Yes, get the second shot for hepatitis A

Dear Dr. Roach: Last July, I ate at a beach restaurant in Florida and shortly afterward was advised to get a hepatitis A shot, which I did. They also said to get the second shot in January 2020. Now I’m hearing that there may be complications with the second shot causing health problems and also that health insurance and/or Medicare won’t pay for it.

Are these just scare tactics? — G.B.

Florida is experiencing a large outbreak of hepatitis A, which causes an acute illness.

The hepatitis A vaccine is recommended for people who might have been exposed. The first dose should be given as soon as possible after exposure, and the second dose six to 12 months later.

I urge you to complete the two-dose series.

Dear Dr. Roach: I had an upper respiratory infection that lasted for a long time, and now I suffer from fatigue. My sister suffered for a long time with the same symptoms. She took CBD and says she feels better. I had open heart surgery to replace my mitral valve, and I take metoprolol and warfarin. Is it safe for me? — A.T.

Cannabidiol, a nonpsychoactive component of cannabis (hemp), is marketed for many conditions. The scientific knowledge about its effectiveness and possible toxicities is quite limited. Warfarin (Coumadin) is one of the most common drugs to cause concern. It is highly bound to proteins, and other drugs that compete with warfarin for protein binding can significantly change drug levels. It also is metabolized by three different enzymes. Although I could not find any published cases of harm from people taking both CBD and warfarin, CBD can affect the platelets. I would recommend against CBD oil in people on warfarin.

I couldn’t find any good studies to show CBD is effective for colds or fatigue.