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Advancing Care - October 2021

advancing care


COVID-19 Vaccine: Third Dose vs. Booster

Certain immunocompromised individuals may now be eligible to receive a third dose of the COVID-19 vaccine. As the eligibility for the COVID-19 vaccine evolves, you may wonder if you should get an additional dose. Experts at Yale New Haven Hospital answer some common questions. 

What is the difference between a “third dose” and a “booster”?

A “third dose” of an mRNA vaccine (either Moderna or Pfizer) is available to people who may not have had a strong enough immune response after receiving the first two doses. Those who are immunocompromised need a third dose to reach a stronger level of immunity against the virus. 

A “booster” is an additional vaccine dose given to individuals who may have waning immunity because they completed their initial vaccine series many months ago. The rise of variants, such as the highly contagious Delta variant, is another reason why some people may have a waning immune response.
Who is eligible for a third dose?

A third dose of the Pfizer or Moderna vaccine is available for people with certain immunocompromised conditions including current treatment for cancer, those who received an organ transplant or those with advanced or untreated HIV.

If you are eligible, you can schedule your third dose on our website. If you have questions about whether you are immunocompromised, speak to your healthcare provider.

Who is eligible for a booster?

Booster doses of the Pfizer COVID-19 vaccine ONLY are currently available for those:

  • 65 and older
  • in long-term care settings
  • 18 to 64 who are at high risk of severe COVID-19
  • 18 and older at high risk of exposure to COVID-19 due to their work

If you are eligible, you can get your booster if it has been at least six months since your first two doses.

Learn more about eligibility for booster doses.

If you are eligible for a booster or a third dose, schedule your vaccine appointment online.

What you need to know about flu season

COVID-19 has dominated news reports for more than a year, but healthcare professionals want people to remember another virus: seasonal influenza. 

Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Symptoms of influenza, commonly called the flu, are fever, aching muscles, cough, sore throat, headache and fatigue. Influenza and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. 

Flu viruses are most common during the fall and winter. While the timing and duration of flu seasons can vary, flu activity often begins to increase in October and peaks between December and February. People shouldn’t let their guard down, because the flu can extend into May. 

“We usually say that flu is predictably unpredictable,” said Richard Martinello, MD, medical director of Infection Prevention at YNHH. 

Between 3 - 11 percent of the U.S. population gets sick from flu each season, depending on the year, according to the Centers for Disease Control (CDC). In an average year, deaths from flu range between 12,000 and 61,000 people. 

Last year, however, the U.S. experienced a relatively mild flu season thanks to more people wearing masks, maintaining physical distance, avoiding mass transportation and staying home to prevent the spread of COVID-19. The combination of these preventive methods helped stop COVID-19 as well as flu viruses from spreading, according to Dr. Martinello. 

“We did anticipate seeing a reduction in flu due to the measures taken to prevent COVID, but it was remarkable to see so little influenza last year,” he said. 

A year later, more than 64 percent of the U.S. population has received at least one dose of a COVID-19 vaccine. Wearing masks and physical distancing, while still recommended, are much less common. Families and friends are gathering once more, students have returned to in-person instruction, and the opportunities for influenza exposure are returning to pre-COVID levels. 

“This year we may experience a more typical influenza season, so we need people to be attentive. Flu is still a major public health threat and poses a risk to everyone, including healthy children, teens, adults and pregnant individuals,” said Dr. Martinello. “We’ve already started to see an increase in respiratory viruses now, including RSV (respiratory syncytial virus), which is unusual during the summer months.”  

So what should you know about this coming fall and winter? Dr. Martinello recommends the following safety measures: 

  1. Get the flu vaccine. The best way to protect yourself from the flu is to get your annual flu shot. It’s safe and recommended for everyone six months or older, including pregnant women, unless you’re known to have a severe allergy to the flu shot.

    “Contact your primary care provider or local walk-in care location for more information and to schedule your flu vaccination, preferably by the end of October,” Dr. Martinello said. “Flu activity can begin increasing at any time and you want to be protected when it starts to spread. After you get your flu vaccine, your body takes about two weeks to build immunity to flu.” 

    You can get your flu vaccine at the same time as a COVID-19 vaccine. Just get them in different arms.

  2. Continue to practice physical distancing and wearing masks. “COVID-19 and influenza are both viruses that spread through respiratory droplets. So, the strategies people can employ to minimize the spread of the influenza virus are very similar to the practices used to control the spread of COVID-19,” he said. 

  3. Wash your hands frequently and thoroughly with soap and water to reduce the likelihood of transmitting viruses. At the very least, wash your hands before preparing or eating food, after using the bathroom and after touching surfaces that others have touched (like doorknobs and light switches in public places).

  4. Stay home if you feel sick. People who feel unwell or who have symptoms of influenza such as fever, body aches, sore throat or coughs should stay away from others to avoid transmission.

  5. Get tested if you are sick. Because some symptoms of flu and COVID-19 are similar, people may need to be tested to tell what virus is causing their illness. Know that people can be infected with the flu virus and the COVID-19 virus at the same time. 

It’s difficult to predict what this flu season will be like, but good preparation remains the same as previous years. Take the proper precautions, be alert and consult a physician or health professional if symptoms are concerning. 

One thing Dr. Martinello knows for sure: it’s best to be prepared. "Every flu season is unique. Every time we think we know what will happen, it will do something totally different,” he said.  

Screening is key to detect breast cancer 

Breast cancer is the second-leading cancer among women in the U.S. – but millions of women are surviving the disease, thanks in part to regular screening, early detection and improvements in treatment. October is Breast Cancer Awareness Month, when women are encouraged to learn about the importance of early detection and how to reduce the risk of breast cancer. 

When should you be screened? The earlier cancer is detected, the better the chances that treatment will be effective, so the goal is to find cancers before they begin to cause symptoms. All women of average risk who are 40 years and older should receive annual screening mammograms. Women who are at an increased lifetime risk of breast cancer (due to strong family history, known genetic mutations that are associated with breast cancer, and/or received chest radiation for other cancer or conditions between the ages of 10 – 30) may consider screening before age 40. If you have any of these risk factors, talk to your health-care providers about when and how to screen for breast cancer. 
The Breast Center at Smilow Cancer Hospital at Yale New Haven performs approximately 20,000 breast examinations each year. These consist of screening and diagnostic mammograms, breast ultrasounds, and magnetic resonance imaging (MRI) examinations. To learn more about breast cancer screening, prevention and services at the Breast Center, call 203-200-2328.  

Schedule your mammogram online

An annual mammogram is an important, proactive way women can take care of their health. Mammograms are the best tests doctors have to find breast cancer early-- sometimes up to three years before a lump is felt.

Mammography is a type of imaging that uses low-dose X-ray to examine breast tissue. There are two types of mammograms: 

  • Screening mammography is recommended each year to examine breast tissue and check for breast abnormalities. 
  • Diagnostic mammography may be recommended to further examine an area of concern, lump, cyst or follow-up after a screening mammography. 

Breast tomosynthesis, also called 3-D mammography, may also be used in a screening or diagnostic mammography. This allows the radiologist to view the breast in thin "slices" rather than as a whole, which improves the detection of lesions and reduces the need for additional views of the breast.

Yale New Haven Health offers screening mammography at 15 locations across Connecticut and one location in Rhode Island. No prescription is needed at most locations if you are 40 years and older and have not had a mammogram in the last year.

Schedule your mammogram appointment online now. 

How to spot a counterfeit car seat

Counterfeit car seats sold online could put children and babies in harm’s way. These counterfeits may be more common than you might think. 

Nick Aysseh, manager for the Yale New Haven Hospital Center for Injury and Violence Prevention, shares his top tips to spot a counterfeit child car seat.

In the U.S., all child car seats must include: 

  • A 5-point harness with straps that go over the hips and shoulders
  • A chest clip
  • A splitter plate in the rear
  • Labeling with specific weight and height limits
  • Manufacturing label with name, model number, date of manufacture and expiration dates
  • Registration card and manual

“The reason we require the chest clip is it helps disperse the crash forces and keep the child secured so they don’t come out,” Aysseh said. “If you have a seat that doesn’t comply with those standards, you could potentially have a child come out of the seat or be injured by the mechanism that’s designed to protect them.”

To spot counterfeit child car seats, you should purchase car seats only from a reputable company. When shopping online, Aysseh recommends avoiding third-party vendors. If you are not sure, look at the bottom of the listing. You can also look for these red flags:

  • Missing labels
  • Missing registration card and manual
  • Labels with bad grammar
  • Seats without a chest clip

If you realize you have a counterfeit car seat, stop using it immediately. Contact the YNHH car seat hotline at 203-200-KIDS (5437) or email [email protected] to connect with a certified car seat technician who can help point you in the right direction.

Once you have a car seat, the YNHH Center for Injury and Violence Prevention can help you install it correctly. The center offers free appointments in New Haven and Bridgeport twice a month. Email [email protected] for an appointment or call the car-seat phone line at 203-200-KIDS (5437). 

Find a Doc at YNHH

YNHH provides free information about and referrals to more than 2,600 affiliated physicians 24 hours a day. Call 888-700-6543 or visit our Find a Doctor feature on the hospital's website for information on physician specialties, office hours, locations and accepted insurance plans. Many of our physician practices offer telehealth video visits for your convenience.

Billing questions?

Yale New Haven Hospital offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.