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Am I Doubly Protected if I Had COVID and Also Got a Vaccine?

“People who had been vaccinated after already being infected with COVID-19 had even more protection against the delta variant than vaccinated individuals who had not had COVID-19 before,” said Dr. Joanna Drowos , an associate professor at Florida Atlantic University’s medical school.

Small vials of a COVID-19 vaccine.
(TNS) - As the delta variant ravages Florida, we are answering your questions about the COVID-19 vaccine and what we need to do next.

Q. “Is there any research on how much more protected you may or may not be if you have been infected by COVID-19 and recovered from it and also been vaccinated? Do you have greater immunity because of both of those events?” — Mark, Pompano Beach

A. According to research out of Great Britain , you do. The Oxford study on the delta variant checked whether having both COVID-19 vaccination and natural infection had an effect on immunity. The results haven’t been published yet, but initial findings show extra immunity for people who had both the virus and their vaccines.

“People who had been vaccinated after already being infected with COVID-19 had even more protection against the delta variant than vaccinated individuals who had not had COVID-19 before,” said Dr. Joanna Drowos , an associate professor at Florida Atlantic University’s medical school. “This is difficult to quantify as many personal and physiologic factors impact immune response. Vaccination continues to be recommended for anyone who is not yet vaccinated and has had a natural COVID-19 infection.”

Q. “I had COVID at the beginning of August but am now negative. I was able to get monoclonal antibodies five days after I presented symptoms. Will I need a booster? I had my second Pfizer vaccine Jan. 28 ; I received the infusion on Aug. 11.” — Sandi Block-Brezner

A. Your situation is almost ahead of the science, as the recommendations for people to get vaccines after getting antibody treatment focus on the unvaccinated. There isn’t substantive research yet on vaccinated people who received the treatment.

“Currently, there are no data on the safety and efficacy of COVID-19 vaccines in people who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment,” according to the Centers for Disease Control and Prevention . “Based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon within the 90 days after initial infection, vaccination should be deferred for at least 90 days after receiving monoclonal antibodies or convalescent plasma. This is a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses.”

This advice doesn’t specifically apply to boosters, which will not be available to the general population until  Sept. 20 . But Dr. Andrea Klemes , chief medical officer at MDVIP , a physicians’ network with headquarters in Boca Raton , said to wait the 90 recommended days and see if new research emerges.

“That will take you to November,” she said. “By then we should have greater clarity and more data on who needs a booster shot and when.”

Q. “My physician said I was not allowed in the office until I got vaccinated. Is that a new law in Florida?” — Carol Aiken , Lake Worth Beach

A. A Florida law that went into effect July 1 prevents businesses and schools from requiring “vaccine passports,” or proof of COVID-19 vaccination, as a condition of entry or service. However, the law exempts health care providers.

“The doctor may request proof of vaccination,” Boca Raton attorney Peter Sachs said.

Q. “Does a person have to wait eight months from the second vaccination before getting the booster or can a person get it sooner, say five to seven months? My husband and I got our boosters and I am concerned about my son who lives with us. He is 45.” — Ellen Ingber

A. Anyone who has a weak immune system can go now to get a booster. Boosters are approved for the general population starting Sept. 20 . However, you are supposed to wait eight months from your second vaccine to get this third dose.

Vaccinated Floridians who are fearful about the delta variant have already started getting their boosters, even though eight months have not passed for them, and pharmacies appear to not be asking too many questions. Your son might want to ask his doctor whether it’s a good idea for him to get his third dose now.

Q. “I will be getting my flu shot on Sept. 20. How long should I wait before getting the Moderna booster?” — Lisa Rosen

A. This is one of those situations where the advice from the Centers for Disease Control and Prevention has changed and you have to pay attention to keep up. Here’s what Dr. Andrea Klemes, chief medical officer at MDVIP , a physician network with headquarters in Boca Raton , said you should do.

“The CDC originally said to wait two weeks in between a COVID-19 vaccine and any other vaccine like the flu shot,” she said. “They have since changed their recommendations and have stated you can get the COVID-19 vaccine with any other vaccine.”

Q. “I’m 63 and live with my daughter and her 3-year-old daughter. None of us are vaccinated. Will it make them more susceptible to COVID if I get vaccinated?” — Mark Jones , Winter Haven

A. No, you will actually be protecting them. According to the U.S. Centers for Disease Control and Prevention : “COVID-19 vaccines reduce the risk of people getting COVID-19 and can also reduce the risk of spreading it.” Your granddaughter is vulnerable because she’s too young to get a vaccine, but encourage your daughter to get vaccinated with you to defend yourselves and the little one from the delta variant’s pernicious spread.

Q. “Does the vaccine go to waste if I don’t go back for my second shot?” — Cheryl, Miami

A. The COVID vaccines have short shelf lives, so if no one else walks into the clinic around the time of your second scheduled shot, it likely will get thrown out.

Once a Moderna vial is opened, the 10 to 15 doses in the package last only 12 hours.  Pfizer and  Johnson & Johnson  vaccines also must be used quickly once opened. There are six doses in Pfizer vaccine vials, which must be used within six hours, and five doses in Johnson & Johnson vials, which also must be used within six hours.

There are many reasons vaccines go to waste. Some are improperly stored or transported or break in their packaging. But people not showing up for appointments is definitely one of the reasons they have to be thrown out.

The Centers for Disease Control and Prevention says that waste is to be expected. New federal guidance advises: “Providers should not miss any opportunities to vaccinate every eligible person who presents at a vaccination site.” That means if people show up at a clinic and wants a Pfizer shot, even though a Moderna set of vials is already open and may have to be tossed if not used, patients should get the shots they prefer.

Q. “I have had COVID twice. Will the vaccine hurt me?” — Betty, Belews Creek, N.C.

A. Even if you have had the virus, you may not be immune from the delta variant and others that likely are coming and that vaccines protect us from. The Centers for Disease Control and Prevention says you can get the vaccine as soon as you’re out of quarantine and symptom-free, with one caveat: If you received monoclonal antibody treatments, you should wait 90 days after your full recovery.

A recent study of patients in Kentucky who were infected more than once showed the vaccines provide better protection than natural immunity.

“If you have had COVID-19 before, please still get vaccinated,” CDC Director Dr. Rochelle Walensky said. “This study shows you are twice as likely to get infected again if you are unvaccinated. Getting the vaccine is the best way to protect yourself and others around you, especially as the more contagious delta variant spreads around the country.”

Q. “Are local school districts taking into account vaccination status when deciding who has to quarantine after a potential exposure? If parents provide proof of vaccination, will their child NOT get sent to quarantine? I am wondering if the school districts are providing incentives for students ages 12 and up to get vaccinated, or if the children whose parents refuse vaccinations are treated exactly the same quarantine-wise?” — Amy Sherman , Fort Lauderdale

A. There are no incentives, but the school districts do take into account vaccination status in deciding who needs to quarantine. In Broward and Palm Beach County schools, fully vaccinated students do not need to isolate if they are notified they have been exposed to COVID-19, as long as they don’t have symptoms. It’s the same for students who have tested positive in the past three months and recovered; they don’t need to quarantine as long as they remain asymptomatic.

Despite these rules, thousands of South Florida kids, including those too young to be vaccinated, have been forced to isolate because they have been exposed, which is defined as being within six feet for at least 15 minutes of someone who received a positive test. These kids can go back to school if they have no symptoms and test negative on day five or later after exposure, or seven days have passed since exposure and they have no symptoms.

Q. “I was told it didn’t matter if I received the COVID vaccine, I could still get COVID. Then why get the vaccine?” — Linda, Sanford

“Why get the vaccine if you can still get COVID” — Brenda Sue Plouvier

A. The vaccines prevent severe illness and death. We all know people at this point who have been vaccinated but still got COVID, but it’s super rare for them to be hospitalized or die from it. In July, 98.3% of people hospitalized for COVID were unvaccinated.

You don’t want to be unvaccinated and contract COVID. If you don’t die from it, you risk long-term effects, including muscle atrophy, brain fog, autoimmune conditions and mental health challenges. Since the virus is relatively new, we don’t know how long these problems last.

So even though the vaccines are imperfect, scientists recommend them so you can avoid these physical and emotional consequences.

Q. “Can my country club community require me to get the COVID-19 vaccine as a condition of using the facilities for which I am paying annual membership dues?” — Brian, West Palm Beach

A. The club cannot require this, although they can mandate mask-wearing, Boca Raton attorney Peter Sachs said. He said a Florida law that went into effect July 1 prohibits businesses from asking about vaccination as a condition of service.

“Fines up to $5,000 may be imposed for violations,” he said. “However, in my opinion, your country club may require you to wear a mask when utilizing amenities and may accept a vaccination passport produced by a member, on a voluntary basis, to waive the mask requirement. Although you are paying annual membership dues, the club does have an obligation to act in the best interests of its members, to protect its staff and may adopt reasonable rules to accomplish same.”

Q. “Have there been any studies done on the effects of the vaccine on people taking drugs for rheumatoid arthritis like Humira, Xeljanz and Rinvoq? It seems that my RA flared up after the second shot and I had to switch from one biologic to another arthritic medication. I know that it has been said people with autoimmune disease were not included in the trials for the vaccine but have any studies been done since then regarding autoimmune disease?” — Gary Cohen

A. New studies are confirming the vaccines are safe for most people with autoimmune diseases such as rheumatoid arthritis, said Dr. Joanna Drowos , an associate professor of family medicine at Florida Atlantic University’s medical school.

In May, she said, researchers reported in the Annals of the Rheumatic Diseases that 82 percent of people with RA mounted a strong immune response to the vaccines, compared with the control group in which 100 percent of the patients responded.

Other studies have provided reassurance about side effects and flare-ups. The European Alliance of Associations for Rheumatology COVID-19 Registry documented the experiences of 1,500 people with RA and other rheumatic diseases. Drowos said those who got the vaccine generally had short-term side effects similar to those experienced by the general population.

“Based on this data, only 5% of people with RA experienced a flare in their rheumatoid disease following their inoculations, with 1.2% rating it as severe,” Drowos said. “If this is what you experienced, it is definitely important to check in with your physician.”

Q. “If I scan my COVID vaccination card and load the scanned version onto my cell phone, will that be acceptable proof of my vaccination? How about a copied paper version that I can carry in my wallet?” — Lisa Rosen

A. Each place you visit will likely have a different rule. If you go to Hawaii , for example, you have to upload a picture of your card to a state website and also have your card with you to show to officials.

I was in New York City recently and was asked to show my card before entering a building. I showed a picture from my phone and was surprised that sufficed. But from now on when I travel I’m going to keep my actual card with me, in a little plastic bag to protect it, in case I visit somewhere with different rules.

You can also scan your CDC  card into several free phone apps, including Clear, VaxYes and Airside, but there’s no universal app that we know will be accepted everywhere.

Q. “I had COVID-19 in January, and I received my Moderna shots in May and June. I plan to travel after Labor Day to see my grandson in New Jersey . Is there any danger of me contracting and/or passing along COVID to him, as he is too young to be vaccinated?” — Catherine Stamm , Fort Lauderdale

A. It’s so hard to know how to handle these situations. We desperately want to see our relatives and friends but don’t know who’s carrying the virus. Here’s advice from Dr. Andrea Klemes , chief medical officer at MDVIP , a physicians’ network based in Boca Raton .

“The COVID-19 vaccines we have are effective in preventing hospitalization and death from COVID-19,” she said. “But you can still get infected with the virus and pass it on to others even if you are vaccinated. I would employ all the safety measures we have been taking since the beginning: masking, social distancing and hand washing.”

Q. “The University of Miami and Nova Southeastern University are requiring the vaccine for staff and faculty. Why isn’t Lynn University implementing a similar mandate?” — Lynn professor

A. You are correct that Miami  and NSU are requiring COVID vaccines for their employees. But Lynn, which has about 3,000 students in Boca Raton , believes the campus has COVID under control with mask requirements and other rules implemented over the past year and is not planning a vaccine mandate.

“The diligence and hard work of our faculty, staff and students has kept Lynn University operating safely during the pandemic and since we reopened in August 2020,” spokeswoman Jamie D’Aria said. “Over the last year, COVID-19 cases remained manageable on campus, and we did not see any significant transmission inside the classroom as students and faculty followed facial covering and healthy hygiene protocols.”

Q. “My grandson just had his first dose of the Pfizer vaccine. His second dose will be Sept. 2 . Will he have any protection when school starts on Sept. 15?” — Debby Pasquarella

A. His timing is good because he is considered fully vaccinated two weeks after the second dose. That would technically be the day after his school starts. So he will have full protection in his first week of classes.

Q. “I am 69-year-old female who is fully vaccinated. Is it risky for me to go on a cruise out of Florida now?” — Linda Brace

A. This is a tough one. I asked Bari Golin-Blaugrund , spokeswoman for Cruise Lines International Association , the industry’s trade group, and here’s what she said:

“Cruise lines today are operating with some of the highest levels of COVID-19 mitigation of any industry in the world, with a lower incidence rate than we are seeing on land. In addition to the multiple layers of public health protocols that cruise lines have adopted, many of our members are requiring vaccination for eligible passengers on many itineraries, and crew vaccination has been a top priority of the industry since vaccines have become widely available. We have heard from many people who have just completed a cruise itinerary from Florida , and the reviews so far have been nothing but positive!”

Obviously, that’s what we would expect someone from the cruise industry to say. Here are some other facts: There are frequent reports of COVID cases on board ships that are sailing now. Twenty-seven ships that currently operate or will be operating in  U.S.  waters have reported COVID-19 infections to the Centers for Disease Control and Prevention since cruising resumed this summer.

Of the 27 ships, 14 are sailing with passengers. Most recently, there’s the case of the Carnival Vista, which made a stop last week in Belize : Twenty-six crew members and one passenger tested positive for COVID. That’s out of 1,400 crew members and almost 3,000 passengers, according to Belize’s Tourism Board.

So do a lot of research about your cruise line and ship before making a decision, including vaccination requirements for passengers and crew and for the destinations where the ship will dock. You can get more information and check the COVID status of the ship you want to sail on at this website: cdc.gov/quarantine/cruise.

Q. “Can I get the first dose in Los Angeles and the second dose in Miami?” — Jaime Delgadillo

A. The Florida Department of Health does not want you to do this. According to their website: “Someone should only get their shot in Florida , however, if they will be in Florida for the time period needed to receive both shots.”

The department says shots in Florida are for full-time and seasonal residents, and for people doing business in the state. So I recommend you choose either LA or Miami and try to get both shots in the same location, three to four weeks apart.

Q. “Where can seniors with immune deficiencies get their third shot now?” — Barry Baitch

“I am 74, had my first Pfizer shot in January, second in February. I really would like to get a booster because it’s seven months since I got vaccinated! Can I show up and get another Pfizer shot somewhere?” — Geraldine Bielawski

“I had both shots of the vaccine in February and March. I am 92 years young with asthma. I’ve had double pneumonia two times. When I get a cold I usually get chest congestion. Should I get a third booster shot?” — Lucille Tarant

A. The Biden administration is now recommending a booster shot eight months after your second Pfizer or Moderna shot. These third shots are expected to become widely available in mid-September.

In the meantime, a third dose is only recommended for people with moderate to severe immune deficiencies, such as organ transplant patients, people on meds that suppress the immune system and people with active HIV or cancers of the blood. It’s not recommended for people who got the Johnson & Johnson vaccine or others anxious that their shots have worn off. Ask your doctor whether you qualify.

If you’re eligible now, go to vaccines.gov, put in your zip code and find a site near you. Most of the pharmacies that offered shots earlier this year are still open, including Publix , CVS and Walgreens.

Q. “Have there been any studies about long-term effects in breakthrough COVID cases? Can vaccinated people who get COVID have long-term effects?” — Marsha, Pompano Beach

A. Studies on vaccinated people who contract COVID are just starting to trickle in, but research is showing that some patients already are reporting long-lasting symptoms, including not only fatigue and shortness of breath but heart, lung and brain challenges.

Several studies are showing vaccinated people remain sick after they are considered recovered. An Israeli study of 1,497 vaccinated health care workers reported 39 breakthrough infections, and 19 percent of those workers still had symptoms six weeks after their convalescence.

A new federal initiative called RECOVER, sponsored by the National Institutes of Health , is looking at post-recovery symptoms, known as long COVID, and the best ways to treat them. Congress has set aside $1.15 billion for this project, so hopefully they will come up with good strategies to help patients who continue to suffer for months after they leave the hospital.

Q. “What do you do about getting vaccinated if you leave a vaccine trial? I am part of the Novavax trial, and with a return to work in person with no mask or vaccine mandate, I feel strongly that I would want to get a third shot when it is available. I teach at a university and have a 175-person college course. With low vaccination rates among college-age adults, the surging Delta variant, and two small kids at home that are too young to be vaccinated, I just don’t see any other way to keep my kids and myself safe.” — Boca Raton professor

A. There’s no third shot available to anyone in the United States at the moment, so that’s not an option, said Dr. Joanna Drowos , an associate professor at Florida Atlantic University’s medical school. In the meantime, you can quit the trial and consult with the trial coordinator and your doctor about how to proceed.

“Participation in any clinical trial is voluntary,” she said. “You have the opportunity to withdraw from the study at any time. It would be important to check in with the coordinator for the trial about any care that you received, as some trials involve the use of both vaccine and placebo or alternate treatments.”

She said to keep in touch with the trial coordinator as recommendations could change in the coming months about a booster dose.

“By the time this recommendation changes, your trial may also be testing additional doses as well, so it would be important to check in with the clinical trial team and your personal physician about what is currently recommended and available before making any decisions about additional vaccine doses,” she said.

Q. “I got my first shot of the vaccine four months ago but never went back. Should I get the second shot now?” — Jamie B. Daniels

A. Yes, go now, said Dr. Joanna Drowos , associate professor of family medicine at Florida Atlantic University’s medical school.

The Centers for Disease Control and Prevention recommends you get the second Pfizer or Moderna shot three to four weeks after the first. But waiting six weeks is also OK, and if you wait even longer, you still don’t have to start over again, Drowos said.

“There is currently limited information on the effectiveness of receiving your second shot earlier than recommended or later than six weeks after the first shot,” according to the CDC . “However, if you do receive your second shot of COVID-19 vaccine earlier or later than recommended, you do not have to restart the vaccine series.”

Q. “Are Florida teachers resigning due to lax COVID rules in the state during the surge?” — Wendy Traver

A. The school year has just started or is about to start in most Florida school districts, so the districts are still compiling their numbers. Teachers leave the profession for an assortment of reasons, even during COVID-19. But here’s what happened last year:

In Broward , in the first half of the last school year, there were 665 “separations,” which would include retirements, resignations, terminations or leaves of absence. The previous year there were 428 in the same time period, and the year before that, 540. That’s out of about 14,000 total on the force.

The largest category of people leaving was retirements, with 340. But 93 said they got a new teaching position, 14 were dissatisfied with pay or working conditions, 60 relocated and 143 called their reasons “personal.”

Palm Beach County also had a higher than normal number of resignations and retirements in the first half of the last school year, totaling 473, up from 268 the previous year and 350 the year before that. The district has more than 13,000 instructors.

It was a tough year for Florida teachers. Many had to get used to wearing masks and teaching students at home and online at the same time. This year, they won’t be teaching students online anymore, but we’re about to see if their jobs become easier without this task or harder because of the Delta surge and mask restrictions.

Q. “Can the citizens of Florida form a class-action suit against Governor DeSantis for depraved indifference concerning our health and welfare regarding illness from COVID-19 and his inaction for enacting laws or mandates to help prevent the spread? Many of us are masking and are vaccinated but are still very scared of breakthrough infections in a state that is rampant with this virus.” — Sue, Boynton Beach

A. A class-action lawsuit allows the claims of many people who have been harmed to be settled in a single proceeding instead of each filing a separate case. Although it may sound like COVID-19 would be a natural for this type of proceeding, since there are so many victims, Boca Raton attorney Peter Sachs recommends against this route.

“While we are all very concerned with the latest turn of events regarding the Delta strain of the virus, disagreeing with the governor’s policies is not the basis for a class action,” Sachs said. “Questions and concerns of this sort are best dealt with at the ballot box in a democracy.”

Q. “Can my country club make me wear a mask even though I am vaccinated?” — Ronnie, Boynton Beach

A. They can, said Boca Raton attorney Daniel E. Weber.

“Whether it is a traditional country club or a country club operating as a homeowners association, the association, through its board, will have control over the governance and operations of the facilities, including the ability to impose reasonable rules and regulations,” Weber said. “So long as the rules created are reasonable, they will be upheld by a court if challenged.”

This view is the consensus among several attorneys I asked, even though Gov. Ron DeSantis has prohibited mask mandates at some sites, such as schools.

“There’s nothing prohibiting country clubs from mandating such actions,” attorney Guy Shir said. “The issue, of course, becomes whether the governor’s orders can override that. I believe that he’s made it clear that for private businesses and establishments, he’s not going to mandate like he did for Broward County schools. So I believe I’m safe to say in a resounding yes, they can mandate masks.”

Q. “Five days after receiving my first Pfizer shot, do I have any protection from the virus if I still wear a mask, but no one else is wearing one inside a crowded restaurant?” — Linda, Sunrise

A. After your first dose, you’re considered partially but not fully protected from the virus. And that partial protection doesn’t come until two weeks after that first injection, said Dr. Joanna Drowos , an associate professor at Florida Atlantic University’s medical school.

“Assuming that your immune system is not compromised by any underlying medical conditions or medication use, you will have some protection 14 days after your first dose,” she said. “You would be considered well protected once you have completed your second dose of the Pfizer vaccine, raising your COVID-19 protection from what might be as low as 33% better than an unvaccinated person up to 90%. The vaccine’s protection is generally achieved somewhere between seven to 14 days after the second dose. It is important to continue to take precautions to limit your exposure, including masking, social distancing, avoiding crowds and hand-washing.”

Q. “I want to go to church. I have both COVID-19 shots but I’m high risk. I’m 63 years old. Both of my sisters do not want me to go yet. Because of the variant, what should I do?” — Cary, Orlando

A. I can relate to this feeling of wanting to re-engage with like-minded people and the rituals we miss. Dr. Andrea Klemes , chief medical officer at MDVIP , a national physicians’ network, said you should figure out a plan with your doctor.

“If she is at high risk, even though she is vaccinated, she should consider waiting longer to go in person as the numbers have increased in Florida,” Klemes said. “Maybe she could take advantage of the virtual services that are taking place.”

I know, they’re not the same as attending in person. Hopefully we won’t have to wait much longer to reconnect in the group settings we had come to love and now value more than ever.

Q. “I got vaccinated by the Health Care District of Palm Beach County . I have my vaccine card but would like to know if they provide a digital record of vaccination? If not, are they planning to? Such secure proof may be needed when traveling or for other purposes.” — Scott Reiter

A. The Health Care District is not offering digital records and doesn’t plan to, spokesman Thomas Cleare said. The only exception is if you were vaccinated at the district’s C.L. Brumback Primary Care Clinics , which maintain digital records of patients’ entire vaccination history.

Unfortunately, there’s no statewide or nationwide database for you to access your information and get a printout.

“With COVID vaccines, there is no government tracking or entering of information for who has received the vaccine at this point, like we do with the Florida SHOTS database for other vaccines,” said Dr. Joanna L. Drowos , an associate professor of family medicine at Florida Atlantic University’s medical school.

Q. “The state of Florida could not wait to stop reporting COVID infections and deaths some months ago. When will daily reporting begin again since the Delta variant appears to be the new ‘it’?” — Alan, Delray Beach

A. The Florida Department of Health stopped issuing daily reports on the rate of COVID infection and death in the state in June. At the time, the infection rate had fallen to 5%, the World Health Organization threshold for safe re-openings. A spokeswoman said the reports were no longer needed.

“As vaccinations increase and the new case positivity rate decreases, the Florida Department of Health has moved to a weekly reporting schedule for key COVID-19 data,” department spokeswoman Weesam Khoury said in a statement.

Obviously, things have changed since then. The positivity rate was 17.8% as of  July 29 , which we know because the state issues weekly reports now instead of daily. The state has not announced any plan to resume the daily update.

Q. “My son was born on Aug, 3, 2004. He is turning 17. Can he get the Johnson & Johnson vaccine?” — Hemi, Doral

A. Happy birthday to your son, but he can’t get the Johnson & Johnson vaccine. It’s only approved for age 18 and older. He can get a Pfizer shot, which is OK for ages 12 and older. It’ll be two visits instead of one, but tell him it’s worth it.

Q. “If I got the Pfizer vaccine for my first shot and then by mistake got Moderna for second shot, is that dangerous?” — Antonelle Chunka

A. You should be fine, said Dr. Jose R. Mateo , an infectious disease specialist at KIDZ Medical Services, which has offices throughout South Florida.

“It is probably not dangerous,” Mateo said. “Both the Pfizer and Moderna vaccines have the same active ingredient — a synthetic coronavirus genetic material or messenger RNA. They also share two inactive ingredients and have the same mechanism of action. During separate clinical trials, both vaccines demonstrated a comparable efficacy and safety profile.”

He said it’s unlikely that mixing the two would result in a different outcome than if you got two shots with the same brand. The CDC actually allows for the use of a different mRNA vaccine for the second dose, at a minimum interval of 28 days between doses, if the brand given for the first dose cannot be determined or is not available.

Q. “My wife’s aunt had a half-brother in Tampa who recently died from COVID. He had the full Pfizer vaccine quite some time ago. He and his wife both were infected and he died after only three days. The wife has recovered. Is there any data being compiled about fully vaccinated people dying after contracting the virus?” — Alan, Delray Beach

A. I am so sorry to hear this. We read stories like this in the news but when it hits close to home, it’s really painful. Please keep in mind that this situation is super-rare. Here’s what the Centers for Disease Control and Prevention is saying about the number of cases of vaccinated people hospitalized or dying.

As of July 19 , there were 1,141 deaths attributed to these breakthrough cases reported to the CDC out of 161 million people vaccinated. Among vaccinated people who died or were hospitalized for COVID, 49% were women and 74% were age 65 or older.

“No vaccines are 100% effective at preventing illness in vaccinated people,” according to the agency. “There will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19.”

Q. “Can my job lay me off if I do not have the COVID shot or refuse to take it?” — Jason Cintron

A. Yes, you may lose your job if you decline a COVID-19 vaccine. The Sun-Sentinel asked several workplace experts this question and the consensus was that as long as the employer treats everyone equally, a mandate is allowed. Here’s what two of the experts said:

Donna Ballman , Fort Lauderdale employment lawyer: “Yes, employees can be terminated for refusing to vaccinate, unless they fall within a legal exception. If they do fall within an exception, then the issue will be whether there is a hardship on the employer. If the employer can prove there is a hardship, they may still be able to terminate, even with an exception.”

Jay Starkman, founder and CEO of the Miami -based human resources firm Engage PEO: “If it is not a refusal where [the employees] are taking steps to show a religious belief or a bona fide medical reason, then the answer is yes, as long as the policy is uniformly enforced. You can’t say these three employees are going to be fired, but this fourth one is essential to the business — we’re going to keep them on. You can’t do that.”

Got a question? Email Sun Sentinel staff writer Lois K. Solomon at AskLois@sunsentinel.com

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