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COVID-19 Vaccines: To Get or Not to Get, That Is the Question

By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR

Vaccine hesitancy, whether due to vaccine fatigue, misinformation or genuine concern for side effects, is very common these days. Headlines from trusted news sources and even not-so-trusted sources come at us fast and can be misleading. So how do you know if the vaccine is right for you?

First and foremost, know that your concerns are valid and that these concerns should be discussed with your trusted physician. There are many reasons why the vaccine is important for some to receive and other times when the benefits may not outweigh the risks and therefore should be avoided.

So, let’s address some of the common concerns providers have heard.

  1. Blood Clots
    The largest global study recently published by the Global Vaccine Data Network, after just shy of 1 million doses of vaccines given, showed a statistically significant increased risk of a type of blood clot in the brain after immunization with viral-vector vaccines such as the one developed by the University of Oxford and made by AstraZeneca. It showed that these vaccines were linked to a threefold increase in cerebral venous sinus thrombosis, a type of blood clot in the brain; identified in 69 events, compared with an expected 21. This vaccine was never given the U.S. In the same study, mRNA vaccines (Pfizer and Moderna) showed as small increase in observed ration of blood clots related to low platelet counts but not to statistically significant levels.

    Several smaller studies have investigated the potential link between mRNA COVID-19 vaccines and have also not found any clear associations.

  2. Heart Conditions
    Myocarditis is inflammation of the heart muscle and has been seen with both mRNA and viral-vector vaccines in several studies. Though cases are rare, they are mostly seen in adolescent and young males. The severity of myocarditis can vary; however, most will have resolution of symptoms. The risk of myocarditis is 5-10 per million vaccine doses. The rate of myocarditis with COVID-19 infection is 40-80 cases per million people infected with COVID.
  3. Neurological Disorders
    In the same study done by the Global Vaccine Data Network referenced above, Guillain-Barre Syndrome, a syndrome that affects the nerves, was observed to occur at a statistically significant increase in cases with viral vector vaccines. This was NOT observed with mRNA vaccines. However, inflammation and swelling in the brain and spinal cord  was observed after both viral-vector and mRNA vaccines. Seven cases of acute disseminated encephalomyelitis after vaccination with the Pfizer mRNA vaccine were observed, versus an expectation of two.

As with any vaccination, there are many potential side effects. However, it is important to note that severe side effects are very rare. In some cases, your provider may recommend against vaccination due to an underlying medical condition. On the other hand, for those in the majority, these vaccines are safe, effective, and lifesaving. Be sure to discuss with your MPCP provider when making these important health care decisions. We are here to support you any way we can.

Article Sources
K. Faksova et al., Vaccine, https://doi.org/10.1016/j.vaccine.2024.01.100
CDC. Clinical Considerations: Myocarditis after COVID 19 Vaccine. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.html. February 24, 2024

 

Dr. Bacchus is a MPCP partner and is certified by the American Board of Internal Medicine. She sees patients in the Columbia office and serves as MPCP’s Medical Director.

What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office

By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR

Having an illness or injury often results in a good deal of anxiety and worry. You want medical attention and relief from your symptoms as quickly as possible. But where should you go to get the best, most appropriate and cost-effective care? The following are the most widely used treatment options and suggestions about when each might be best suited to meet your particular medical needs.

The emergency department

Most emergency departments are part of hospitals, although there are free-standing emergency departments in Bowie and Queenstown. The ED is designed and equipped to handle serious or life-threatening emergencies. It is always open, including nights, weekends and holidays. Patients are seen according to how sick or injured they are. The most serious cases jump to the front of the line, even if they arrive later than everyone else. Physicians in the ED are trained to look for life-threatening conditions, and the tests you will receive in the ED will help them decide if you have any of these.

The emergency department is the right place to go if you have a serious or potentially life-threatening illness or injury: chest pain, sudden weakness on one side of your body, a new seizure, severe headache, persistent heavy bleeding, poisoning, or a large broken bone.

The emergency department is probably not the right place to go if you have a milder illness or a longstanding issue. You are likely to wait longer for treatment. The emergency department doctors do not have access to your medical records. Your visit will be much more expensive — as much as 4-6 times as expensive! Remember, they have to keep all that life-saving equipment available all the time. That’s great if you need it, but it’s just an extra charge if you don’t.

Urgent care centers

There are lots of these in our area. They often have extended hours, including evenings and some weekend hours. They are designed and equipped to handle medical problems that need attention the same day but are not life-threatening. Patients are usually seen in the order they arrive, so your wait will depend on how many other people go to the urgent care center at the same time you do. Many urgent care centers have X-ray and blood testing equipment.

An urgent care center is the right place to go if you have a new illness or injury that occurs when your doctor’s office is closed, such as sprains and strains, painful urination, ear pain, severe cough or wheezing.

An urgent care center is probably not the right place to go if your doctor’s office is open or if you have a serious or life-threatening condition. A visit to an urgent care center is more expensive than a visit for the same condition at your doctor’s office. The provider in the urgent care center does not know you and will not have access to your medical records. Urgent care centers are not equipped with life-saving equipment or providers trained to treat life-threatening illnesses or injuries.

Your doctor’s office

No one knows you like your own doctor. Your doctor is equipped to treat many illnesses and injuries, and can arrange any testing you may need. Your primary care doctor has your medical records and knows your medical history. Patients are seen by appointment. Maryland Primary Care Physician offices reserve appointments for patients who need same-day treatment. Many MPCP offices have evening and/or Saturday hours for your convenience. Call or check our website, mpcp.com, for a list of hours at your doctor’s office.

Your doctor’s office is the right place to go if you have a new problem, such as sinus pain, ear pain or flu, cuts or other wounds, sprains or strains, cough, or a flare up of an old problem, such as back pain or migraine headache, or an ongoing problem that may require more testing or treatment, such as persistent stomach problems or joint issues. You will pay the lowest copay at your primary care doctor’s office, and many times you will be able to get an appointment the same day you call. For extra convenience, all MPCP offices offer telemedicine visits after hours, in addition to evening and weekend appointments at some sites.

Your doctor’s office is the wrong place to go if you have a serious or life-threatening condition. If you need care in the next hour, go to the emergency department.

If you’re not sure what to do, call your primary care provider

Even when the office is closed, there is always someone on call who can direct you to the care you need. If you ever need to go to the emergency department or an urgent care center, take a list of all your medications and allergies with you. Let the staff know who your primary care provider is, and schedule a follow up appointment if needed.

 

 

Dr. Bacchus is a MPCP partner and is certified by the American Board of Internal Medicine. She sees patients in the Columbia office and serves as MPCP’s Medical Director.

Flu, Covid-19, RSV: Which vaccines do you need?

By: RAFEENA BACCHUS, M.D.

Each year, the influenza (flu) virus sickens millions of Americans. This fall we expect two other respiratory illnesses — Covid-19 and RSV — to surge around the same time.

Fortunately, safe and effective vaccines are available for the three viruses, and your doctor may recommend you get vaccinated against all three. Here’s what you need to know.

Flu

With symptoms like fever, chills, body aches and fatigue, the flu makes us feel lousy.  It can be very serious for older adults, young children and people with chronic illnesses. The flu virus continues to mutate new strains, so the vaccine typically protects against several types at once. The CDC recommends the vaccine for everyone 6 months and older, but it is especially important for adults 65+, children under 5, and those with weak immune systems.

Coronavirus

As we know, the coronavirus can mutate quickly, introducing new and risky variants. The dominant strain in the U.S. is currently EG.5, which spreads easily and causes symptoms similar to earlier versions, such as runny nose, fever, cough, headache, fatigue and sore throat. A new vaccine scheduled for release this fall will likely protect against EG.5 and other strains of the virus. The CDC recommends that everyone 6 months and older get the Covid-19 vaccine.

RSV

RSV (respiratory syncytial virus) usually produces mild cold-like symptoms, but it is increasingly recognized as a threat for young children and seniors with certain chronic health conditions. The FDA recently approved the first RSV vaccines for adults 60+ and pregnant women 32-36 weeks pregnant (to give their unborn children immunity). There is also a long-acting antibody treatment for infants up to 8 months of age and up to 19 months of age that are at high risk for severe infection.

Can you test positive for 3 viruses at once?

Flu, coronavirus and RSV are all highly infectious viruses, and in past years we’ve seen cases of people infected by two of them at once. It is even possible to catch all three at the same time. Hospitalization is often required for those suffering from these co-infections due to their more serious cases of illness. As you would expect, this is especially risky for young children, older adults, and people with chronic health conditions.

Which vaccines should you get?

The CDC recommends everyone 6 months and older to get the flu and Covid-19 shots as soon as possible this fall. The RSV vaccines are approved for people 60 years and older and the CDC suggests people 60+ with conditions such as congestive heart failure, coronary artery disease, COPD, asthma, diabetes, chronic kidney disease, immunocompromised conditions, and those that are long-term care residents, consult with their doctors.

Most of us can safely get the flu and Covid-19 shots at the same time. Since the RSV vaccine is new, health experts recommend getting it separately, but older adults in poor health may be able to get all three shots at once.

To schedule vaccinations, or if you have questions about them, contact your MPCP healthcare provider.

Rafeena Bacchus, M.D.Dr. Rafeena Bacchus sees patients at MPCP’s Columbia office. She received her medical degree from SUNY at the Buffalo School of Medicine and completed her residency program in Internal Medicine at the University of Maryland. She is certified by the American Board of Internal Medicine.

Are You Addicted to Social Media?

By: RAFEENA BACCHUS, M.D.

People are social by nature. We need the company of others, and the strength of our relationships affect our mental and physical health.

Today, many of us use social media platforms such as Facebook, Twitter, TikTok, YouTube and Instagram to connect with each other. Kids, teens, and young adults are the heaviest social media users, but most adults are also active on at least one platform.

For most of us, social media is an enjoyable way to pass time and connect with family and friends. However, some people say social media has a negative impact on their lives, but they continue to use it anyway. Their behavior seems to be out of control, causing some health professionals to say they are addicted to social media.

How social media addiction works
The process of using social media – posting and reacting to content — causes your brain to release the pleasure chemical dopamine. The more you use social media and receive the rewarding dopamine, the more your brain will want it. Over time, your brain can become dependent/addicted to the good feeling social media gives you.

Social media platforms like Facebook, TikTok, Twitter and YouTube also track your activity and customize your feed to show you posts you want to view and comment on. This makes social media more addictive in nature.

One of the signs of addiction is continuing to use something even after it has clearly had a negative impact on you. If social media use is interfering with your relationships, self-esteem, work or school, but you can’t stop using it, that is a possible sign of addiction.

Signs you may have a social media addiction
If you have several of the behaviors below, it may be a sign that your social media use is getting out of hand.

  • You log in very often, wasting time with unproductive browsing. You check social media first thing in the morning and repeatedly through the day.
  • You constantly check your notifications and update your status.
  • You use social media to escape from the real world. If stress and discomfort in your life are getting to you, you seek refuge in the virtual community.
  • If you can’t get on social media, you get agitated. You become anxious over time spent away from your device or without an internet connection.
  • You plan your social media posts in advance. You go places just to take selfies there, and get distracted during daily activities by thinking about how you plan to describe them later on social media.
  • You get upset when your posts online aren’t appreciated.
  • Social media gets in the way of your real-life connections. You make choices that cut out friends and family and replace them with avatars and status updates.

Health risks of social media addiction
People who habitually and excessively use social media can suffer mental and physical effects.

  • You may unfavorably compare yourself to people online, causing you low self-esteem.
  • Seeing others have a good time may contribute to a greater sense of loneliness, isolation, and the fear of being left out.
  • Exposure to misinformation, especially false health news, can keep you from getting the medical care you need or persuade you to try unsafe products and treatments.
  • Dealing with negative people, trolls and bullies can make you anxious and depressed.
  • Checking your feed late at night/during the night can disrupt your sleep patterns, affecting your performance at work or school.
  • Hours of screen time means less physical activity, which may lower your overall health.
  • Being obsessed with online people can make you ignore the important relationships in your life.
  • Motivated by the desire for online approval, you may engage in risky behavior, such as playing dangerous pranks or posting embarrassing material. And if you glance at your news feed while driving, you are up to four times more likely to be involved in a crash.

How to cut back on social media
If you think social media is becoming a problem, you may need to cut back to reach a healthy level of use. Try the helpful tips below, but if you still struggle, consult with your healthcare provider for additional resources.

  1. Turn off notifications from social media apps. They are a major source of distraction and temptation.
  2. Change the desktop color settings of your phone to black and white to make them less attractive.
  3. Silence your phone during work, as well as during school, meals, and recreational activities.
  4. Delete social media apps from your phone to decrease the amount of time spent on them. (You can still use them on your computer at home.)
  5. Set aside a certain amount of time for social media each day. Don’t go beyond it.
  6. Turn on a timer to help keep you accountable for how much time you spend online.
  7. Leave your phone, tablet, and computer out of your bedroom.
  8. See your friends and family in person more often.
  9. Take up a new hobby that’s not technology-related like sports, art, or classes.

Rafeena Bacchus, M.D.Dr. Rafeena Bacchus sees patients at MPCP’s Columbia office. She received her medical degree from SUNY at the Buffalo School of Medicine and completed her residency program in Internal Medicine at the University of Maryland. She is certified by the American Board of Internal Medicine.