DEAR DR. ROACH: You recently answered a question about vaccination among health professionals by saying, “They are ethically obligated to get the vaccine so as not to infect their patients.” But isn’t it the case that the vaccinated get COVID and infect others as well? It is protection for the vaccinated, but it is not protection for the people around them. — SC
ANSWER: You are mistaken that the vaccine does not protect others. While it is true that breakthrough infections can occur in the vaccinated, the risk of infection in the vaccinated is much lower than in the unvaccinated. As a result, the chance of the disease spreading is much smaller. People who have had a breakthrough infection are contagious for a shorter time than unvaccinated people and generally have less contagious virus. It is the unvaccinated who are continuing this pandemic, and if everyone (or even almost everyone) were vaccinated with the currently available vaccines, there would be no more pandemic.
Many people say that because the vaccine is not 100% effective, they will not take it. No medical treatment is 100% effective. Even a partially effective vaccine is beneficial, and the vaccines currently available are all highly effective.
Another excuse is that mandatory vaccines are an invasion of one’s freedom. This is true. No freedoms are absolute. The freedoms of others must be taken into account. Vaccinations have been required by public schools for many years. Personal liberties must be balanced by the responsibility to protect others. Vaccination mandates have repeatedly been found legal during a public health emergency. It makes medical and scientific sense to require health professionals who are at particularly high risk of infecting others to be vaccinated.
DEAR DR. ROACH: After I was diagnosed with polycythemia vera, I started donating blood when my hemoglobin level was elevated. I’m going to donate half a liter of blood every two months. So far, so good. My regular doctor and hematologist are happy with the result. Are there vitamins I should take? — PPF
ANSWER: In polycythemia vera, the bone marrow makes too many red blood cells. It is a myeloproliferative neoplasm, a type of blood cancer.
P. vera can cause many complications, but the most common is either abnormal blood clotting or bleeding, but it can also turn into a more aggressive blood cancer, such as leukemia. Aspirin is almost always used to reduce abnormal blood clotting in people with P. vera. In more advanced cases, chemotherapy drugs, such as hydroxyurea, are used to control blood production.
Phlebotomy, the therapeutic removal of blood, is a mainstay of people with early or mild P. vera. In the past, phlebotomy was used to treat many diseases, but today it is only the standard treatment in hereditary hemochromatosis and polycythemia vera. The potential for abnormal bone marrow cells to be present in the blood means it will never be transfused into another person.
You might think that minerals such as iron would be helpful in people with P. vera, but iron supplements are not given, as low iron levels help control excess blood production. Likewise, vitamin B12 and folic acid, which are necessary for the production of red blood cells, can also stimulate the production of blood cells. They should only be taken on the express orders of your hematologist.
dr. Roach regrets not being able to answer individual letters, but will include them in the column whenever possible. Readers can email questions to: [email protected] or email 628 Virginia Dr., Orlando, FL 32803.
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