Continued precautions still necessary

Dear Dr. Roach: Can you elaborate on how the COVID vaccine is different — or inferior — from other vaccines? As far as I know, we do not need to continue to take precautions for polio, or the Spanish flu or bird flu — those vaccines protect us. Why the need for continued precautions for COVID after being vaccinated?

W.S.

Answer: The COVID vaccines are new, but the evidence is mounting that in the real world (as opposed to just studies), these vaccines are very safe and effective. Part of the continued caution in the current

COVID-19 pandemic is due to the unknown duration of the effect of the vaccine, but much of the concern has to do with just how many people are infected. There is the possibility of a new variant becoming prevalent that might be more contagious, more deadly, less amenable to our therapies or able to overcome the resistance conferred by the vaccines.

I should note that without continued vigilance, there remains the possibility that polio could return, and every year brings the concern of a new influenza strain. This year, social distancing and mask use dropped influenza transmission to historic lows.

Dear Dr. Roach: My doctor switched me from 20 mg atorvastatin to 20 mg pravastatin because I was having some muscle cramping. I still had these side effects with the pravastatin, but they were noticeably reduced. I also preferred the pravastatin, as it is supposedly less risky in terms of liver and kidney disease.

Unfortunately, the pravastatin did not work well enough to lower my LDL. Now I have a decision to make between increasing the pravastatin to 40 mg or going back to the 20 mg atorvastatin.

Which do you think is the safer choice?

Anon.

Answer: Assuming you do not have blockages in the arteries of your heart, I believe that for prevention, it’s particularly important to find a treatment plan that does not cause undue side effects. Liver and kidney problems due to any statin are quite unusual. However, most muscle aches noticed by people taking statins are likely not due to the statin. Aches are just about as likely while taking a placebo pill as a statin.