Get first available COVID-19 vaccine

Dear Dr. Roach: Could you please explain the science behind the new Johnson & Johnson COVID-19 vaccine? I hear it differs from the Pfizer/Moderna vaccines as it does not contain the mRNA and is only a single dose.

D.J.

Answer: All the available vaccines are very effective at preventing serious illness from COVID-19. The “best” vaccine for virtually everyone is the one they can get the fastest. Although all are excellent vaccines, there is an advantage in that the Johnson & Johnson vaccine is a single dose. It also has less stringent requirements for freezing/refrigeration, so it will likely have a major impact worldwide. But the J&J vaccine is much more similar to the Ebola vaccine than it is to the flu vaccine. It uses the mechanism of adenovirus (a cause of the common cold) to bring DNA into the muscle cells, which then tell the muscle cells to make the COVID-19 spike protein. The vaccine uses an adenovirus that is incapable of replication, so there is no risk of getting a cold from the vaccine.

The vaccine is about 65% effective at reducing moderate-to-severe COVID-19 disease, but it’s extremely effective (100% for those fully vaccinated) against mortality and COVID infections requiring hospitalization in the initial study.

I continue to recommend that my patients get the first available approved vaccine.

Dear Dr. Roach: I have to have an umbilical hernia operation and I am concerned about the use of mesh. It seems that in so many operations done with mesh, the patient later had to have the mesh removed. What is your opinion about the use of mesh?

L.R.

Answer: Many of my own patients have had complications from hernia surgeries using mesh. I understand why you are concerned. However, multiple studies have confirmed that a tension-free hernia repair (which usually requires mesh) reduces post-operative pain, speeds healing and reduces recurrence rates.

Mesh infections and migration can happen after the surgery. However, newer surgical techniques and materials have improved the results from surgery in recent years.