possible with a molecular PCR (Polymerase Chain Reaction) swab test. I also advise you to self-isolate in a private room and use a private bathroom, if possible, while you wait for your result.

If your PCR test is positive, I recommend you continue self-isolation for 10 days if you are not immunocompromised and 20 days if you are immunocompromised.

It is currently recommended to defer vaccination in persons with known-current COVID-19 infection until the person has recovered from the acute illness and no longer requires isolation.

As for your husband, if you test positive, I recommend your husband self-quarantine separately since he is not fully vaccinated.

His quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Another option is his quarantine may end after Day 7 if a diagnostic specimen done on Day 7 tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My partner and I live together and have been following all safety protocols for the past year. We were going to see my partner’s family over the weekend and got a PCR test the previous Wednesday.

“I got my results Thursday night that said negative, but my partner got his on Friday morning saying he was positive. I got a rapid test on Friday and tested negative again. The only out-of-normal thing I did was see my friend who had COVID, but was no longer contagious, based on what her doctor said. Is it possible the positive test was a mistake? Or should I assume I have already been infected?

“Thank you for your time and all the great work you do!”

The answer:

In my experience, a positive PCR (molecular Polymerase Chain Reaction) swab test is highly accurate. I recommend your partner who tested positive self-isolate separately in a private room and use a private bathroom if possible.

His isolation can end after 10 days if your partner is not immunocompromised, and 20 days if your partner is immunocompromised.

You are a close contact, and I advise you to self-quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Another option for you is that your quarantine may end after Day 7 if a diagnostic specimen tests negative on Day 7 and if no symptoms were reported during daily monitoring.

Finally, I’m assuming neither of you were vaccinated. If that’s true, I recommend vaccination for both of you. Your partner may be vaccinated when he has recovered from acute illness and no longer requires isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I saw that someone recently asked if they could give their husband COVID if they were vaccinated and he wasn’t. They can.

“My husband is fully Pfizered.

“His second dose was five weeks ago. He just came down with COVID, and he is pretty ill. His doctors said he is highly contagious. He has been sick now for seven days and in isolation for only three because we assumed it was just a cold at first and then had him tested. So the vaccine, from my personal opinion, only protects the person who is vaccinated in that they are not likely to be hospitalized or die from COVID.

“People are believing they are safe because they were vaccinated, but they still could infect someone.”

The answer:

Thank you for your statement.

It is known that vaccinated individuals are protected from severe COVID-19 illness. The question of transmission is one that science is still working out. This is why we all still need to wear our masks.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am about to get my second dose of vaccine, but my husband refuses to be vaccinated. Will I still be protected?”

The answer:

It will take two weeks from the last shot of the series for you to reach full protection. Even with that, the vaccine efficacy – how well it will protect you – is not 100%. For the Pfizer vaccine, when tested, prior to the variants emerging, the effectiveness was 95%. The Moderna vaccine, when tested, prior to the variants emerging, was 94.1% effective.

What does that mean? If you received the Pfizer vaccine, you have a 5% chance of becoming infected. For the Moderna vaccine, it is a 5.9% chance.

I am sure you have spoken to your husband about why he does not want to get vaccinated, but if you are looking for more resources, please check out www.inthistogethercambria.com. This is a local group in Cambria County that is working to provide education surrounding COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had both of my vaccinations by the end of January. Two weeks after receiving the last shot, I started having a horrible reaction of swelling and joint pain in both my hands, wrist and elbows. My hands are definitely the worst. It’s been two months, and the swelling and pain have not completely gone away. I’ve been to my health care provider two times with steroids give both times. However, my hands have not returned to their prior state. I have had inflammatory lab work done and nothing came back showing anything. I had the Pfizer vaccination.

“Are you seeing any other responses of other people having the same issue? I have an upcoming appointment with a rheumatologist in a few weeks to try to help. I have no prior history of this.”

The answer:

Thank you for your question, and I’m sorry to hear of your arthritic problem after Pfizer vaccination.

We have given about 8,000 Pfizer vaccinations at our medical center and have not encountered what you are describing.

Patients and health care providers (HCP) are encouraged to report adverse events after vaccination to VAERS (Vaccine Adverse Event Reporting System) even if it is not clear that the vaccine caused the adverse event. In addition, HCP are required to report certain adverse events after vaccination.

VAERS is co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), agencies of the U.S. Department of Health and Human Services (HHS).

I’m glad you have an appointment scheduled with a rheumatologist, and I strongly encourage you to keep that appointment.

Your history and physical findings are suggestive of an acute inflammatory arthritis which may be immune-mediated.

I’m hoping you’ll have a complete recovery.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“What should I do if I’m exposed to a person with COVID-19 11 days after I am fully vaccinated?”

The answer:

It does take 14 days to reach full vaccination. While vaccination is highly effective, a good way in preventing you from getting COVID-19, you must meet three criteria to avoid quarantining.

According to the CDC, they include:

• Being fully vaccinated, meaning it’s been two or more weeks since you’ve received the second dose in a two-dose series or two or more weeks since you’ve received a single-dose vaccine.

• You’re within three months of the last dose of a vaccine (the second dose if you’ve received a two-dose vaccine or one dose of a single-dose vaccine).

• Remaining asymptomatic since your current COVID-19 exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have been trying to find out if I can get the second Moderna vaccine (scheduled for March 28).

“About 40 minutes after my first shot, I experienced a minute of shortness of breath (shallow breathing) with abdominal pain, immediately followed by a flushing event (felt like when I had dye injected for a non-invasive angiogram). As soon as the flushing was done, the breathing was normal and the pain subsided. I am trying to find out if I am OK to have the second dose of Moderna. I talked with my PCP and he said for me to talk to the people where I received the vaccine, but they only said to discuss with my PCP.

“I read the CDC presentation and it sounds like I should not get the second dose. I do want to be fully vaccinated since I am high-risk (coronary heart disease and chronic bronchitis).”

The answer:

Hypersensitivity (anaphylactoid) reactions have been reported with the COVID-19 vaccine (mRNA) during vaccination outside of clinical trials. You didn’t mention if you had any adverse reactions to the influenza (flu) vaccine.

I can’t predict with certainty whether or not you’ll have a serious adverse reaction to the second Moderna (mRNA) dose.

Another option is to consider getting the single dose Johnson & Johnson vaccine 28 days after your first Moderna dose. The Johnson & Johnson is a viral vector vaccine.

If you decide to proceed with vaccination, I advise the following:

• Receiving the vaccine at a medical center facility, where there are trained and readily available medical personnel to treat any serious adverse reactions.

• Having appropriate medical treatment, including epinephrine, for anaphylactoid and/or serious hypersensitivity reactions immediately available during vaccine use.

• Being closely observed for at least an hour or longer.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had a positive COVID test three days after the second shot. I’m having the typical side effects from the vaccine itself, but I lost my sense of taste and smell. Will the vaccine help treat the virus?”

The answer:

One dose of either the Pfizer or Moderna vaccine may offer 50-80% protection against symptomatic COVID-19. The Pfizer and Moderna vaccines are 94-95% effective two weeks after the second dose.

You didn’t mention if you had a SARS-CoV-2 (COVID-19) viral diagnostic test. I recommend a molecular PCR (Polymerase Chain Reaction) swab test.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my first vaccine March 3. This morning I received a message that I could sign up for my second dose, but it’s been only 13 days. Is it safe to get the second shot this early, or is it better to wait 21 days?”

The answer:

I am sure that request was confusing.

It is necessary for the second dose of the Pfizer vaccine to be 21 days or more after the first. I advise you to schedule the shot for the next available appointment after March 24. It is my guess that the establishment that contacted you wanted you to schedule for a time slot after that date.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive in December. I am scheduled to get the Moderna vaccine this coming week. After getting the vaccine, I’m scared that I will experience worse side effects and feel more sick than I did when I had COVID. I’ve heard that people who already had the virus and get the vaccine react worse than those who have not previously had COVID. Is this true?”

The answer:

Thank you for your question, and I understand your concerns. In my opinion, the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible are worse than the potential vaccine side effects.

I advise you to consider the Johnson & Johnson single-dose vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Me and my husband had COVID. We both will be getting the Pfizer vaccine in May. We both decided to only get one shot as more and more evidence is coming out that if you had COVID already, one shot is all that is needed. My husband had no symptoms of COVID. I only had a headache for 11 days.”

The answer:

As with any medical procedure, you should follow the guidance set by science and medical professionals. This means that you should get both shots of the mRNA vaccine you are scheduled for.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had two vaccines of the Moderna about a month ago. I am considering having some contractors in the house. I have been told that I will have to remind them to wear masks. What is risk the to me of them working in my home?”

The answer:

The Moderna shot is 94.1% effective at stopping infection with the virus that causes COVID-19. I would like to point out that the data it was based off was before the emergence of any of the variants.

This means that the vaccine may not be as effective against the variants. This is normal and happens with all viruses. When viruses replicate, they make mistakes at a rate science can predict.

What does this mean for your question?

It means that you and your contractors should wear masks when in the home together, since there is a chance that you could develop an infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“On Jan. 19, I had my first COVID vaccine (Chinese) and the date for second dose was Feb. 9, but unfortunately I had pneumonia during the second dose time with all symptoms, but the PCR swab test was negative. I did an IgG test and it was positive.

“What shall I do in this case for second dose? Can I take the vaccine now or wait for months and start again with first and second? I am totally confused.”

The answer:

First, I’m not sure which vaccine you received on Jan. 19. Since the second dose was scheduled on Feb. 9 (21 days later), perhaps the first dose was the Pfizer COVID-19 vaccine. However I’m not certain.

Second, your positive IgG antibody test means you were previously infected, but it doesn’t give the exact date. It’s also not known for certain whether you are either fully or partially protected from future infection with SARS-CoV-2 (COVID-19), or how long your natural protective immunity may last.

Therefore, my advice for you is to consider vaccination with the Johnson & Johnson single-dose vaccine. I recommend you discuss this with your physician.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“When I received my second Pfizer vaccine, the immunizer gripped a few more inches of the skin above my deltoid muscle and squeezed it tightly while injecting the vaccine. I’ve read that this could have resulted in the vaccine being administered subcutaneously rather than intramuscularly, and that the efficacy could therefore be diminished. I had a very noticeable reaction to the second shot the evening after it was given: aches, headache, fatigue and weakness. Does that mean that despite the immunizer are squeezing the flesh on top of my deltoid, that the vaccine was administered properly into the muscle?”

The answer:

The immune system is a marvelous thing! Any foreign substance is recognized, and a response is generated. While the vaccine is to be administered intramuscularly, with the practitioner flattening the skin instead of pinching, any introduction will result in an immune response.

Rest assured that your immune system responded to the vaccine. The symptoms you describe are indicative of a robust reaction to the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I received the first dose of the Moderna vaccine on Dec. 30. I got COVID 10 days later. I was still too sick to get the second vaccine within the 43-day period. Since I am not considered fully vaccinated, I wanted to redo the whole thing. I do not know how to go about this because I am unable to make an appointment in VAMS.”

The answer:

The Vaccine Administration Management System (VAMS) is an appointment scheduling system provided by the Center for Disease Control (CDC). Creating an account and registering in VAMS requires creating an account for yourself with a unique email that is not shared with anyone else.

In my opinion, there are two options, either receive the second Moderna dose even though it’s late, or consider the Johnson and Johnson single-dose vaccine.

I suggest you contact your local health department for assistance in scheduling your vaccine choice.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“How long do I have to wait after testing positive to get a shot?”

The answer:

If you are not symptomatic, you do not have to wait for the vaccination. If you are experiencing symptoms, you should wait for those symptoms to resolve before getting the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I would like to know why adverse reactions to the COVID nasal swabs aren’t being documented. Also, are there any chemicals in the swabs? What negative side effects have people experienced from the nasal swab procedure such as headaches, migraines, blood pressure spikes, strokes, heart attacks and other cardiac issues as well as reactions to any ingredients used in the actual materials used to make the swabs? As someone who has had some life-threatening reactions to various drugs and procedures that most people never experience, it’s vital that I have this information before I get tested.”

The answer:

I can infer from your comments that you have experienced side effects from pharmaceuticals.

The nasal swab that is used in the COVID-19 test is a cotton swab that is sterile, no contaminants of any kind. When you are swabbed for the test, the practitioner will place the swab no more than ³/4 of an inch into the nose. Some individuals will experience discomfort and have a bit of a runny nose after the swab. No headaches of any kind should occur as a result of the sampling.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My grandson had a COVID test on March 4 and it came back positive. He is asymptomatic. I have been fully vaccinated (Pfizer) two weeks ago. Am I safe to be around him at eight days in?”

The answer:

You are fully vaccinated, and the Pfizer vaccine is 94-95% effective. Therefore, your risk is low, less than 5%.

If your grandson is not immunocompromised, his isolation should end 10 days since the date of his positive test. If he is immunocompromised, then 20 days of isolation is recommended.

At this time, I recommend you and your grandson wear a mask and continue good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mom and sister have had two doses of their shots for a couple of months now. My daughter and I tested positive for COVID-19 on Feb. 28 with mild to moderate symptoms. We have ended our isolation period after 10 days and have not had fever for over a week. We still have slight fatigue but no other symptoms. Is it safe to visit my mom and sister who have had their shots?”

The answer:

In my opinion, yes.

At this time, I recommend everyone wear a mask and continue good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Can the Moderna vaccination affect routine blood work, my labs came back bad after vaccination?”

The answer:

I’m not aware of any lab abnormalities caused by the currently available COVID-19 vaccines. I recommend you follow-up with your physician as soon as possible regarding your abnormal lab results.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had my first Moderna vaccine on Feb. 12, then was diagnosed with COVID-19 on March 11 (one day prior to my scheduled second vaccine. I almost made it.)

“I am immune suppressed, 69 years old, good physical shape and experiencing mild symptoms. An antibody infusion is scheduled but I

am having second thoughts if I should take it. The current literature recommends waiting

90 days before the second vaccine after receiving the infusion.

“My question – if it is recommended to wait 90 days after the infusion for the second vaccine, why is it safe to have the infusion 29 days after the first vaccine?”

The answer:

Intravenous monoclonal antibodies can be used to treat persons with mild to moderate COVID-19 who are at high risk (defined as immunosuppressive disease, currently receiving immunosuppressive treatment, age greater than 65, diabetes, chronic kidney disease; or age greater than 55 and have at least one of the following: cardiovascular disease, hypertension, or COPD/chronic respiratory disease) for progressing to severe COVID-19 and/or hospitalization. The monoclonal antibody infusion should be given as soon as possible after a SARS-CoV-2 positive test result and within 10 days of COVID-19 symptom onset. The person should be monitored in a medical center facility for possible hypersensitivity reactions at least 1 hour after completion of the infusion.

The proposed mechanism is the monoclonal antibodies bind to the SARS-CoV-2 spike protein and acts as neutralizing antibodies, thereby preventing viral entry and replication. As a precaution, it is recommended to defer vaccination for at least 90 days following receipt of COVID-19 convalescent plasma or monoclonal antibody therapy.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I just recovered from COVID, and have already tested negative, but all other members of my household are still testing positive, can I infect others?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks or longer after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection. Therefore, you are likely not infectious at this time.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My roommate started feeling sick around March 8 and tested positive on March 13. My last exposure was March 13 and I have tested negative three. I am supposed to get vaccinated. Should I postpone? Also, at one point will I know for sure that I am not at risk of being tested positive?”

The answer:

Based on current literature, the incubation period (the time from last exposure to development of symptoms) for SARS-CoV-2 (COVID-19) ranges from 2 to 14 days. Thus, your potential incubation period is March 15-27.

You are a close contact and should self-quarantine separately. Vaccination following exposure is not likely to be effective for preventing the disease from that exposure. Therefore, persons with known exposure should wait to seek vaccination until their quarantine period has ended.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter is flying to Florida for a vacation. She is scheduled for her COVID vaccine the day after she returns. Should she wait seven days after return to get her COVID vaccine in the event she may have been unknowingly exposed during her travel?”

The answer:

As long as your daughter is not symptomatic, she can receive her second shot. There is no need to delay because of possible exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My entire family had COVID-19 in early January. Symptoms ranged from just coughing to a slew of symptoms for some of us. My son had surgery 10 days ago after a negative test.

“Today, due to continuous difficulties following his surgery, they moved him to another intermediate care unit. They tested him beforehand. He tested positive, so he is now in COVID ICU. I was allowed to be his only visitor these past 10 days. No visitors now. Doctor said I should get tested despite having had the virus.

“Do I need to isolate from the rest of my family, who have all had COVID, until I get a result that is negative? Three of them have already received their first dose of Moderna or Pfizer. The youngest is too young for a vaccine. I am not vaccinated yet.”

The answer:

We don’t know how long natural immunity lasts after infection. Studies of the mRNA

vaccines (Pfizer and Moderna) suggest that one dose may offer between 50% and 80% protection against symptomatic COVID-19 infection.

You are a close contact of your son who was diagnosed with COVID-19. Therefore, I recommend you self-quarantine separately. Your quarantine can end after day 10 without testing and if no symptoms have been reported during daily monitoring. Another option is your quarantine may end after Day 7 if a diagnostic specimen done on Day 7 tests negative and if no symptoms were reported during daily monitoring.

Persons with known exposure should wait to seek vaccination until after their quarantine period has ended.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I get the vaccine and my husband doesn’t, could I give him the virus?”

The answer:

Anyone who is not vaccinated is at a greater risk of infection with SARS-CoV-2. You will not give the virus to your husband because of vaccination, but you may be able to transmit it to him in the 1-3 days it takes your immune system to destroy the virus after exposure.

Individuals who have been vaccinated may still be able to transmit the virus. A study done in monkeys shows that the virus may be in the nose in the 1-3 days after exposure. This equates with no clinical infection, as the immune response will destroy the virus, but it does not assume that those individuals are incapable of spreading the virus in that time frame.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband and I had both vaccines. Can we visit our family who all had the virus five months ago?”

The answer:

If you and your husband are fully vaccinated (i.e., 2 weeks after the second dose of either the Pfizer or Moderna COVID-19 vaccine), the vaccine is 94-95% effective. Therefore, your risk is minimal, less than 5%.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I took the first dose of Pfizer on Jan. 8. It’s been 11 weeks. Could I still take the second dose?”

The answer:

Yes. Research conducted during the clinical trials says that 21 days is the least amount of time that can occur between doses. In the United Kingdom, they are delaying 2nd doses of the Pfizer vaccine up to 12 weeks.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am scheduled to have my second Moderna vaccine on March 24. I am currently having an outbreak of shingles and started antiviral treatment March 11. Will I be safe to have that second dose of Moderna vaccine?”

The answer:

When your shingles rash has no blisters, wait 2 weeks before you get the second COVID-19 vaccine dose.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received the second dose of the vaccine exactly two weeks ago and decided to see another fully vaccinated family member whom I have not seen in a year. We were sitting in close proximity outside in an open field with no one within 10 feet of us with our masks off for at least an hour.

“She is a health-care worker who has been seeing patients and has been seeing other fully vaccinated people without masks on since the new CDC guidelines. Should I be worried that she has seen patients and other people within hours/days of seeing me? How long should we be waiting in between seeing our fully vaccinated loved ones without masks on?”

The answer:

Current guidelines say that small groups of vaccinated individuals can gather. This is great news!

Since you are both vaccinated, it is unlikely that you will develop clinical symptoms of COVID-19 from an exposed individual. However, it is best for us all to keep wearing our mask and washing our hands when in public. You wouldn’t want to give COVID-19 to an unvaccinated individual.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I just received my first Pfizer COVID-19 shot on March 13, and have a scheduled physical and blood work. Will it be OK if I get blood work done prior to receiving my second shot?”

The answer:

Yes.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had a second vaccine dose of Moderna a month ago. I work as a nurse practitioner in an urgent-care center where I am exposed to positive COVID-19 every day. A few days ago, after a month from my second and last dose, I felt mild symptoms that I recognized as possible COVID-19.

“A rapid ID NOW test gave a positive result. Then 24 hours later, I was feeling well, and a rapid ID NOW test gave me a negative result. To be sure, I sent it to the lab for the actual viral testing and the result was not detected.

“Can vaccinated people overcome infection in 24 hours? Or was my positive a false one?”

The answer:

If the lab viral testing was a PCR (Real-Time Reverse Transcriptase Polymerase Chain Reaction), my opinion is the first rapid SARS antigen test result was a false positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I got my first COVID-19 vaccine (Pfizer) and change my mind about the second vaccine, can that bring any complications in the future?”

The answer:

Oh, I wish you would reconsider.

There have been more than 109 million doses of the vaccines given to individuals and very few severe side effects documented.

You made it over the last hurdle, now sprint to the finish line!

Your body is already making antibodies to protect you from SARS-CoV-2, please give it the boost it needs to cross the finish line.

However, to answer your question, no, there are no complications that could occur as a result of not completing the vaccination series – unless you consider getting COVID-19 a complication.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife and I have had our COVID shots. My daughter and my grandson have just tested positive. Are we safe? They do live with us.”

The answer:

The short answer is no.

It will take two weeks from the last shot of the series for you to reach full protection. Even with that, the vaccine efficacy, how well it will protect you, is not 100%. For the Pfizer vaccine, when tested (prior to the variants emerging) the effectiveness was 95%. The Moderna vaccine, when tested (prior to the variants emerging) was 94.1% effective.

The Johnson & Johnson vaccine was tested after the emergence of the variants and it was found to be 85% effective at preventing severe disease and 66% effective at preventing all infection.

What does that mean? If you received the Pfizer vaccine, you have a 5% chance of becoming infected. For the Moderna vaccine, it is 5.9% chance. For Johnson & Johnson, it is 37% chance of becoming infected, but only a slight chance it will be severe.

I suggest that you have your daughter and her son self-isolate, and that you and your wife avoid sharing space with them. Wear a mask in common areas and wash your hands regularly.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My daughter had to have a blood transfusion seven months ago for female issues. When signing up for a COVID-19 vaccine, it asked if she had a blood transfusion in past year. Does that mean that she shouldn’t get the vaccine?”

The answer:

Thank you for your question.

Certain vaccines cannot be given to an individual who has received a blood transfusion. Vaccines that contain live virus are not recommended for individuals who are within six weeks of the transfusion.

The Moderna and Pfizer vaccines contain mRNA. For this reason, they can be administered to individuals who have received a blood transfusion. The Johnson & Johnson vaccine contains an adenovirus, the causative agent of the common cold. This vaccine has a live attenuated virus in it, the genome of the adenovirus has been removed and the mRNA for the spike protein of SARS-Cov-2 has been inserted. More research needs to be conducted to determine if this viral vector vaccine is suitable for individuals who have received a blood transfusion.

The question was asked for your daughter’s protection. I suggest that she seek out an mRNA vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had a mild case of COVID-19 in early winter. I have completed my vaccine dosage. I have been exposed. Do I need to quarantine?”

The answer:

Thank you for choosing vaccination. If you are fully vaccinated the current guidelines state that you do not need to quarantine as long as you are asymptomatic.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am on chemo. On March 4, I received my second Pfizer shot. I felt pretty good the next two days but Sunday and especially today I’m exhausted and just feel awful. Is this normal with second shot?”

The answer:

Fatigue may be a side-effect of the COVID-19 vaccine and/or chemotherapy. I recommend you contact your medical oncologist as soon as possible for further instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am scheduled to get my COVID shot, and also scheduled to have surgery four days later. Will I be safe to do this?”

The answer:

You didn’t mention which COVID-19 vaccine you’re scheduled to receive. You’ll be fully vaccinated two weeks after the second dose in a two-dose series (Pfizer and Moderna), or two weeks after one dose of a single dose vaccine (Johnson & Johnson).

Surgery is not a contraindication to the vaccine.

I recommend you discuss with your surgeon whether to delay surgery until after you are fully vaccinated.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have pneumonia and I got the vaccine without telling them that, because I was afraid they wouldn’t let me get it. Will this hurt me?”

The answer:

The decision to administer or delay vaccination because of current or recent illness depends on the severity of symptoms and the cause of the disease (pneumonia).

In general, it is recommended to defer vaccination in patients with moderate or severe acute illness (with or without fever) and to provide vaccination in patients with mild acute illness (with or without fever).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I saw someone else mention them getting the vaccine and some of it leaked out. I got my shot today and afterward the tech said, ‘Oops, some is running down your arm,’ and she wiped it up with a cotton ball. Should I be worried that I didn’t get the proper dosage? My second shot is in 28 days.”

The answer:

I don’t know how much of the vaccine leaked out. Therefore, I cannot advise repeating the first dose. I do recommend receiving the scheduled second dose in 28 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My physician told me that I should wait on getting a vaccine shot because I have a mild case of COPD and I had a couple real light strokes. I’m 60 years old I just want to know why she said that.”

The answer:

I don’t know why your physician said that, and you should ask her for an explanation.

In my opinion, you should receive whichever COVID-19 vaccine is available.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 66-year-old husband is five days away from getting his second Moderna shot. He has decided to play poker with seven players, most of whom are younger and have not been vaccinated.

“I objected to that since I’m not vaccinated yet due to being only 56. I’m considering isolating from him as much as possible. Is that unreasonable? He claims he is mostly protected and I shouldn’t worry. We do not live in a high transmission area, but you never know.”

The answer:

One dose of either the Pfizer or Moderna vaccine may offer your husband between 50-80% protection against symptomatic COVID-19. What is not known for certain at this time, is whether he can transmit the SARS-CoV-2 (COVID-19) virus to someone who is not vaccinated.

The decision to isolate from him depends upon his exposure to another person with COVID-19.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive for COVID on Feb. 12 with a pcr test. I had no symptoms. I tested again on Feb. 14, both rapid and pcr. Those tests were negative. Regardless of negative tests, I was told to isolate as a precaution. During this period, I have been congested and a few bouts of diarrhea but no other symptoms. It has been 22 days since I tested positive and I was informed that I was safe to return to work and end isolation. Is this sound advice?”

The answer:

In my opinion, you may end isolation and return back to work with safety precautions including masking and good hand-washing hygiene.

We don’t know how long natural immunity lasts after COVID-19 infection. Due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, vaccine should be offered regardless of whether you already had COVID-19 infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“We would like to know the likelihood that our adult daughter would be exposed after my daughter-in-law goes for her 20-week ultrasound. Our family includes husband 68, daughter 30, me 70. Husband and I received second dose of Moderna; daughter not yet eligible. My son’s family includes son 33, daughter-in-law 31, their daughter/our granddaughter 3. Son and daughter-in-law received first dose of Moderna. We are all in the same pod.

“We don’t live together, but households self-isolate and mingle exclusively together since March 2020 – with occasional re-isolations for medical/vaccination appointments. My daughter is the only one not yet qualifying for vaccine. All are members of same HMO medical system. Both households use no contact, online/Instacart shopping only. Son and daughter-in-law work from home. Husband and I are retired. Daughter not employed.

“Could our daughter-in-law be exposed to virus during medical appointment including ultrasound, and could she would expose/transmit to our granddaughter, who might expose/transmit to adult daughter? We believe our vaccination status minimizes our ability to transmit exposure.

“We watch our granddaughter 3-4 days a week. We recently quarantined for 20 days to accommodate our first vaccinations and daugh-

ter-in-law’s previous prenatal visit. Granddaughter experienced serious separation anxiety during our time away. We very much want to minimize the effect on granddaughter. We also want to be mindful of adult daughter’s risk of exposure. My son has a chronic medical condition.

“Advice?”

The answer:

Persons are considered fully vaccinated two weeks after the second dose in a two-dose series (Moderna COVID-19 vaccine). At that time, the Moderna vaccine is 94% to 95% effective. Thus, the risk is minimal, approximately 5% for persons fully vaccinated with the Moderna vaccine. One dose of the Moderna vaccine may offer 50% to 80% protection against symptomatic COVID-19.

It’s not known for certain at this time whether persons who are fully vaccinated can transmit the SARS-CoV-2 virus to people who are not vaccinated. We’re hopeful that vaccination reduces transmission of the virus, and some preliminary data seems to suggest that; however, more research is needed to draw a definitive conclusion.

In my opinion, exposure risk is minimal during medical appointments when taking adequate safety precautions.

Finally, transmission risk depends on multiple factors, i.e., prevalence of COVID-19 in the area, exposure(s) to other person(s) with COVID-19, whether the exposure was infectious and how contagious is the virus, length of time and proximity of the exposure, preexisting medical condition(s) and immune status of the contact, etc.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my first shot of the Moderna vaccine on Feb. 3. Unfortunately, that shot seemed to be given too high, and I have been experiencing some shoulder pain and tingling in my shoulder blade and neck. That has gone on for five weeks now. I can move my arm, and I am treating the intermittent problems with heat, Tylenol and a consultation with my neurologist. We believe the shot hit a nerve and/or was injected into the bursa.

“My second shot, which was on March 3, was, as suggested, administered in the opposite arm. The health professional administering the shot, who knew very well of what happened the first time, ended up administering this shot too low, about eight fingers down from my shoulder bone instead of the three.

“We do not believe it was in the deltoid muscle.

“I have been extremely distraught and frightened over thinking that I very well may not be vaccinated at all from either shot. I have been working with the health center and reported my concerns to Moderna. As of now, Moderna has said that I should not be administered another shot or new series of two. I am scheduled to have the Roche Elecsys antibody test on March 17, which will be two weeks after my last shot. We are hoping that maybe the information from there will give me some idea if I am vaccinated at all.

“There seems to be some protocol if one shot of the two series is administered improperly or at the wrong site, but it is an extraordinary situation to have both shots given incorrectly. My biggest questions are the following:

“Do vaccines that are administered incorrectly provide any immunity at all?

“How am I to proceed in life – as a vaccinated person or as one who has no immunity?

“I am 71 years old. This is a matter of life and death to me. Can I see my vaccinated friends? Can I see my children and grandchildren? I have no idea how to view my future. I need to be vaccinated and I need to have the confidence that I can go out into the world and be safe.”

The answer:

My goodness! I am so sorry to hear about your issues with vaccination. I am happy to hear that you are being an advocate for yourself.

While there is no specific data regarding your exact situation, I can tell you that our immune system is amazing! We are exposed to pathogens in so many ways daily.

The vaccines may have been given incorrectly (for that I feel for you), but they were still given. Your body was exposed to the pathogen and is making antibodies to it right now. I am confident that your antibody test will show what I am saying.

Until you have the results of your antibody test, I suggest that you remain cautious when visiting those who are not vaccinated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am 68 and my husband is 72.

“We have both had our first and second doses of the Moderna vaccine. Our son is in dire need of our help to take care of our 2- and 4-year-old granddaughters all day, twice a week. They attend preschool the other three days. It will be difficult to stay masked all day while caring for them. How critical is it that we keep those masks on?”

The answer:

Wearing masks protects both the grandparents and the grandchildren. The Pfizer and Moderna vaccines are 94% to 95% effective two weeks after the second dose. Therefore, there is a 5% risk for the grandparents. More research is needed to draw a definitive conclusion if COVID-19 vaccination stops the spread of SARS-CoV-2 (COVID-19) to the grandchildren. The CDC continues to recommend masking regardless of vaccination status.

Therefore, at this time, I recommend that the grandparents mask as much as possible. Better safe than sorry.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband and I had our two Pfizer shots. I am 68 years old. He is 78, with a pacemaker and some heart issues. Is it safe to go food shopping? We have been using Instacart for a year. We haven’t gone anywhere except around the block and occasional doctor appointments. My gut tells me to wait and see how the virus trend continues. We live in south Florida.”

The answer:

Thank you for choosing vaccination.

Individuals who are fully vaccinated, two weeks post second shot for Pfizer or Moderna and two weeks post Johnson & Johnson shot, should still wear their masks when in public.

If you are comfortable venturing out, it will be OK for you to do so.

Remember to wear your mask, social distance and wash your hands regularly.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I received my first vaccine (Pfizer) Sunday evening. I tested positive the next day after displaying symptoms. In retrospect, I realize that I probably had symptoms at the time of my vaccine. They were just not obvious to me. I continually hear to delay vaccination if you are currently sick. Am I in any danger from receiving the vaccine while I was probably already symptomatic?

“I am now three days out from the vaccine, and my COVID infection so far is mild.

The answer:

Your self-isolation will be 10 days since symptoms first appeared if you are not immunocompromised, and 20 days if you are immunocompromised. You are not in any danger from receiving the first dose of the Pfizer COVID-19 vaccine.

It is currently recommended to defer vaccination in persons with known current COVID-19 infection until the person has recovered from acute illness and no longer requires isolation.

In my opinion, it’s OK for you to receive the second dose of the Pfizer vaccine after your isolation has ended and you are recovered.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My wife received her first dose of the vaccine about three weeks ago. We believe my family was exposed/contracted COVID from a fast-food chain about 10 days ago.

“I and my two daughters started having symptoms. Four to five days after symptoms started, we all tested positive. My wife tested negative. She started having symptoms two days after testing.

“Should she get retested?”

The answer:

I do not see the need for your wife to get retested. There is a high likelihood that she is positive. She can still get her second dose, as long as she is not symptomatic on the day it is to be administered.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My brother-in-law has recently undergone a major surgery. He is now being transferred to a skilled nursing facility. He has been fully vaccinated for COVID-19 and does not have the virus, but they are being told he must be quarantined for two weeks. The facility is telling them this is a CDC guideline.

“Is this true, and does the guideline not provide exceptions for individuals who have been fully vaccinated? He has some cognitive issues, and being quarantined will likely worsen his condition.”

The answer:

Thank you for choosing vaccination.

Each individual facility has the right to require their own safety procedures. The interim guidance from the CDC states that fully vaccinated individuals, those that are two weeks post-second shot with Pfizer or Moderna or two weeks post-J&J shot, do not need to quarantine if they are not symptomatic.

I suggest that you speak to the facility regarding your brothers-in-law’s condition. Maybe something can be worked out.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“In our family, eight adults have been vaccinated. Four teens and an 11-year-old old have not. Is it safe to have Easter dinner with them all inside?”

The answer:

Thank you for choosing vaccination for you and your family.

Current guidelines allow for vaccinated individuals to gather with other vaccinated individuals. Those in your group who are vaccinated have the potential to expose those in your group who are not vaccinated to the virus.

Science is still working to determine whether vaccinated individuals can transmit the virus to those that are not vaccinated.

A few studies show that the Pfizer vaccine reduces transmission from vaccinated individuals to non-vaccinated individuals to almost nothing after full vaccination, 14 days post-second shot.

Those studies have not been completed with the Moderna or Johnson & Johnson vaccine yet.

Bottom line, there is risk of transmission to the teens and 11-year-old. I suggest you have those that are not vaccinated wear a mask when the whole group is together and have them eat in a separate room that is well-ventilated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

“Can I be immune from COVID-19 if I haven’t had the virus? Could there be something in my DNA or in my immune system to where I can’t get COVID-19?”

The answer:

What a great question. Scientists are looking into this question daily.

A study done in Denmark showed that blood type O may offer some protection against COVID-19 infection. Researchers compared data from more than 473,000 individuals tested for COVID-19 to data from a control group of more than 2.2 million people from the general population. Among the COVID-19 positive group, they found fewer people with blood type O and more people with A, B and AB types.

It is a great question and one we all want to see answered. For now, I hope that you choose vaccination. It is the most effective way of preventing COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My girlfriend and I are seniors and do not live together. We have been separately quarantining except for masked trips for essential shopping or medical appointments. We both practice hand-washing as well as disinfecting surfaces religiously. We both now have completed the Pfizer vaccine’s second shot and have recently taken nasal-swab tests that were negative. What is our risk level of COVID-19 infection if we were now to meet for dinner at my home without masks?”

The answer:

I’m glad that you both received the COVID-19 vaccine. In my opinion, if it has been more than two weeks following your’s and your girlfriend’s second dose of the Pfizer vaccine, the risk is low, less than 5%.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had my first shot on Feb. 13. Now, 20 days later, my arm is swollen and feels hard. Also, it is red and feels hot. Should I be concerned?”

The answer:

Thank you for choosing vaccination.

Your issue sounds more like an infection called cellulitis than a response to the vaccine. I recommend that you contact your medical provider and be seen.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have a vaccine scheduled for 13 days after my pneumonia shot. Is that ok?”

The answer:

COVID-19 vaccination is recommended 14 days before or after other vaccines. In my opinion, 13 days is OK.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had my first vaccine on Feb. 27. Rite Aid has scheduled my second on March 23. This is not the recommended 28 days. I had reactions to the first shot – body aches, sore burning throat and chest and bad headache. Is it safe to get the second at this interval?”

The answer:

I can understand your concern. Things keep changing and they likely will keep changing.

For the Moderna vaccine, 28 days is the shortest time that can occur between doses.

If you must delay the shot by a few days, that is OK. In fact, recent guidance from the CDC notes that six weeks can occur between doses without a loss of efficacy.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband tested positive for COVID seven days ago on Feb. 23 and started with symptoms on Feb. 22. On Feb. 26, I started having mild symptoms such as a sore throat and nasal congestion, but not aches and chills like my husband. These mild symptoms lasted a couple of days. I got a rapid test through my school district and it came back negative on March 1. I am wondering if I have COVID. If I don’t, what is the time window/chance I could still get it? I haven’t been able to self-isolate from my husband, so I guess I am still exposed daily.”

The answer:

If your husband is not immunocompromised, his self-isolation should have ended. If he is immunocompromised, his self-isolation should be for 20 days since his symptoms first appeared.

Since you haven’t self-quarantined separately, your chance of COVID-19 infection is 50/50. For you, a negative rapid SARS antigen test result does not rule out COVID-19 infection.

If a RT-PCR (Real-Time Reverse Transcriptase Polymerase Chain Reaction) test result is positive, I recommend you self-isolate 10 days if you are not immunocompromised and 20 days if you are immunocompromised.

Due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, I advise vaccination regardless of whether you already had infection. It is recommended to defer vaccination in persons with known current COVID-19 infection until the person has recovered from acute illness and no longer requires isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband and I both have COVID. He tested positive on a Tuesday. I tested positive the following Monday. It’s just the two of us in our small home. Do we need to isolate from one another and wear masks even though we both have the virus?

“We each are struggling with low-grade fevers, body aches and feeling tired. We do keep up with sanitizing the counters and laundry. However, I feel it seems pointless to wear masks when we both have the virus.”

The answer:

You and your husband can be isolated together since you’re both positive.

There’s no problem in having multiple people isolate together as long as we’re sure they’re all positive.

I do recommend that you and your husband wear masks outside your home when isolation ends.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received the first dose of the vaccine from my job as a nurse and was waiting on the second dose when a family member tested positive, went into quarantine for 10 days as per protocol. I tested prior to and was negative in the rapid and PCR test, retested on day 10 and was positive for the virus, so another 10 days of quarantine, and missed the second dose.

“Question is do I need the second dose if I had the first and still contracted the virus?”

The answer:

Due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, vaccine should be offered regardless of whether you already had COVID-19 infection.

Studies of the mRNA vaccines (Pfizer and Moderna) suggest that one dose may offer between 50% to 80% protection against symptomatic COVID-19, although more data is needed. We also know you get some amount of protection after infection, but we don’t know in either case how long that protection lasts.

Therefore, I do recommend the second dose of the vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Does the Pfizer shot turn your urine red?”

The answer:

No.

If your urine is red, I recommend you immediately seek medical evaluation because that may be a sign of genitourinary bleeding due to a tumor or stone or possibly a bladder bacterial infection (cystitis).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am 86 years old and it has been five weeks since my first Moderna vaccine injection from Advocate/Aurora at Lutheran General Hospital.

“The original schedule for the second shot was canceled and they keep saying they will get more vaccines soon. I know the directive say that a six-week lapse is OK, but I fear it may be longer.

“I have been looking for other locations – such as the United Center – and do not even know if they will offer the second shot. Any advice would be appreciated. What I do not understand is if the weather delayed the initial shipment, where did it go when the weather cleared? Supposedly, these doses were earmarked for senior citizens’ second doses.”

The answer:

You are correct the current guidelines are a six-week lapse is OK. In the United Kingdom, second doses have been delayed for up to 12 weeks. That is not the recommendation, but the data out of the UK is showing that individuals are still mounting an immune response that is comparable to the three-week data.

I cannot speak to the vaccine distribution in your area or why it is delayed except to say that vaccine supply is an issue across the country.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I got the vaccine shot on

Friday, March 5. I am having thyroid surgery about two weeks later. Am I safe?”

The answer:

You didn’t mention which COVID-19 vaccine.

If you received the Johnson & Johnson single dose vaccine, you’ll be fully vaccinated two weeks following the single dose of Johnson & Johnson vaccine.

If you’re received either the Pfizer or Moderna COVID-19 vaccine (both of which are a two-dose series), one dose may offer between 50-80% protection against symptomatic COVID-19.

If you are receiving either the Pfizer or Moderna vaccine, I recommend you receive the second dose as scheduled (21 days for Pfizer vaccine and 28 days for Moderna vaccine).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had my first vaccine on Feb. 10. I came down with a stomach ache off and on, fatigue, slight headache and diarrhea for two days, no temperature. This started on March 1 and now I am better.

“The clinic noted this could be a reaction from my first vaccine. The body is building immunity.

“Could this be a possibility? I

did do a COVID mail-in test to

make sure, and I am waiting for results.”

The answer:

I have good news! Your symptoms indicate that your immune system is mounting a response to the vaccine. I have no doubt that your body is making an army of antibodies to protect you. Since you had a reaction like this to the first one, the second shot may produce slightly more of a reaction. There is nothing to worry about in that case either.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had my first Pfizer COVID-19 vaccine on Feb. 25. The next evening I had an accident and lost a lot of blood. I did not have to get a transfusion but my hemoglobin dropped to 10. I was also given a tetanus shot. Will my vaccine still be good? Should I get the second dose as scheduled or redo both shots?:

The answer:

I’m sorry to read of your accident.

I do not recommend repeating the first dose of the Pfizer COVID-19 vaccine. Your second dose of the Pfizer vaccine is probably scheduled on March 18 (21 days after the first dose).

Since you were given a tetanus vaccine, allow a minimum interval of 14 days after the tetanus vaccine before receiving the second dose of the Pfizer COVID-19 vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“On Jan. 6, I had a monoclonal antibody infusion done because I tested positive for COVID-19

three days prior. At 64, I have COPD and hypertension. A week ago, I got tested again and received a positive result. Is it possible I got reinfected again? My only symptoms are nasal and feeling fatigued. Should I take the test again?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks or longer after infection, but likely isn’t infectious. The cause of this persistence of detectable virus has yet to be determined. For this reason, people previously diagnosed with COVID-19 shouldn’t undergo virus testing within 3 months after the date of symptom onset for the initial infection.

Since you were treated with monoclonal antibodies, you should wait 90 days before getting a COVID-19 vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am due for my regular allergy immunotherapy shot this coming Thursday – for allergies ranging from trees, ragweed and grass to cats. As an educator, I received notification via email that we will be getting our COVID vaccines next week, also.

“Is it safe to get these two shots so close together or is it necessary for me to spread them out a few days.”

The answer:

There have not been formal studies looking into time frames for vaccination after allergy shots. It is recommended by the American College of Allergy, Asthma and Immunology that you not receive the COVID-19 vaccine on the same day as your allergy shots.

I urge you to reach out to your allergist for more information. Since your vaccine appointment is scheduled, may I suggest that you reschedule your allergy shot?

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had my COVID test on a Saturday and didn’t receive positive result until Wednesday. How long do I need to quarantine?”

The answer:

You didn’t mention if you had symptoms or if you are immunocompromised.

• If you have symptoms and are not immunocompromised, your self-isolation is 10 days since symptoms first appeared.

• If you have symptoms, and you are immunocompromised, your self-isolation is 20 days since symptoms first appeared.

• If you don’t have symptoms

and are not immunocompromised, your self-isolation is 10 days since the date of your positive test

result.

• If you don’t have symptoms, and you are immunocompromised, your self-isolation is 20 days since the date of your positive test result.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband tested positive for COVID-19 via rapid result test. I’ve read they are less accurate. He has been sick for three days with flu-like symptoms, so I am inclined to trust the positive result. I had my second vaccination on Feb. 4.

“I have him upstairs, and because I was exposed to him, my job has me staying home for the next 10 days as well. I have bleach to clean our dishes with and will spray disinfectant in our home to diminish germs. I wash my hands. He will wash his also as often as possible.

“Can I be with him, such as sleeping at night in the same bed?

“Are there limitations to how much I can care for him? Should I wear a mask in my house around him?

“I’m hoping it is safe for me to care for him since I have been fully vaccinated. I just don’t know if there are precautions or limitations as to how much I should expose myself or what to do.”

The answers:

The Pfizer and Moderna COVID-19 vaccines are 94-95% effective two weeks after the second dose, which for you was Feb. 18. There remains a 5% risk of infection for you. Therefore, I recommend your husband self-isolate for 10 days if he is not immunocompromised and 20 days if he is immunocompromised. Your husband should self-isolate in a private room and use a private bathroom, if possible. If you are caring for him while he is in isolation, both should wear a mask and continue good and frequent hand-washing.

On Feb. 10, the CDC updated its quarantine recommendations to reflect SARS-CoV-2 vaccination status. People who are vaccinated (you) against COVID-19 do not need to quarantine after an exposure to another person with COVID-19 (your husband) if they meet all of the following criteria:

• They are fully vaccinated (i.e., more than two weeks following the second dose in a two-dose series, or more than two weeks following one dose of a single dose vaccine);

• They are within three months following the last dose in the series; and

• They have remained asymptomatic since the current COVID-19 exposure.

Therefore, if you (wife) have no symptoms, you do not need to quarantine separately.

Outside your home, the CDC continues to recommend COVID-19 preventative measures such as masking, physical distancing, avoiding nonessential travel and good hand-washing hygiene for all people regardless of vaccination status.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my first shot of the vaccine on Feb. 4. I was scheduled for the second one 30 days later.

“However, that appointment was canceled because the vaccine was not available at that facility. What if I am unable to schedule the second shot prior to the 28 days?”

The answer:

Thank you for your question.

This question was addressed in a New England Journal of Medicine article published on March 4. This article outlined that it is acceptable to delay the second dose of an mRNA vaccine up to six weeks.

I hope this information helps to ease your worry about the vaccine, and thank you for choosing vaccination.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had a severe reaction to a TB test in the early ‘70s, where my entire arm became red, swollen and itchy. Are any of those ingredients in the COVID-19 vaccine? I have many allergies to antibiotics, also. I get flu shots with no problems. Should I not get the vaccine?”

The answer:

Serious hypersensitivity reactions have been reported with the COVID-19 vaccines, but are rare.

Minor side effects include discomfort or pain at the injection site, fatigue, headache, muscle or joint aching, chills, fever, nausea or vomiting.

I’m not aware of cross-reactivity with a TB test and the COVID-19 vaccines.

Since you’ve had no problems with flu shots, I believe you can receive the COVID-19 vaccine with reasonable safety.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had my second vaccine two days ago. I just received an email from someone I was in the same office with for a whole day, indicating that I have been exposed – she experienced symptoms and got tested and it came back positive.

“How should I proceed? Do I get tested? Can I go to work, or do I need to quarantine?”

The answer:

An excellent question.

If the exposure was two weeks after your second dose, quarantine would not be necessary. However, that is not the case. Therefore, I recommend that you self-quarantine separately. Your quarantine can end after Day 10 without testing if no symptoms were reported during daily monitoring. The other option is that quarantine may end after Day 7 if a diagnostic specimen on Day 7 tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I just had my second COVID vaccine – Pfizer. Tomorrow, I am suppose to visit my 86-year-old brother because he is having surgery the next day. Am I taking a chance of taking any sickness to him? Today I have a headache, chills and low-grade fever. Also, is my immune system down because of the shot, and could I catch something myself?”

The answer:

Thank you for your question.

It takes 14 days after the second shot to be fully immunized. There are studies being done to determine transmission after vaccination now.

Some studies with the Pfizer vaccine show that it not only prevents COVID-19 but may stop the spread of the virus, SARS-CoV-2.

Your immune system is responding to the vaccine with the fever, chills and headache. This means that you are building your response to COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have received both COVID Moderna vaccines. My 74-year-old brother has had some bad info given to him and he is thinking of not getting the shots. We are supposed to do a road trip moving him back to Alaska from Arizona in May, and I do not feel comfortable if he does not get his shots. We are close, and I have been looking forward to this trip for a year.

“Information on driving through Canada does not state shots are necessary, but I would like to help him change his mind. He is diligent about flu shots, shingles shots and his health, but he has a friend that is sort of anti-everything.”

The answer:

I suggest that you check out this website: https://inthistogethercambria.com/resources/covid/vaccines/#immunity.

I have addressed many of the common myths here.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“After my wife and I have received our second Pfizer, will we always test negative? Is it still possible that we could test positive? We want to travel to the Bahamas in May. We must present a negative test to enter the Bahamas and a negative test to reenter the United States. Is there a risk that we will not test negative?”

The answer:

The COVID-19 genome test looks for active infection. If you receive the rapid test, it is also looking for active infection. Antibody tests for COVID-19 should be positive in the few months after vaccination. After that, the natural response will decrease and our immune system will hibernate. When and if you are exposed again, within two to three days, the immune system will respond and destroy the virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

“Are there any studies of people vaccinated for COVID that were infected and subsequently were long haulers?”

The answer:

What a great question. In fact, it is one that is being looked at by science now. Currently, there are no published studies looking at reinfection and severity of that infection after vaccination.

We simply don’t have enough people vaccinated yet.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband received the vaccine and there was a problem with the needle.

“Some of the serum leaked out. Now they want to give him a new shot two days later. Is that safe?”

The answer:

I don’t know how much of the vaccine leaked out. Therefore, I cannot advise getting another vaccine injection in two days.

I do recommend getting the second dose of the vaccine at the scheduled time, which is in 21 days for Pfizer and 28 days if Moderna.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“What is ‘COVID arm’? I received my first Moderna shot on Feb 13. Slept a lot, no big deal. On Sunday, Feb. 21, the injection site swelled and became extremely itchy. Apparently they have dubbed this ‘COVID arm.’ Why did this happen, and am I likely to get very sick with a second dose? I also feel this is an effect that is underreported.”

The answer:

Thank you for your question.

What you experienced is called delayed hypersensitivity. You may be familiar with an allergy test. When this occurs, a small amount of an allergen (tree pollen, cat dander, mold) is injected into the layer just under the skin surface. If a person is allergic, the body (via the immune response) will produce a hive. It will be itchy and red and swell a bit.

Some individuals who were vaccinated with the first shot may experience a similar reaction. Their bodies mounted immune responses to the vaccine contents, and when they get the second shot, a hive is produced at the site of infection. This may mean that they are allergic to the lipid delivery system, polyethylene glycol. It is harmless and will not cause any decrease in efficacy of the vaccine. In fact, just the opposite! The body did mount a response, and it showed how willing it is to fight the pathogen.

There is a Vaccine Adverse Event Reporting System. This hypersensitivity has been documented in a few of the more than 76 million doses.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had my first shot on Jan. 8 and second on Feb. 6. Both were at drive-thru sites. In January, I could not see what the technician was doing as he had his back to me. I had absolutely no reaction to the first shot and I became suspicious as to whether the syringe had vaccine in it. I did have a mild reaction to the second shot – a sore arm and fatigue for a day. Also, in February, the technician showed me the syringe. Is there any test that will indicate if I have full immunity?”

The answer:

Our immune systems respond to infections by mounting an adaptive response. This specific adaptive response is dependent on how severe our symptoms are, how old we are and if we have any underlying medical conditions. After the response occurs, our immune system generates four types of memory cells: Helper T-cells that help the other white blood cells, Killer T-cells that kill cells of our body that are infected, memory B-cells that make antibodies, and antibodies, found in the serum of our blood.

Most individuals who are vaccinated will not experience any side effects. A few experience fatigue, injection site pain and fever.

If you are concerned about your vaccination efficacy, you can get a COVID-19 IgG antibody test. I do not think this is necessary. Our immune systems are amazing! If you had any response at all, you are protected.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Can I still get the vaccine if I am on an antibiotic?”

The answer:

I can understand your concern. Antibiotics are taken for bacterial infections. The vaccine is for a virus. You can receive the vaccine if you are on antibiotics. You shouldn’t get the vaccine if you are having symptoms of an infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Will getting the mRNA vaccine prevent me from finding out if I presently have Memory B-Cells for COVID-19? I’m presently trying to get a diagnosis for post viral symptoms from a respiratory illness from Feb. 20 and would like to know what exactly caused this before I get the vaccine. Otherwise I may never know what’s wrong with me.”

The answer:

In general, a positive blood SARS-CoV-2 IgG test result is presumed to mean a person has been infected with SARS-CoV-2, the virus that causes COVID-19, at some point in the past. SARS-CoV-2 IgG detection occurs a median 14 days after infection with a range of 10-21 days.

In my opinion, vaccination will not interfere with a blood SARS-CoV-2 (COVID-19) IgG antibody determination.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I initially got a negative COVID test result 3-4 days after symptoms first appeared. I took another test 4 days after that first test and received a positive result. I suspect my first test result was a false negative because I was in the early infection stage.

“I took another test 17 days after my positive test date (24 days since initial symptoms) which came out negative. It has been 28 days since my initial symptoms, but symptoms have not improved. (I am specifically concerned about my breathing difficulty, though X-ray came out normal.) Is it safe to stop isolating, or is it likely I got a false negative result on my recent test and so should continue isolation?

“My doctor has reassured me that I am clear to end isolation, but I am very hesitant especially considering the similarity of my current condition to my initial condition (with symptoms but negative result). All my tests were nasal swab RT-PCR tests.”

The answer:

I agree with your physician that it is OK to end isolation. A study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at one symptom, particularly fatigue and shortness of breath.

I recommend you follow-up with your physician.

If your breathing difficulty persists, you may need further testing including possibly a CT scan of your chest, pulmonary function studies, and/or cardiac evaluation.

Also, due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, you should be vaccinated regardless of whether you already had COVID-19 infection. If you were treated for COVID-19 symptoms with either monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

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