If you have a vagina, you’ve probably been told that it’s an absolute must to pee immediately after having sex to prevent urinary tract infections (UTIs). But it turns out there isn’t a lot of evidence to support this idea. There is shockingly little research on the question of whether this oft-repeated advice actually works. One study in a journal called Evidence Based Practice found that, overall, it doesn’t seem to make a difference. But that’s just one study, and the results didn’t point strongly in either direction.
The American College of Obstetricians and Gynecologists (ACOG) does not include peeing after sex in its tips for preventing UTIs. Here’s what they do recommend:
Wash the skin around the anus and the genital area.
Drink plenty of fluids (including water) to flush bacteria out of your urinary system.
Empty your bladder as soon as you feel the urge or about every two to three hours.
They point out that factors like being pregnant, having diabetes, or going through menopause can increase your risk of contracting a UTI. And some people just seem to be more prone to them: If you’ve had UTIs before, your chances of getting one again are higher than somebody who has never had one.
That said, if you’ve been peeing after sex, there’s no need to quit that habit. While there’s no conclusive evidence that it helps, there’s also no conclusive evidence that it hurts—or even that it’s useless.
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Does peeing after sex prevent pregnancy or STIs?
While we’re at it, I’d like to mention two myths that have gotten mixed up in the whole peeing-after-sex advice. Peeing after sex is not likely to prevent pregnancy, or to prevent sexually transmitted infections.
When it comes to preventing pregnancy, sperm go into the vagina, not the urethra. These two holes are close to each other, but they are not the same thing, and the pee that leaves your urethra has no influence on what’s going on in your vagina, cervix, or uterus. People who are trying to become pregnant may have heard the advice to delay urinating for at least a short time after having sex to let gravity assist their chances in conceiving—but the American Society for Reproductive Medicine notes that “this belief has no scientific foundation.”
Urinating after sex has not been found to have a significant effect on your risk of contracting HIV, chlamydia, herpes, or any other sexually transmitted infection. To prevent STIs, ACOG recommends using condoms, being aware of the increased risk of anal sex or other acts that can result in breaking the skin, and making sure to get vaccinated against HPV and hepatitis B, both of which can be transmitted sexually.
An Arizona resident recently contracted the mosquito-borne disease known as dengue, and the dengue virus has been detected in mosquitoes in the area. Dengue, normally associated with tropical countries, may be spreading in Arizona for the first time.
It’s not the first time dengue has shown up in the United States, but we don’t usually get local transmission of the disease in the 48 contiguous states. Florida has had at least three local cases of dengue this year, and has had several local outbreaks in recent years, with the largest being 66 cases in 2010. (Before 2009, there had been no cases since 1934, Outbreak News Today reports.) Dengue is common in several U.S. territories, including Puerto Rico, American Samoa, and the U.S. Virgin Islands.
So how big a deal is dengue, and what should you know about it? Let’s look at the facts.
How bad is dengue?
About 75% of people who are infected with dengue won’t have noticeable symptoms. Statistically, 25% will get sick, 5% will get severe dengue, and 0.01% die from it.
It’s worth noting that you’re more likely to get severe dengue if you have had dengue before. There are four types of the dengue virus, so in theory you can get it four times in your life. But if you’ve had one type, and then contract another, that second infection carries a higher risk than the first of progressing to severe dengue.
Symptoms of an ordinary dengue infection may include nausea, vomiting, a rash, or muscle or joint pain. There may be a sensation of pain behind the eyes. The illness typically lasts between two and seven days. During this time, the CDC says, you should rest and you may take acetaminophen (Tylenol), but not aspirin or ibuprofen.
Symptoms of severe dengue can include belly pain or tenderness, bleeding from the nose or gums, blood in the vomit or stool, vomiting more than three times in 24 hours, or feeling unusually tired or irritable. If you have these signs, seek medical care right away.
How does dengue spread?
Dengue is caused by a virus, and that virus is transmitted by mosquitoes. Not all mosquitoes can transmit it, though. It requires Aedesaegypti or Aedes albopictus mosquitoes. These mosquitoes bite during the day as well as at night, and they can breed in small containers of standing water. Both species are more common in the southern U.S. than in northern areas.
(The little brown mosquitoes that live in more northern areas and bite more often at night are Culex mosquitoes, which do not transmit dengue. They can transmit West Nile virus, though.)
For a mosquito to give you dengue, it would have to bite someone with dengue, and then later bite you. If this happens in a given area, it’s considered local transmission of dengue. People can contract dengue while traveling and then bring it home, which accounts for most cases of dengue in the continental U.S.
How to avoid getting dengue
The main way to protect yourself from dengue is by protecting yourself from mosquito bites, and you can also help to protect your community by making sure the mosquitoes don’t have places to breed.
Mosquitoes will lay their eggs in stagnant water. This can include items like garbage cans and tires that fill with rain water, sources of water like dog bowls and birdbaths, and puddles that form on the ground or in tarps. Drain these items regularly if you can’t prevent them from filling up in the first place. (For example, if your dog has an outdoor water dish, make sure to empty it twice a week.)
To protect yourself from bites, the CDC recommends using an effective insect repellent (such as one containing DEET), wearing long-sleeved shirts and long pants where possible, and using window screens to keep mosquitoes out of the home.
There is a vaccine against dengue that is currently approved for children aged 9 to 16 who live in areas where dengue is common. It is not approved for people who are just traveling to those places.
Imagine yourself outdoors in a cold winter landscape. There’s a chill in your toes and the sting of cold air against your face. Sounds are muffled by the snow. You may smell a sort of clean freshness to the air. And your bladder, most likely, feels like it’s about to burst. What’s up with that?
It’s not just Murphy’s Law making you need to go as soon as you’re all bundled up. The cold itself seems to make our body fill its bladder more quickly. It’s a phenomenon known to scientists as cold-induced diuresis.
What is cold-induced diuresis?
One of the ways our body deals with the cold is to constrict blood vessels around the skin, so that our blood (which is warm) circulates more around our organs and is less exposed to cold temperatures near the surface of our skin. This is related to why your fingers and toes start to feel numb.
But if there’s less blood in the outer parts of our bodies, that means there’s more blood circulating around our organs. Internally, our blood pressure is a bit higher than it normally would be.
And that means that our kidneys are now filtering our blood a bit faster than they would be normally. The result of that filtering is, you guessed it, urine. So our bladder fills up sooner than it otherwise would.
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What to do about cold-induced diuresis
Fortunately, cold-induced diuresis is more an annoyance than a problem. You may want to go to the bathroom before you head out into the cold, rather than having the urge hit you a few minutes after you leave the house.
Bundling up can also help. Remember, this is our body’s response to feeling cold, so if you dress warmly enough, you may not trigger that response at all.
It’s also worth remembering to stay hydrated. If you’re constantly getting cold and then peeing more than usual, you could end up more dehydrated than you realize. So if you feel extra thirsty when you come back in after a long day outdoors, make sure to drink up.
Aedes aegypti mosquitos, the primary vector of dengue, seen at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January 8, 2016 in Sao Paulo, BrazilPhoto: Nelson Ameida/AFP (Getty Images)
A dangerous viral disease transmitted by mosquitoes has seemingly landed in Arizona. Earlier this week, health officials reported that a Maricopa County resident recently contracted dengue, while routine surveillance has found traces of the dengue virus in at least one nearby mosquito population. These discoveries suggest that the infection could be spreading locally in the state for the first time, though the investigation is still ongoing.
Maricopa County Department of Public Health (MCDPH) officials announced the human case of dengue on Monday, though no other details about the patient were provided. They also reported that the Maricopa County Environmental Services Department had detected the virus last month in samples taken from a mosquito trap in a neighborhood of the county. Though there have been cases of dengue reported in Arizona before, they’ve been found in people who likely caught it while recently traveling to countries where the disease is endemic. But given the surveillance data, officials say, it’s possible that this is the first locally transmitted case of dengue to be reported in the county and the state as a whole.
“While previous dengue cases in Maricopa County have been related to travel to countries where dengue commonly occurs, it is important to understand if others could have been exposed or if this is an isolated incident,” said Nick Staab, medical epidemiologist, in a statement released by the MCDPH. “This is in addition to our routine investigations of anyone suspected to have dengue or other mosquito-borne diseases.”
Dengue is spread by bites from infected mosquitoes. Most infected people will experience no illness, but about one in every four will develop flu-like symptoms, according to the Centers for Disease Control and Prevention. About one in every 20 people will develop severe dengue, which can lead to life-threatening complications like internal bleeding and shock. There are four major serotypes of the virus, and surviving infection from one type does not provide immunity to the others. In fact, it actually raises the risk of severe dengue should you ever catch another type of the virus.
Though dengue is most common in the hottest and most humid areas of the world, it’s become remarkably widespread in recent decades, with the virus now believed to be endemic in over 100 countries, according to the World Health Organization. Many experts fear that climate change will allow dengue and similar viruses to become a local problem in previously unaffected parts of the world, like much of Europe and the United States. Notably, two of the best known vectors of dengue, Aedes aegypti and Aedes albopictus mosquitoes, can now be found throughout much of the Southern and Eastern U.S. during their peak seasons, though it’s still not clear whether these populations could sustain the widespread local transmission of dengue and other viruses yet.
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For the time being, Maricopa officials are planning to go door to door in the area, armed with mosquito prevention kits and tests that should be able to detect whether any residents have been infected with dengue in the past several months.
Kids never seem to want to dress appropriately for any occasion—or at least mine don’t. They want to wear pajamas to school, halloween costumes to bed, and summer clothes when it’s snowing out. So we say what we need to say to get them to put their hats on, right? “You’ll catch your death of cold!”
But can you really catch a cold from cold weather? Colds are caused by viruses, so no. But can cold weather make you more susceptible to those viruses? Well, that’s a little more complicated. But probably still no.
Colds are caused by viruses
Colds are infectious diseases caused by germs—specifically viruses. So, no, chilly weather cannot cause a cold all by itself. There is more than one virus that can cause a cold, though. A “cold” is just a word we use to describe a group of symptoms that occur with common respiratory viruses: sore throat, runny nose, coughing, sneezing. According to the CDC, some of the viruses that cause colds include:
rhinoviruses
adenoviruses
respiratory syncytial virus (RSV)
coronaviruses (not counting COVID and SARS, even though they are also coronaviruses)
human parainfluenza viruses
human metapneumoviruses
Because colds spread from person to person, to avoiding catching one the CDC recommends washing your hands, not touching your face with unwashed hands, and avoiding close contact with people who are sick. Putting a hat on when you go outside is not on the list of preventive measures.
Why are colds more common in winter?
The idea that colds can cause a cold may have arisen from the observation that colds are more common in the winter. But a lot of things are different in winter than in summer that affect the spread of respiratory viruses.
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For one, we tend to stay inside when it’s cold out, and this puts us into closer contact with others. Cold viruses spread more easily this way—just like COVID does.
Another factor is that cold air carries less moisture than warm air. That means the mucous membranes inside our noses can dry out more easily, whether we’re in the cold weather outside or in dry warm air indoors. (That warm air is often just the cold, dry air from outside, warmed up.) Those membranes are part of our defenses against viruses, so the dry air may make us more susceptible to colds.
There are still more hypotheses for why respiratory viruses, including colds and flu, are more common in winter. One is that we get less sunlight and thus less vitamin D. Another is that the viruses may survive longer outside the body when the weather is cold. Some proponents of the “cold makes you catch a cold” myth like to point out that being cold can stress your body, and any stress can potentially affect your immune system. While this is true, it seems unlikely to be much of a factor in whether or not you come down with a cold.
What about William Henry Harrison?
That probably all makes sense, but what about William Henry Harrison, our ninth president, the one who served for barely a month? As the history books tell us, he wanted to make a big deal about how hale and hearty he was, so he gave a long inauguration speech while standing in the cold sans hat or coat. He caught a cold as a direct result of that, it developed into pneumonia, and he died. So how is that possible?
First off, it’s worth being suspicious of that story because of how neat and convenient it seems. The man died because of the consequences of his own hubris. Great story. But did he really catch a cold, and was it really because of the hatless speech? According to a reexamination of the evidence in a 2014 issue of the journal Clinical Infectious Diseases, the answer to both questions is probably no.
Harrison definitely didn’t catch a cold after his speech. He only started feeling unwell three weeks later. His symptoms in the first few days were a headache, abdominal pain, and constipation, along with a fever. A cough appeared later, a few days before he died. So why does everybody think he died of pneumonia? His doctor was puzzled by the president’s collection of symptoms, the authors of the 2014 analysis wrote, yet had to give an answer that would make sense to the public:
In response to intense pressure from a stunned public to provide an explanation for the loss of their newly elected leader, he gave them pneumonia as his answer, though with obvious reservations. “The disease was not viewed as a case of pure pneumonia [he wrote]; but as this was the most palpable affection, the term pneumonia afforded a succinct and intelligible answer to the innumerable questions as to the nature of the attack”
But the authors note that the president’s gastrointestinal symptoms were more severe than his respiratory ones, and that it’s likely he died of “enteric fever”—or to put that in simpler terms, a really bad stomach bug (possibly typhoid).
Washington, D.C. did not have a sewer system at the time, and the White House’s water supply was suspiciously close to one of the city’s dumping grounds for human waste. The authors point out that presidents James Polk and Zachary Taylor also had episodes of severe gastrointestinal illness while living in the White House during this era (Taylor also died of it). But, sure, let’s blame Harrison for not wearing a hat in the cold.
In a recent case study, doctors describe the unfortunate tale of a man who developed an allergy-like reaction to his own orgasms. The bizarre and rare affliction left him unable to pursue sexual and romantic relationships. But thankfully, the doctors managed to treat his problem using a simple over-the-counter antihistamine.
The condition is known as postorgasmic illness syndrome, or POIS. Sufferers (almost always men) experience symptoms similar to hay fever or a flu following ejaculation, such as fatigue, itchy eyes, stuffy or runny nose, and even memory problems. These symptoms appear after every or nearly every orgasm, usually within seconds but sometimes up to hours later, and they can last anywhere from two to seven days.
There are many different illnesses that can affect a person’s sexual function, but POIS is especially rare. The National Institutes of Health estimates that fewer than 1,000 people in the U.S. currently have it. And according to the authors of this latest case study, set to be published in the November issue of Urology Case Reports, there are fewer than 60 reported cases of POIS in the medical literature.
The report describes an otherwise healthy 27-year-old man who first began to experience his symptoms at the age of 18. In addition to his flu-like illness, he would often break out into hives along his forearms after orgasms. He had seen several medical providers over the years, including an otolaryngologist, an infectious disease specialist, and multiple allergists, but nothing they offered seemed to help. By the time he saw these doctors, he had long been actively abstaining from any kind of sexual activity and romantic relationships.
Because of its rarity, there’s very little known about exactly why POIS happens. But it’s suspected to be a type of hypersensitivity reaction to something within a person’s ejaculate. Most people with POIS, for instance, have tested positive on skin prick tests using their semen as the allergen. One plausible theory is that sperm cells might trigger this immune response, since they contain only half of the genetic material found in most other cells. But even sterile individuals have developed POIS, suggesting that the true culprit is usually some other ingredient in semen.
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In this particular case, the man recalled that his first episode occurred after he had recovered from a case of acute epididymitis, or inflammation around a specific area of the scrotum. Epididymitis is often caused by a urinary tract infection or sexually transmitted bacterial infection. It’s possible, the doctors speculate, that this infection set off a chain reaction that caused his immune system to become sensitized to his semen from then on.
There’s no official treatment for POIS, but the doctors decided to test out an antihistamine, which can tamp down the symptoms of other types of allergy. Their initial treatment didn’t seem to work, but they then switched to an over-the-counter version of fexofenadine, taken daily (the drug has long since become generic but is sold under the popular brand name Allegra). Additionally, they advised the man to gradually ramp up his frequency of orgasms. The fexofenadine worked like a charm, leading to a self-reported 90% decrease in symptoms and allowing the man to finally resume sexual activity.
The doctors suspect that the other antihistamine may have failed to help because its peak effects only last for a few hours, while fexofenadine is both long-lasting and non-sedative. But although this drug is safe, cheap, and easy to take, the doctors do recommend that more research be done to confirm that it can be a reliable option for those with POIS.
“Our experience demonstrates the feasibility of treating a complex disease with a simple medication and hopefully will be replicated in future patients,” they wrote.
An illustration of norovirus particles. Illustration: Shutterstock (Shutterstock)
A nasty but short-lasting stomach bug may have lingering consequences for an unlucky few. Researchers have found evidence in mice and human cells that norovirus infection can trigger Crohn’s disease in people already genetically predisposed to it. The findings may also help scientists one day find better treatments for the chronic gut condition.
Crohn’s is one of two major types of inflammatory bowel disease. In Crohn’s, this inflammation occurs along the lining of the digestive tract, most commonly in the small intestine. Symptoms can vary widely in severity but often include diarrhea, weight loss, and intense stomach cramps. Sufferers also tend to experience flare-ups of illness, with symptoms reappearing or getting worse. About 3 million Americans are thought to have IBD.
The underlying mechanism behind Crohn’s and IBD is a dysfunctional immune system that attacks the gut. But there are likely multiple, connected causes as to why this dysfunction arises in the first place. There have been several genetic variations associated with developing Crohn’s, for instance. But it’s also suspected that some infections can trigger Crohn’s as well, while other microbes may worsen the illness.
This new study, led by researchers at New York University, tried to examine the interplay of these risk factors. They studied mice bred to have a mutation linked to Crohn’s, as well as cultivated human gut cells from people with Crohn’s. The mice were exposed to norovirus, which is one of the most common causes of foodborne illness in humans. In these mice, the infection led to a greater risk of intestinal damage and the loss of certain cells in the small intestine, called Paneth cells, which help provide the first line of defense against infection. Their loss or dysfunction appears to play a driving role in causing Crohn’s along the small intestine.
The researchers also identified a protein produced by certain T cells known as apoptosis inhibitor five, or API5, that might provide protection against Crohn’s. In their mice, the norovirus infection appeared to damage Paneth cells by inhibiting the secretion of API5 from T cells.
To test this hypothesis further, the team introduced the protein to mice with Crohn’s-like illness, finding that all the treated mice survived while only half of the untreated mice did. They also tested the protein on gut lining cells taken from Crohn’s patients with and without the mutation, finding that it only appeared to have a protective effect on the cells from people with the mutation. Lastly, they found evidence that people with Crohn’s tend to have lower levels of T cells that produce API5.
The findings were published in Nature on Wednesday.
“What we found is really interesting,” study co-author Ken Cadwell, a professor of microbiology at the NYU Grossman School of Medicine, told NBC News. “In an unexpected way, T-cells protect the lining of the gut and infectious triggers interfere with that ability.”
The results don’t prove that norovirus is a smoking gun trigger for Crohn’s, so more research will be needed to validate what Cadwell and his team have found here. It’s likely that other common microbes can trigger Crohn’s in vulnerable people as well. A study last year, for instance, suggested that a common yeast found in the gut can help cause or worsen IBD symptoms, but only when left unchecked by the immune system. And there may be more genetic mutations that can raise the risk of these infections or other factors triggering Crohn’s.
But if Cadwell’s research continues to show that API5 can short-circuit the complicated chain of events that leads to Crohn’s, that might point to more effective or easier-to-tolerate treatments someday. Standard drugs for Crohn’s usually work by weakening or suppressing the immune system, which can increase the risk of infections in general or other serious complications.
The CDC recently issued an alert to healthcare providers about enterovirus D68, which has turned up in children who were hospitalized with severe respiratory illnesses. This virus can also cause a form of paralysis known as acute flaccid myelitis. Most illnesses with this virus do not cause the paralysis, but it’s good for providers to have this on their radar. So what does that mean for you as a parent?
What is enterovirus D68?
This virus is an enterovirus, in the same family as polio. (In fact, there are a whole group of these “non-polio enteroviruses.”) Enteroviruses spend part of their time in the intestine, hence the name, but they can also cause respiratory symptoms like runny nose, sneezing, and coughs. Some of the recent cases of EV-D68 have involved severe respiratory symptoms, especially in children with a history of asthma or wheezing.
EV-D68 is one of the viruses that has been linked to acute flaccid myelitis (AFM), which was described as a polio-like paralysis during its first big wave in 2014. There have since been surges in the late summer and early fall of 2016, 2018, and 2020, and it seems to be continuing the pattern this year.
What is acute flaccid myelitis?
Myelitis is an inflammation of the spinal cord that can cause weakness and paralysis. “Acute” means it comes on suddenly, and “flaccid” means that the affected body part may appear floppy. (That’s to distinguish it from other forms of paralysis in which the muscle can cramp or twitch.)
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Symptoms of AFM can include weakness in an arm or leg, but other body parts can be affected, including drooping eyelids, slurred speech, or difficulty swallowing. The CDC calls AFM “rare but serious.” If your child has any of these symptoms, make sure to seek medical care.
What should parents know?
It’s important to remember that this virus is not super common, and AFM is even rarer. In short: don’t panic.
Fortunately, the ways to protect yourself and your child from this virus are the same things you should already be doing to reduce your risk of getting colds, flu, COVID, stomach bugs, and other common illnesses. The CDC has an informational poster for parents, which advises the following:
Avoid close contact with sick people
Cover your coughs and sneezes
Wash your hands often with soap and water
Clean and disinfect surfaces
Avoid touching your face with unwashed hands
Stay home when you’re sick
There is no vaccine for EV-D68, but the CDC still advises staying up-to-date on vaccines to protect yourself from other illnesses that can cause similar symptoms, including polio and the flu.
If your child has asthma, the CDC recommends making sure they have an updated asthma action plan that specifies what medications and precautions to take depending on how much their asthma is bothering them. And, as always, seek immediate medical care if they have trouble breathing.
A illustration of a herpes simplex virus. Illustration: Shutterstock (Shutterstock)
Scientists may be able to turn a long-time germ foe into a cancer-fighting ally, new research this week suggests. In preliminary data from a Phase I trial, a genetically modified version of the herpes virus has shown promise in treating difficult-to-eradicate tumors, with one patient having experienced a complete remission for 15 months so far. Much more research will be needed to confirm the treatment’s early success, however.
The viral treatment is known as RP2 and is a genetically engineered strain of herpes simplex 1, the virus responsible for most cases of oral herpes in humans, as well as some cases of genital herpes. Developed by the company Replimune, RP2 is designed to work on two fronts. Injected directly into the tumor, the virus is supposed to selectively infect and kill certain cancer cells. But it also blocks the expression of a protein known as CTLA-4 produced by these cells, and it hijacks their machinery to produce another molecule called GM-CSF. The net result of these cellular changes is to weaken the cancer’s ability to hide from and fend off the immune system.
In a Phase I trial conducted by scientists at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust in the UK, RP2 was given as the only treatment to nine patients with advanced cancers that failed to respond to other therapies; it was also given in combination with another immunotherapy drug to 30 patients. Three patients on RP2 alone appeared to respond to the treatment, meaning their cancers shrank or stopped growing, and seven patients on the combination therapy responded as well. One patient in particular, with a form of carcinoma along his salivary gland, has shown no signs of cancer for at least 15 months after treatment with RP2 alone. There were no life-threatening adverse events reported in the trial, with the most common symptoms post-treatment being fever, chills, and other flu-like illness.
The findings, presented this week at the 2022 European Society for Medical Oncology Congress (ESMO), are preliminary, since they’ve yet to be vetted through the formal peer review process. They’re also based on a very small sample size, meaning that any results should be taken with caution. But Phase I trials aren’t intended to show that a treatment is effective, only that it’s safe enough for humans to take. So the fact that some people with seemingly incurable cancers already appear to be responding to RP2, the team argues, is a very good sign that it can live up to its potential.
“Our study shows that a genetically engineered, cancer-killing virus can deliver a one-two punch against tumors—directly destroying cancer cells from within while also calling in the immune system against them,” said lead author Kevin Harrington, professor of Biological Cancer Therapies at The Institute of Cancer Research, in a statement from the organization.
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Scientists have been hopeful about cancer-fighting viruses for a long time. But it’s only recently that this hope has finally been starting to pay off. In 2015, the first viral therapy was approved in the U.S. for certain advanced cases of melanoma. This May, scientists in California launched a Phase I clinical trial of their anticancer virus, called Vaxinia. Other companies are developing their own candidates, either alone or in combination with other treatments. And Replimune is developing two other candidates based on their modified herpes virus.
While many experimental therapies ultimately fail to cross the finish line and reach the public, it’s possible at least some of these viruses could one day become a new standard cancer treatment.
When the COVID shots first came out, the CDC wanted to be cautious. It was a new vaccine, after all, so they recommended waiting two weeks before or after getting any other vaccine, including a flue shot. That guidance has changed. You can now get your flu and COVID shots at the same visit—but maybe not in the same arm.
The CDC recommends using separate arms if you are getting a COVID shot and a high-dose or adjuvanted flu shot. That’s because both types of shots are considered more “reactogenic” than other common vaccines. With either, you might have a sore arm, or experience redness or swelling around the injection site. You also might get a swollen lymph node in the same armpit. If your reaction is severe enough to seek medical care or to make a report to the vaccine adverse event reporting system, it would be really helpful to know which vaccine caused the issue.
That said, you’re not prohibited from getting both shots in the same arm. And most flu shots are not of the high-dose or adjuvanted type anyway. (Those shots are only recommended for people over age 65.) In most cases, it’s fine to get any two shots in the same visit, but double check with your provider because there are a few vaccines that have more specific guidelines. Separating shots by a few weeks is sometimes recommended for the monkeypox vaccine, for example, although if you know you’ve been exposed to monkeypox you should not delay getting the vaccine.
Most of the time, if you’re getting two shots, providers will assume that you would like to get them in separate arms. Anytime my kids have gotten two or more vaccines, the nurses will generally double-team the kid, delivering shots in both arms (or both legs, for babies) at the same time. Anytime I, a grownup, have gone to the pharmacy for more than one shot, they do one in each arm. (This is how I got my travel-related typhoid and hepatitis A shots a few years back.)
Ultimately, the choice of arms and the choice of scheduling are up to you. Your immune system is likely to respond just as well to the shots whether they’re in one arm or two, Katherine Wu reports for the Atlantic. The question is really whether you’d rather have two mildly-sore arms or one potentially super-sore arm. You can also dodge the question entirely by scheduling your flu and COVID shots for different days, which is convenient enough if you’re getting them at a neighborhood pharmacy.
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