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Advancing Care - October 2022



What’s a bivalent COVID booster? Do I need one?

For the first time, booster shots that specifically target the latest COVID-19 variants are available. When should you get yours? Richard Martinello, MD, medical director of Infection Prevention for Yale New Haven Health, explains what sets these boosters apart and why you should get vaccinated if you are eligible.

The new booster shot is a “bivalent” vaccine because it targets two versions of the coronavirus: the original strain, and the Omicron subvariants BA.4 and BA.5. The previous booster targeted only the original version of the virus. The new booster dose protects against the original strain and these new variants.

Experts say this bivalent booster will likely provide a better response to future variants, because when the immune system faces different versions of the same virus it generates broader protections overall.

What’s very clear and consistent across these vaccines is they keep us from getting severe disease that could lead to hospitalization or death.

- Richard Martinello, MD

Not only will the bivalent booster decrease the likelihood of infection and severe illness and help reduce transmission of the virus, but it could also decrease the likelihood of developing long COVID.

“What’s very clear and consistent across these vaccines is they keep us from getting severe disease that could lead to hospitalization or death,” Dr. Martinello said.

Is the booster safe?

“At this point in time our COVID vaccinations are probably the most extensively studied vaccines that are in use,” Dr. Martinello said. “In the United States, we have used over 600 million doses. There have been billions of doses used worldwide.”

Combining different components into one shot is a common approach to vaccines. Our current flu vaccines, for example, are quadrivalent, which means they protect us against four different strains of flu at the same time.

Why should I get the new booster if I already got boosted months ago?

You should get the new booster if it has been at least two months since your last shot. The COVID-19 virus continues to circulate. Getting boosted helps reduce transmission of the virus and protects others as well as ourselves. This is especially important for anyone who may be at risk for more severe cases of COVID-19, such as those who are immunocompromised and those who are pregnant.

Keep in mind that it typically takes one to two weeks after you get the shot for your antibodies to activate.

Can I get the booster and the flu vaccine at the same time?

Yes, you can get the bivalent booster on the same day as your flu shot.

How long should I wait to get the new booster if I recently had a shot or got COVID?

If it has been at least two months since your last COVID vaccine, you can get the booster now, according to the FDA.

If you were recently infected, you should wait at least two months after your infection to schedule your shot — and you can consider waiting up to six months. For specific guidance based on your personal health history, talk to your doctor.

Use this CDC tool to find out when you can get a COVID-19 vaccine booster.

What about children under 12 years old?

Kids under the age of 12 currently cannot receive the new booster. Children between the ages of 5 and 11 will get the previous booster; the CDC recommends that they get that shot five months after their second dose. Kids under 5 are not eligible for booster shots.

Where can I get the new booster shot?

The new vaccine is available at most pharmacies. You can search for vaccine providers and schedule an appointment at

Learn more about COVID-19 information and resources.

Managing food allergies in children

Parents of children with food allergies often face a confusing, frustrating and scary journey as they try to find ways to treat -- and protect – their kids. The experts at Yale New Haven Children’s Hospital can help parents navigate and manage these challenges.

With more than 170 foods reported to cause allergic reactions, where does a parent begin? Studies show that the introduction of allergenic foods during a child’s first year of life may reduce the chances that they will develop a lifelong allergy. Based on the research, Stephanie Leeds, MD, and Julie Flom, MD, pediatric allergy and immunology physicians at Yale New Haven Children’s Hospital’s Allergy and Immunology Program, developed the Pediatric Food Allergy Prevention Program. The program is among the first of its kind in the Northeast.

Understanding food allergies

“Guidance on managing food allergies has changed dramatically over the past few years. It is important that caregivers have early access to accurate information about prevention initiatives that can significantly impact their child’s future,” Dr. Leeds said.

Nine major food allergens — milk, eggs, peanuts, tree nuts, wheat, soy, fish, sesame and crustacean shellfish — are responsible for most of the serious food allergy reactions in the United States.

Symptoms typically appear within a few minutes to a few hours after a person eats the food. Reactions can be mild, with tingling or itchy sensation in the mouth, a few hives, rash, dizziness, abdominal cramps; or severe, including symptoms like throat tightening or swelling, wheezing, difficulty breathing, loss of consciousness.

Start early

The best window to start introducing allergens in many infants is at 4 to 6 months. It is possible to introduce food allergens for infants early even if other household members have food allergies, Dr. Flom said.

This is where clinical dietitians who specialize in food allergies come in. These dietitians work with allergists to make sure that families can manage a child’s allergy while providing meals that meet the child’s nutritional needs.

“With every child, the goal is a fun and colorful diet that takes culture into consideration,” said clinical dietitian Julia Shook Munoz, RD. “Many families can accomplish this at home by introducing the top allergens one at a time and monitoring for a reaction. Typically, if there is an initial reaction, the first one is mild, but it is a signal that should be noted.”

Dr. Flom says allergy tests can be a useful tool if conducted in a clinical setting where the clinical team can interpret the results. The team does not recommend at-home food sensitivity tests as they are not backed by any evidence to diagnose a food allergy. False positives or negatives can increase risks of allergic reactions or unnecessary avoidance. The best test is what happens when a child eats the food.

“Food allergies can impact everyday activities like going to the playground or even what daycare options are available,” Dr. Leeds said. “That’s why it’s best to see a specialist if a family has concerns.”

Make an appointment

If you suspect your child may have a food allergy, schedule an appointment with our pediatric allergy and immunology specialists at the Pediatric Specialty Centers in New Haven and Old Saybrook, where individual treatment plans are tailored to each child’s specific needs.

To schedule an appointment, call 877-YALE-MDS (877-925-3637).

Screening is key to detect breast cancer

Breast cancer is the second most common cancer among American women, except for skin cancer – but millions of women are surviving the disease, thanks in part to regular screening, early detection and improvements in treatment.

“Compared to 15 or 20 years ago, the proportion of early-stage breast cancers we are seeing in our clinics is significantly higher. We can directly attribute this to the improvements in screening technologies, in mammography, tomosynthesis, breast MRI, breast ultrasound and computer-assisted detection methods over the years,” said Meena Moran, MD, chief of Breast Radiation Oncology for the Smilow Cancer Network. “Another major factor attributing to earlier detection over the last two decades is the overall increased awareness of breast cancer and the importance of screening in the general population.”

When should you be screened for breast cancer?

The earlier cancer is detected, the better. Early detection improves the chances that treatment will be effective. The goal is to find cancers before they cause symptoms. We join with the ACS, American College of Radiology, American College of Obstetrics and Gynecology in recommending that 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 may consider screening before age 40.

What constitutes increased risk? Women who have 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. If you have any of these risk factors, talk to your healthcare providers about when and how to screen for breast cancer.

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

Breast tomosynthesis, also called 3-D mammography, is often used in a screening or diagnostic mammography. This allows the radiologist to view the breast in thin "slices" rather than as a whole, improving the detection of lesions and reducing 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 referral 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 now.

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.

Laboratory services are open

Did your doctor order a test? We’re open for services. When your physician orders blood work, we make it easy with blood draw stations conveniently located in your community. A physician requisition form is required. All major insurance plans are accepted. Our blood draw stations honor requisitions from other labs. Please call 1-800-305-3278 for a list of locations near you. If you need help figuring out which lab services are covered by your insurance, call 1-888-542-2925 Monday - Friday from 8 am - 4:30 pm.

Find a Doc at YNHH

Are you looking for a physician? Call 888-700-6543 or visit our Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience.

Billing questions?

Yale New Haven Health 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.