No need to wait to get COVID vaccine after testing positive

DEAR DR. ROACH

» My wife and I tested positive for COVID-19 on December 20, 2020. Due to our ages, we qualify to receive a vaccine now. But we have heard and read conflicting advice relating to the appropriate vaccination timing for people who have tested positive, ranging from get it as soon as you can, to wait 90 days after the positive COVID test, to wait longer than 90 days, with no specificity as to how much longer. What’s the answer? We have been symptom-free since the end of December 2020.

— M.P.

DEAR READER » People who have had COVID-19 have some degree of protection, but that protection is incomplete and may be short-lived. However, it is rare to get reinfected within three months of the first infection, so it is not urgent that you get the vaccine immediately. But you need not wait three months. You may get vaccinated after COVID-19 infection, as long as the symptoms have resolved. Since you do not have symptoms, you are free to get the vaccine as soon as it is convenient for you.

People who have been treated with monoclonal antibodies should not get vaccinated for 90 days after treatment.

DEAR DR. ROACH » You had several questions regarding using topical diclofenac gel for arthritis pain. My doctor prescribed topical diclofenac for shoulder pain, but my insurance would not approve this item. Voltaren and diclofenac states do not use for back, hip or shoulder. Why not? What do you suggest I use for the shoulder other than pain pills?

— G.T.S.

DEAR READER » Topical anti-inflammatories such as diclofenac gel are good alternatives and worth a try, as they have very low risk of systemic side effects and often give pain relief. However, they only penetrate so far into the body, and for that reason are most useful on joints that are superficial. The dose for lower extremity joints in the upper extremities.

The back, hip and shoulder joints are generally deeper, and the manufacturer has not evaluated the effectiveness of diclofenac in these joints. Insurance companies will often not pay for treatments that have not been shown to be effective. It may still be effective for some individuals.

Other treatments that are helpful for osteoarthritis of the shoulder include exercises (ideally, while supervised by an occupational or physical therapist); oral anti-inflammatories; and Tylenol. Very severe shoulder arthritis is infrequently treated with joint replacement.