South Florida Sun-Sentinel (Sunday)
Fourth COVID-19 booster shot not yet recommended
Q: My husband had the Pfizer booster three months ago. He now wants to get the Moderna booster. Is it safe to get another booster shot after only three months? If not, how long should he wait to get another booster? He has coronary artery disease and heart failure but no problems with weight or diabetes. When would it be safe for him to get a fourth shot?
A: Israel has been at the forefront of COVID vaccinations. Health experts there are debating the pros and cons of a fourth shot. An expert panel recommended that people over 60, immunocompromised patients and health care workers get another booster at least four months after their third Pfizer shot.
Before rolling out this program countrywide, Israeli researchers are testing the additional booster on 150 health care workers. Public health authorities in the U.S. are not yet recommending a fourth shot. The Centers for Disease Control and Prevention did state, however, that people who received the Pfizer-BioNTech shots initially could get a Moderna booster as the third shot.
Q: Thank you for posting articles about Xyzal withdrawal on your website. I am currently going through that awful process. Since stopping Xyzal, I have been breaking out in hives throughout the day on my arms, stomach, legs, hands and
chest. I was searching my brain for what I could possibly be allergic to. Had I changed detergents? (No.) Eaten anything unusual? (No.) The hives look like welts or long scratch marks when I haven’t even scratched the area. Is there any way to make the drug manufacturer warn of this terrible withdrawal process? It seems like they have a responsibility.
A: Levocetirizine (Xyzal) and its chemical cousin cetirizine (Zyrtec) are antihistamines that are less likely to cause drowsiness than older allergy medicines. Readers first reported withdrawal itching more than a decade ago. We badgered the Food and Drug Administration about this problem for years.
Finally, the agency reported more than 100 cases it found in its FDA Adverse Event Reporting System database (Therapeutic Advances in Drug Safety, July 5, 2019). The agency told us that it would require a warning about discontinuation itching in the prescribing information.
Sadly, though, we have
seen no such warning on over-the-counter versions of these antihistamines.
Q: Beginning in my 30s, I tried a variety of prescribed antidepressants. The results were disastrous. When I was 50, I found a psychiatrist who diagnosed me with seasonal affective disorder (SAD) and prescribed a light box. It’s been life-changing. I would encourage people who have problems with depression, especially if it’s more serious in the winter months, to investigate light boxes. Mine has been a huge help for over 20 years.
A: Bright light therapy has been used to treat SAD for at least three decades. A review of 19 randomized controlled trials found such treatment to be effective (Psychotherapy and Psychosomatics, January 2020). Thank you for reminding us that some people find light therapy to be quite helpful.