Vaccination can improve long COVID

Dear Dr. Roach: Is it safe for an unvaccinated person experiencing long-term symptoms after a COVID-19 infection to get the vaccination, or must they wait until the typical 90-day period for symptoms to diminish or disappear?

P.M.

Answer: I do recommend vaccination after COVID-19 infection, with or without persistent symptoms. People should get vaccinated only after they have met criteria for stopping isolation. This usually means waiting until 10 days after symptom onset; after resolution of fever for at least 24 hours; and after improvement of other symptoms. People with severe disease or with an immune system condition may need more time.

Vaccination has not been associated with worsening of symptoms in people with persistent COVID symptoms. There have been some cases of symptoms improving with vaccine. So, for a person who is well past their acute phase, getting the vaccine is safe and may possibly help reduce long COVID symptoms, but is not urgent since immunity is reliable for at least 90 days after infection.

Dear Dr. Roach: I’m a healthy 66-year-old woman who experienced a “gush” of vaginal bleeding a few days ago. It subsided fairly quickly, and I have not experienced any bleeding or spotting since. I immediately saw my OB/GYN. Her visual assessment of my cervix showed no inflammation and a healthy appearance. She then recommended we do a uterine biopsy to rule out cancer. I was informed that no sedation is used and to expect sharp pain. I was perplexed. Why, with modern medicine, am I to be subject to medieval torture?

L.A.

Answer: Either ultrasound or biopsy is a reasonable first step in excluding uterine cancer in women with postmenopausal bleeding.

If a biopsy is needed, you have options. Take a pain reliever ahead of time to reduce pain. Sedation is perfectly reasonable, although you will need someone to help you home after the procedure. Most women do not have severe pain (certainly not “medieval torture” level), according to studies, but you should speak to your gynecologist about the options.

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