The Asthma and Allergy Foundation of America (AAFA) applauds UnitedHealthcare’s (UHC) recent announcement about epinephrine and albuterol. As early as 2023, UHC is getting rid of out-of-pocket costs (cost sharing) for drugs used to treat emergencies. This will apply to standard, fully insured group plans. The emergency medicines include:

• Albuterol – for acute asthma attacks
• Epinephrine – for severe allergic reactions
• Glucagon – for hypoglycemia
• Insulin – for diabetes
• Naloxone – for opioid overdoses
  
  

The UHC change will not go into effect right away. If you have a UHC plan, check your plan to find out what albuterol or epinephrine options they prefer. As early as Jan. 1, 2023, eligible plans will offer the preferred drugs at $0 out of pocket.

You can read UHC’s full statement here.

AAFA hopes and encourages other health insurance groups follow UHC’s lead.

People and families managing asthma and allergies face high and rising costs for medicines they need. They need access to affordable health insurance, medicines, and devices. High out-of-pocket costs:

• Make it more likely that people don’t take their medicines
• Threaten the patient’s health
• Worsen health disparities
  
  

The Asthma and Allergy Foundation of America (AAFA) has joined with PlatformQ Health and MedLive for an educational program, “Breathe Easier with Severe Asthma: the Role of Current and Future Therapies in Reducing Exacerbations and Gaining Control of Your Symptoms.” The live, interactive session will take place on Aug. 15 at 6 p.m. ET.

REGISTER NOW

During this one-hour program, two doctors, a patient, and a representative from AAFA will discuss the multiple factors involved in asthma inflammation. The expert panel will also review:

• How to reduce asthma triggers in your home
• Types of asthma
• Treatment options and side effects, including biologics
• Strategies to communicate treatment goals to your health care providers

If you miss the live session, you can watch it later on demand.

Have questions about severe asthma? The expert panel will answer questions from the audience during the session. Submit your questions now until the start of the webinar.

The Asthma and Allergy Foundation of America (AAFA) has joined with PlatformQ Health and MedLive for an educational program, “It Isn’t Just Skin: the Ins and Outs of Moderate-to-Severe Atopic Dermatitis.” The live, interactive session will take place on Aug. 4 at 9 a.m. ET.

REGISTER NOW

During this one-hour program, two dermatologists, a patient, and a representative from AAFA will discuss the challenges people of color face when managing atopic dermatitis. The expert panel will also review:

• Causes of atopic dermatitis
• Symptoms and triggers of atopic dermatitis
• Treatment options
• Managing related conditions, such as asthma
• Importance of clinical trials, particularly with diverse participants
  
  

This program will help you learn more about managing atopic dermatitis and working with your doctor to create your treatment plan.

If you miss the live session, you can watch it later on demand.

Have questions about atopic dermatitis? The expert panel will answer questions from the audience during the session. Submit your questions now until the start of the webinar.

In December 2019, a new coronavirus named SARS-CoV-2 started spreading and triggered a pandemic (worldwide outbreak). This coronavirus causes an illness known as COVID-19.

The coronavirus spreads through close contact from person to person. A person with the virus can spread it to others by talking, coughing, sneezing, singing, or breathing. The virus will be in large or small droplets that are exhaled from the mouth or nose out into the air.

If you are within 6 feet (2 meters) of someone who is ill with COVID-19, you may be at greatest risk for becoming infected. But it may be possible to catch the virus even if you are more than 6 feet away from an infected person because very small droplets can spread in the air. If someone who is sick coughs on or near your face, you may get infected. People may be infected with the coronavirus and not show any symptoms. They may spread the virus without knowing it. The virus may also spread through direct contact with a person who has COVID-19.

What Are the Symptoms of COVID-19?

According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), COVID-19 symptoms can include:

• Fever
• Chills
• Cough
• Shortness of breath or trouble breathing
• Feeling tired and weak
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Stuffy or runny nose
• Nausea or vomiting
• Diarrhea
  
  

If you or someone you know has these emergency warning signs, call 911 or go to the emergency room immediately:

• Trouble breathing or shortness of breath
• Pain or pressure in the chest that doesn’t go away
• Newly confused
• Can’t wake up or stay awake
• Cyanosis which is tissue color changes on mucus membranes (like tongue, lips, and around the eyes) and fingertips or nail beds – the color appears grayish or whitish on darker skin tones and bluish on lighter skin tones
  
  

According to the CDC, this list may not include all symptoms. If you have any symptoms that are severe or concerning, call your doctor.

The CDC warns that symptoms may appear two to 14 days after coming in contact with the virus.

How Can I Tell the Difference Between Asthma, COVID-19, the Flu, a Cold, or Seasonal Allergies?

Some symptoms are similar between these respiratory illnesses. Respiratory illnesses may worsen asthma, so it’s important to keep taking your asthma medicines. If you have a fever and a cough, call your doctor. If you have seasonal allergies, there are things you can do to treat them at home. If your allergy symptoms are hard to control, make an appointment with an allergist.

This chart can help you figure out if you may be feeling symptoms of asthma, allergies, or a respiratory illness like COVID-19, the flu, or a cold:

Click to see larger image (English)

Click to see larger image (Spanish)

Are People With Asthma at Risk of Severe Illness From COVID-19?

Many studies show that having asthma does not put you at a greater risk of getting COVID-19 or having severe COVID-19.^1,2,3 A study published in “The Journal of Allergy and Clinical Immunology: In Practice” (JACI: In Practice) found that people with well-controlled asthma have less severe COVID-19 outcomes than people with uncontrolled asthma.⁴

The CDC continues to list moderate-to-severe asthma as a chronic lung disease that can make you more likely to have severe illness from COVID-19.

No matter what, it is important to keep your asthma well-controlled. If your asthma is not under control, you are at a greater risk in general of having an asthma episode or attack, going to the emergency room, staying in the hospital, or even death. If you feel like your asthma is not well-controlled, talk with your doctor as soon as possible.

Even though people with asthma are not at the highest risk for COVID-19, it is still important to keep your asthma under control. Common medicines you may take for asthma and allergies do not increase your risk of getting COVID-19. They will help you keep your asthma under control. You are at greater risk for having an asthma attack if you stop taking your medicines. Take your medicines at the first sign of symptoms as listed on your asthma action plan. Continue to take these medicines as prescribed:

• Quick-relief medicine (such as albuterol)
• Inhaled corticosteroids (controller medicines)
• Oral corticosteroids (such as prednisone)
• Biologics
• Antihistamines (allergy medicine)
• Proton pump inhibitors for acid reflux
• Nasal allergy sprays
• Allergy shots
  
  

If you have any questions about asthma medicines and COVID-19, talk with your doctor.

If you need to take quick-relief medicine (such as albuterol) for an asthma episode, use an inhaler (with a spacer if directed by your doctor) if possible. Using a nebulizer can increase the risk of sending virus particles in the air if you are sick. But if you have a nebulizer and solution, it is OK to use it to treat an asthma episode. When using a nebulizer, limit the number of people in the room or use it in a room by yourself.

How Can I Avoid Getting COVID-19 (And Other Respiratory Infections)?

The following steps will help you avoid COVID-19, the flu, and other respiratory infections:

1. Get your vaccines.

Vaccines can help protect you, your loved ones, older adults near you, teachers, and essential workers from getting a respiratory infection. They can also cut down your symptom severity if you do get sick. Vaccines reduce the burden on our health care system by reducing the number of people who get COVID-19 or the flu.

Everyone who is 6 months and older can get a COVID-19 vaccine for free with no out-of-pocket costs in the United States. There are currently four vaccines available: Pfizer, Moderna, Johnson & Johnson (J&J), and Novavax.

Visit vaccines.gov to find out where you can get the COVID-19 vaccine near you. Most people can get the COVID-19 vaccine with no issues. Allergic and adverse reactions are rare.

The flu vaccine is recommended for everyone age 6 months and older with rare exceptions.

It is safe to get both the COVID-19 vaccine and the flu vaccine at the same time.

2. Wear a mask.

Face masks can help reduce the spread of the coronavirus. They can benefit people who are vaccinated and unvaccinated alike. Some people may have COVID-19 and not show symptoms for a few days, while some may not have any symptoms at all. And some vaccinated people have gotten breakthrough infections, which have usually been mild.

Wear a mask that fits snugly on your face, and covers your nose, mouth, and beard completely. Wear a mask when you leave your home, if you are caring for someone at home who is sick, and if you have been exposed to someone with COVID-19. People with asthma should be able to wear face masks.

Face masks offer other benefits as well. They can reduce your exposure to pollen, air pollution, and other respiratory infections like the flu.

3. Keep a physical distance from people outside your household.

In general, the more closely you interact with other people and the longer that interaction, the higher the risk of coronavirus or flu spread. Try to stay home when possible when these illnesses are spreading in your community. Avoid large crowds of people, especially in indoor locations. When in public, keep at least 6 feet apart. Stay away from people who are sick or have been in contact with someone who is sick. Even when you’re at home with family, don’t share makeup, food, dishes, or eating utensils.

Postpone any unnecessary travel during the COVID-19 pandemic. See the CDC’s guidelines on how to protect yourself at specific locations and in certain situations, such as shops, public places, gatherings, and more.

4. Wash your hands properly and often.

Use soap and warm water to wash your hands for 20 to 30 seconds. Always wash your hands before and after eating and after coughing or sneezing. Don’t touch your eyes, nose, or mouth.

If you don’t have access to running water, use an alcohol-based hand sanitizer that is at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol).

5. Make sure your indoor spaces are well-ventilated and have good indoor air quality.

If you are staying indoors more because of COVID-19, be mindful of the quality of your indoor air. The air inside our homes can often be more polluted than the air outside. Unhealthy indoor air can be full of asthma triggers and allergens that can cause symptoms and make your asthma harder to control. Take steps to improve and maintain healthy indoor air quality.

Air circulation is important too. Keep your indoor spaces well-ventilated by opening windows or doors, using fans, running air cleaners, or using proper air filters in your HVAC system.

Current evidence shows the risk of the coronavirus spreading is much lower outdoors than indoors. Good ventilation in your indoor environment may help reduce the spread of the coronavirus. It may also affect the risk of transmission (how fast it spreads).

On days when pollen is low and air quality is good, open your windows to let in fresh air. Run your HVAC system as much as possible (especially when windows are closed). Use high efficiency air filters in your HVAC system and replace them at least every three months.

6. Take care of your health.

Take your asthma control medicines as directed to keep your airways open. Eat well and get enough sleep.

Pollen (such as grass or ragweed pollen) may impact people across the U.S. too. Seasonal allergies can affect people with allergic asthma. If pollen allergies trigger asthma symptoms for you, be sure to follow your allergy treatment plan to keep your allergies under control to prevent asthma episodes or attacks.

If you stopped seeing your allergist or getting allergy shots (immunotherapy) during the COVID-19 pandemic, consider making an appointment soon. Keeping up with your regular allergist visits is an important part of keeping your asthma controlled.

The most important thing you can do is to keep your asthma under control. If your asthma is not under control, call your doctor right away.

In general, tracking your symptoms and following your asthma action plan are key to managing your asthma. Some people use peak flow meters to monitor their airways. Monitoring your blood oxygen levels with a pulse oximeter (or “pulse ox”) is not a recommended part of home management of asthma. Many pulse oximeters you can buy for home use are not as accurate as medical grade devices.

It is important to remember that the symptoms you feel should always come before pulse ox and peak flow numbers. But if your peak flow numbers are down and you don’t have symptoms, follow your asthma action plan and contact your doctor.

There are no data demonstrating that monitoring your pulse ox through an oximeter or smartphone app will help manage your asthma. As always, talk with your doctor about the best ways to monitor your symptoms and asthma control.⁶

If I Think I Have COVID-19, What Should I Do?

If you start having symptoms of COVID-19, get tested or take an at-home test. If you have mild symptoms and are not at high risk for having more severe COVID-19, you do not need to call your doctor. Call your local health department within 24 hours to let them know so they accurately report local cases.

If you are at high risk for severe COVID-19, call your doctor within 24 hours if you test positive. They may want to you to take the medicine Paxlovid.

Many pharmacies have various testing options (including at-home or drive-thru tests). The United States Postal Services is providing free at-home COVID-19 tests. U.S. households can get eight rapid antigen COVID-19 tests for free. To receive them, you’ll need to complete an online form. Please note: You will not need to enter any credit or debit card details to place the order.

Some doctors may offer telehealth (video or virtual appointments). If that is an option, ask your insurance company if telehealth is covered under your plan. And if you have Medicare, you might be able to have a virtual visit with your doctor. The government expanded the coverage of telehealth services during the COVID-19 pandemic.

Stay home and isolate from family members so you don’t spread the coronavirus to other people.

Medical Review, July 2022 by Mitchell Grayson, MD

References
1. Chhiba, K.D., Patel, G.B., Vu, T.H.T, Chen, M.M., Guo, A., Kudlaty, E., Mai, Q., Yeh, C., Muhammad, L.N., Harris, K.E., Bochner, B.S., Grammar, L.C., Greenberger, P.A., Kalhan, R., Kuang, F.L., Saltoun, C.A., Schleimer, R.P., Stevens, W.W., & Peters, A.T. (2020). Prevalence and characterization of asthma in hospitalized and non-hospitalized patients with COVID-19, Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.06.010.
2. Butler, M. W., O’Reilly, A., Dunican, E. M., Mallon, P., Feeney, E. R., Keane, M. P., & McCarthy, C. (2020). Prevalence of comorbid asthma in COVID-19 patients. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.04.061
3. Lieberman-Cribbin, W., Rapp, J., Alpert, N., Tuminello, S., & Taioli, E. (2020). The Impact of Asthma on Mortality in Patients With COVID-19. Chest. https://doi.org/10.1016/j.chest.2020.0air pol.575
4. Huang, B. Z., Chen, Z., Sidell, M. A., Eckel, S. P., Martinez, M. P., Lurmann, F., Thomas, D. C., Gilliland, F. D., & Xiang, A. H. (2021). Asthma disease Status, COPD, and COVID-19 severity in a large Multiethnic POPULATION. The Journal of Allergy and Clinical Immunology: In Practice. https://doi.org/10.1016/j.jaip.2021.07.030
5. Kampf, G., Todt, D., Pfaender, S., & Steinmann, E. (2020). Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection, 104(3), 246–251. doi: 10.1016/j.jhin.2020.01.022
6. Heneghan, C. (2018, January 30). Self-management of asthma – is there an app or pulse oximeter for that? Retrieved from https://blogs.bmj.com/bmjebmsp...-app-pulse-oximeter/

The COVID-19 vaccine is an important part of reducing the spread of the coronavirus, ending the pandemic, and protecting ourselves and other people. It can reduce your chance of severe COVID-19, hospital stays, and death.

What Do I Need to Know About the COVID-19 Vaccines Currently Available?

The COVID-19 vaccine is safe and easily available throughout the United States for anyone 6 months and older. There are currently four vaccines: Pfizer, Moderna, Johnson & Johnson (J&J), and Novavax. The Centers for Disease Control and Prevention (CDC) recommends that people ages 5 and older get booster shots after completing the primary series, or first dose(s). Information on each vaccine, their recommended schedules, and boosters are detailed in the article below.

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Pfizer COVID-19 Vaccine, Also Known as COMIRNATY®, for Everyone 6 Months and Older

COMIRNATY® [koe-MIR-nah-tee] by Pfizer is an mRNA vaccine. It is one of the mRNA vaccines recommended for anyone ages 6 months and older. The CDC’s recommended vaccine schedule is below.

If you or your child are moderately-to-severely immunocompromised, you will have a different vaccine schedule. This includes children and adults on high doses of corticosteroids (like prednisone), who have received an organ transplant, or have other serious health conditions.

Children 6 months to age 4

• Primary doses: Three doses three to eight weeks apart
• Booster doses: Not recommended at this time
• Immunocompromised:
  • Three primary doses (first two doses three weeks apart and the third at least eight weeks after the second dose)
    
    

People ages 5 to 11

• Primary doses: Two doses three to eight weeks apart
• Booster dose: At least five months after the second dose
• Immunocompromised:
  • Three primary doses (first two doses three weeks apart and the third at least four weeks after the second dose)
  • One booster (at least three months after the third primary dose)
    
    

People ages 12 and older

• Primary doses: Two doses three to eight weeks apart
• Booster dose: At least five months after the second dose
• Immunocompromised:
  • Three primary doses (first two doses three weeks apart and the third at least four weeks after the second dose)
  • Two boosters (the first one at least three months after the third primary dose and the second one at least four months after the first booster)
    
    

People ages 50 and older should get a second mRNA booster at least four months after the first booster.

If you got the Pfizer vaccine for your first shot, the CDC recommends that you get the Pfizer shot for your additional primary shots.

Children 5 to 11 years of age will receive a lower dose of the vaccine than people 12 and older. If you have any questions about the vaccine for your child, talk with your family doctor or pediatrician.

Pfizer COVID-19 Vaccine Ingredients

The Pfizer vaccine does not contain any food proteins, latex, or preservatives. It does contain mRNA (messenger ribonucleic acid).

Pfizer COVID-19 Vaccine Side Effects

During clinical trials for the Pfizer COVID-19 vaccine, these were some of the common side effects:

• Pain and swelling on the arm where the shot was given
• Fever
• Chills
• Fatigue
• Headache
  
  

More people felt the side effects after the second dose of the vaccine.

Moderna COVID-19 Vaccine, Also Known As spikevax™, for Everyone 6 Months and Older

The Moderna COVID-19 vaccine, called spikevax™, is an mRNA vaccine. It is one of the mRNA vaccines recommended for anyone ages 6 months and older. The CDC’s recommended vaccine schedule is below.

If you or your child are moderately-to-severely immunocompromised, you will have a different vaccine schedule. This includes children and adults on high doses of corticosteroids (like prednisone), who have received an organ transplant, or have other serious health conditions.

Children 6 months to age 17 years

• Primary doses: Two doses four to eight weeks apart
• Booster doses: Not recommended at this time
• Immunocompromised:
  • Three primary doses (first two doses four weeks apart and the third at least four weeks after the second dose)
    
    

People ages 18 and older

• Primary doses: Two doses four to eight weeks apart
• Booster doses: At least five months after the second dose
• Immunocompromised:
  • Three primary doses (first two doses four weeks apart and the third at least four weeks after the second dose)
  • One booster (at least three months after the third primary dose)
    
    

People ages 50 and older should get a second mRNA booster at least four months after the first booster.

If you got the Moderna vaccine for your first shot, the CDC recommends that you get the Moderna shot for your additional primary shots.

Children 5 to 11 years of age will receive a lower dose of the vaccine than people 12 and older. If you have any questions about the vaccine for your child, talk with your family doctor or pediatrician.

Moderna COVID-19 Vaccine Ingredients

The Moderna vaccine does not contain any food proteins, latex, or preservatives. It does contain mRNA (messenger ribonucleic acid).

Moderna COVID-19 Vaccine Side Effects

During clinical trials for the Moderna COVID-19 vaccine, these were some of the common side effects:

• Pain and swelling on the arm where the shot was given
• Fever
• Chills
• Fatigue
• Headache
• Muscle pain
• Joint pain
• Swollen lymph nodes in the same arm where the injection was given
• Nausea
• Vomiting
  
  

More people felt the side effects after the second dose of the vaccine.

Novavax, COVID-19 Vaccine, for People Ages 18 and Older

On July 13, 2022, the Food and Drug Administration (FDA) authorized the Novavax COVID-19 vaccines for emergency use. The CDC also recommends Novavax as an option for people ages 18 and older.

Novavax is given in two primary doses three to eight weeks apart. If you are moderately-to-severely immunocompromised, two doses are given three weeks apart. Novavax boosters are not authorized at this time.

Novavax is an adjuvanted vaccine. This vaccine is similar to the traditional flu vaccines that have been given for many years.

Novavax COVID-19 Vaccine Ingredients

Novavax does not contain any food proteins, latex, or preservatives.

Novavax COVID-19 Vaccine Side Effects

During clinical trials for the Novavax COVID-19 vaccine, these were some of the common side effects:

• Pain, redness, and swelling on the arm where the shot was given
• Fever
• Nausea/vomiting
• Muscle aches/joint pain
• Fatigue
• Headache
  
  

Johnson & Johnson (Janssen) COVID-19 Vaccine for People Ages 18 and Older in Certain Situations

The J&J vaccine is a viral vector vaccine given in one shot. It is available for people 18 and older.

According to the CDC, the Pfizer and Moderna COVID-19 vaccines are preferred over the J&J vaccine, due to the risk for severe side effects. But you may consider the J&J vaccine in the following situations:

• You’ve had a severe reaction after having an mRNA vaccine
• You are allergic to an ingredient in the Pfizer and Moderna vaccines
• You do not have access to the Pfizer or Moderna vaccines
• Despite safety concerns, you prefer to get the J&J vaccine
  
  

Here is the vaccine schedule for the J&J vaccine:

• Primary dose: One shot
• Booster doses: One booster at least two months after the primary dose for people under age 50; people 50 or older should get an mRNA dose at least four months after the second dose
• Immunocompromised:
  • One primary dose
  • Three boosters
    • First booster: Four weeks after the primary shot (mRNA is preferred, but you may consider the J&J shot in some situations)
    • Second booster: At least two months after the first booster (if you get an mRNA shot for your first booster, you cannot get the J&J shot for your second booster)
    • Third booster: At least four months after the second booster
      
      

Johnson & Johnson COVID-19 Vaccine Ingredients

The J&J vaccine does not contain any food proteins, latex, or preservatives.

Johnson & Johnson COVID-19 Vaccine Side Effects

During clinical trials for the J&J COVID-19 vaccine, these were some of the common side effects:

• Pain, redness, and swelling on the arm where the shot was given
• Fever
• Nausea
• Muscle aches
• Fatigue
• Headache
  
  

Who Can Get a COVID-19 Vaccine?

The COVID-19 vaccine is free to everyone. You can get your shot at a local pharmacy, clinic, or vaccination center. Go to vaccines.gov to find a location.

You can get a COVID-19 vaccine if you:

• Are ages 6 months and older
• Have a medical condition
• Are immunocompromised or immunosuppressed
• Are pregnant and lactating (nursing)
• Have allergies to food, pets, insects, venom, pollen, dust, latex, and oral medicines
• Have a non-serious allergy to other vaccines or injectable medicines
• Have a family history of anaphylaxis or any other history of anaphylaxis to anything other than a vaccine or injectable medicine
  
  

Your doctor may need to give you more information about the vaccine depending on your condition.

If you have a history of severe allergic reactions (anaphylaxis), an immediate allergic reaction to a vaccine or injection, or a mild reaction to a previous COVID-19 vaccine, you may be monitored for up to 30 minutes after the shot.

Talk with your doctor about risks and benefits before getting a COVID-19 vaccine and get the shots in a clinic or doctor’s office if you have a:

• Moderate or acute (short-term) illness (such as the flu)
• History of anaphylaxis to another vaccine or injectable medicines
• Severe or immediate allergic reaction to previous dose or any ingredient (also called “excipients” or “components”) of a COVID-19 vaccine
• History of an allergic reaction to PEG or polysorbate
  
  

Many people who have a history of PEG or polysorbate allergy have been successfully vaccinated for COVID-19.

If you are allergic to polysorbate, you should not get the J&J vaccine.

If you have a reaction to the first dose of an mRNA vaccine, your next shot should only be given in a health clinic, medical facility, or doctor’s office.

People who currently have or recently had COVID-19 should finish isolation and talk to their doctors about when to get the vaccine. You may want to wait until three months to get your next dose after your COVID-19 symptoms started. This also applies if you received COVID-19 monoclonal antibody treatment or convalescent plasma while you had COVID-19. You should get vaccinated and boosted even if you have had COVID-19 in the past.

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What Are the Recommendations for COVID-19 Vaccines for Pregnant People?

If you are pregnant or are thinking of becoming pregnant, you should get the COVID-19 vaccine. Pregnant people are at a higher risk for severe COVID-19 when compared to non-pregnant people.¹ If you had a recent pregnancy (for at least 42 days following the end of pregnancy), it may also raise your risk for developing severe COVID-19. If you get COVID-19 while pregnant, you are at increased risk for preterm birth (delivering the baby earlier than 37 weeks) and other poor pregnancy outcomes.²

What Do I Need to Know Before I Get My COVID-19 Vaccine?

If you have a history of severe allergic reactions (anaphylaxis), an immediate allergic reaction to a vaccine or injection, or a mild reaction to a previous COVID-19 vaccine, you may be monitored for up to 30 minutes after the shot.

Do not take over-the-counter pain medicines like acetaminophen (Tylenol) or ibuprofen (Advil) before getting a COVID-19 vaccine to reduce side effects if you don’t take these medicines regularly. Taking over-the-counter pain medicines or anti-inflammatories may stop the vaccine from working as it should and reduce its ability to make antibodies. Talk with your doctor about taking pain medicines after you get the shot.

You can get the flu shot and the COVID-19 vaccine at the same time.

If you get allergy shots (immunotherapy) or biologic shots or infusions, talk with your allergist if your shot schedule overlaps with getting the COVID-19 vaccine. There is not a lot of data on allergy shots, biologics, and the COVID-19 vaccine at this time. But to help reduce confusion if you have local reactions or side effects, it may help to spread these out by a few days.

What Do I Do If You Have Side Effects to the COVID-19 Vaccine?

The CDC is asking people to help report any side effects to the COVID-19 vaccines. V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell the CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from the CDC may call to check on you and get more information. And v-safe will remind you to get your second COVID-19 vaccine dose if you need one. The information on how to register for v-safe can be found on the vaccination record card you receive when you get the shot. If you cannot find your card, please contact your health care provider.

What Activities Can I Do Safely If I Am Fully Vaccinated and Boosted Against COVID-19? Do I Have to Wear a Mask?

Once you are fully vaccinated and boosted, you can go back to doing many of the activities you did before the pandemic. But it’s a good idea to wear a mask in public indoor places, even if you are fully vaccinated and boosted.

Continuing to wear a face mask may have benefits. If you have asthma or allergies, masks can help protect you from pollen and other allergens and irritants that trigger symptoms. Masks also can protect you from respiratory infections like the flu, COVID-19, and even the common cold. Masks provide increased protection for people who are immunocompromised.

Universal indoor masking is recommended for all teachers, staff, students (ages 2 and older), and visitors to schools, regardless of vaccination.

If you have a condition or are taking medicines that weaken your immune system, talk with your doctor about which activities are safe to do.

Consider postponing unnecessary travel.

What Should I Do If I’m Not Fully Vaccinated and/or Boosted Against COVID-19?

If you have not received a COVID-19 shot yet, plan to get vaccinated as soon as possible. If you have received your primary series of the COVID-19 vaccine but have not gotten a booster shot, plan to do so as soon as possible.

People who are unvaccinated and not boosted are at the higher risk of getting COVID-19, spreading it to other people, and becoming hospitalized and/or dying of the virus. If you believe you are not eligible for the vaccine due to your medical conditions, talk with your doctor to see what options may be available to you.

Are Vaccines Effective Against COVID-19 Variants?

Although you may still get COVID after being fully vaccinated, vaccines can help prevent severe symptoms and complications, such as death. You will likely experience mild symptoms compared to someone who is not vaccinated. Vaccines provide at least some protection against new variants, such as the Omicron strains.

In order to prevent new variants, stopping the spread of COVID-19 is important. We encourage you to wash your hands frequently, wear a mask, practice physical distancing, and avoid crowded areas.

Medical Review July 2022 by Mitchell Grayson, MD

References
1. Zambrano LD, Ellington S, Strid P, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641–1647. DOI: http://dx.doi.org/10.15585/mmwr.mm6944e3
2. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis BMJ 2020; 370 :m3320 doi:10.1136/bmj.m3320

Face masks are an essential tool in our fight against the coronavirus that causes COVID-19. They also have other benefits for people with asthma and allergies.

Can People With Asthma Wear Face Masks?

Yes, people with asthma can wear face masks.

“For people with mild asthma or well-controlled asthma, it’s probably not going to be an issue,” said Dr. David Stukus, member of the Medical Scientific Council for the Asthma and Allergy Foundation of America (AAFA). “For people who have very severe disease and have frequent exacerbations, ER visits, hospitalizations, require lots of medications and frequent symptoms, it might cause more issues for those folks.”

It’s important to keep your asthma under control. Keep taking your medicines as prescribed. If you are having breathing issues that need your quick-relief inhaler (albuterol) more than two or more times per week, it’s a sign to call your doctor.

If you’re having trouble wearing a mask, try a different fabric, type, or fit. According to the WHO, medical masks, when worn the right way, do not cause you to breathe in more carbon dioxide or reduce your oxygen levels. Other studies back this up as well.¹ And a face mask made of three layers probably won’t fit tightly enough to affect your oxygen either. If your mask is uncomfortable, try a new type of mask.

How Do Face Masks Help Reduce the Spread of the Coronavirus?

The coronavirus that causes COVID-19 is airborne and spreads from person to person. It can spread through droplets from your nose or mouth when you breathe, talk, sing, yell, eat, sneeze, or cough. You are most likely to catch it if you are not fully vaccinated and less than 6 feet (2 meters) away from someone who is infected.

It’s best to wear a mask in public indoor spaces even if you are fully vaccinated. They also recommend universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

Masks are effective in reducing the spread of the coronavirus in both vaccinated and unvaccinated people.² Studies have shown many people have COVID-19 and don’t show symptoms. Or they may have the virus a few days before they show symptoms. The purpose of wearing a face mask is to protect you as well as keep you from spreading COVID-19 to other people. This is especially important in public indoor spaces.

Wearing a face mask may also make COVID-19 symptoms less severe if you do get it.³ Several studies show that face masks may reduce the amount of particles of the coronavirus you take in, which can result in milder illness.²

Proper care of your face mask is also important to help you reduce your chances of getting COVID-19. Follow these steps when putting on and removing a face mask:

• Wash your hands or use hand sanitizer before putting on a face mask.
• Avoid touching the face mask while using it.
• If your face mask gets damp, replace it with a clean one.
• Remove the mask by the ear loops or ties, trying to not touch the parts of the mask that touch your face.
• Wash your hands or use hand sanitizer.
• Wash fabric face masks in hot, soapy water right away. Throw away disposable masks immediately.
  
  

What Kind of Face Mask Should I Wear?

There are several types of masks available that can help you reduce the spread of the coronavirus.

N95 and KN95 Masks or Respirators

You may consider wearing an N95 mask or respirator for better protection or if you interact with large numbers of the public or are at increased risk for severe illness. NIOSH-approved N95 respirators labeled “surgical” or “medical” should be prioritized for health care personnel. N95 and KN95 masks should be properly fitted. There are several pharmacies that currently provide free masks (N95 respirators) to the public.

Although respirators may be available in smaller sizes, they are typically designed to be used by adults in workplaces, so they have not been tested for broad use in children.

KN95 masks provide an alternative to N95 respirators and are recommended for non-health-care settings for non-medical use. People who are at increased risk of COVID-19 illness, teachers, staff, and other adults in the indoor school setting may prefer KN95 masks.

Not all KN95 masks meet the similar requirements for N95 masks. Find a reliable source to purchase KN95 masks. Do not use KN95 masks with exhalation valves because they can allow the virus to escape.

Cloth and Disposable Masks

There are many options for cloth face masks. You can buy disposable (surgical) or reusable face masks at many major retail stores or online, or you can make your own. Fabric made from 100% cotton, such as heavy-duty quilt fabric or a knit fabric, can be effective.

If you have a latex allergy, be careful with elastic ear loops. Choose face masks with fabric ear loops or that tie behind your head.

Finding a mask that is comfortable and fits well will provide the best protection. If you feel the need to readjust or pull on your mask, it does not fit well. Consider these following:

• Masks with multiple layers of fabric
• Masks that fit snugly against the sides of your face without any gaps
• Masks that cover your nose, mouth, and chin
• Masks with a metal strip or nose guard to keep air from leaking out
• Mask fitter or brace over a disposable or cloth mask to prevent air leaking out of the sides and top
• Combining one disposable mask underneath a cloth mask (the second mask should push the edges of the inner mask against your face)
• Knotting and tucking ear loops of a three-ply mask (See video below)
• Masks with three layers:

• An outer water-resistant layer (such as polyester or polyester blend)
• A middle layer of non-woven fabric (such as polypropylene
• An inner layer of cotton
  
  

Keep in mind that some businesses or schools may mandate which types of masks are most appropriate in their environment.

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Children 2 years and older should wear a mask that is made for children to ensure it is snug without any gaps. Children with a disability that keeps them from safely wearing a mask and children under 2 should not wear masks.

Try different styles and fabrics to see what works for you. To tell if a face mask will be effective, hold your mask up to a light. If you can easily see the light through your mask, it may not provide enough protection. Make sure your face mask blocks the light but still allows you to breathe through it.

Some types of face coverings are not effective at preventing the spread of coronavirus. Bandannas cannot fit tightly enough against your face. If you have a mask with a vent or valve, check the inside of the mask. If you see fabric inside that covers the valve or vent, then the mask is OK to wear. If you see the vent or valve from the inside of the mask, you should not wear the mask because droplets from your mouth and nose can pass through the valve as you exhale.

Do not choose masks that:

• Are made of fabric that makes it hard to breathe, such as vinyl
• Have exhalation valves or vents which allow virus particles to escape, unless the inside of the valve/vent is covered by fabric
  
  

Do not wear two disposable masks at a time or combine a KN95 mask with any other mask.

What Can I Do If My Job Requires Me to Wear a Face Mask?

You may be required to wear a mask as part of your job. Different places may require you to wear a mask. And if your job is located indoors around other people, it is best to wear a mask. If your asthma is not well-controlled and you have trouble breathing while wearing a face mask, what are your options? (Reminder: If your asthma is not well-controlled, talk with your doctor!)

The first step is to try a different mask style – most people with asthma should be able to wear a mask comfortably. Try different types of face masks in different fabrics or styles to find something more breathable. If your job is strenuous, it may feel harder to breathe through a mask.

The second step is to work with your employer. Talk about ways you can work while still helping prevent the spread of COVID-19.

Here are some ways you may be able to work with your employer:

• Ask for time off to get the COVID-19 vaccine and boosters.
• Ask to serve in a role away from the public or other employees.
• Ask if you can work a different shift or from home.
• If you are part of a union, work with your union representative to ask for reasonable accommodations.
• Ask if you can take more frequent breaks if you feel a face mask is affecting your breathing.
• Stay home if you start having asthma or COVID-19 symptoms.
  
  

People with asthma may be covered under the Americans with Disabilities Act (ADA). Under this act, people with disabilities can ask for reasonable accommodations so they can work. If your work requests won’t create a hardship for your employer, you can ask for accommodations.

But the ADA also says if an accommodation could cause harm to other people, then a business does not need to provide the accommodation. If a person with asthma is coughing and not wearing a mask, they might be exposing other people to COVID-19. In this case, the employer could require the person with asthma to stay home or wear a face mask.

If your company requires a face mask, try to find one that works for you. Refer to the mask suggestions above.

Don’t be afraid to talk to your supervisor or human resources representative. They may also have some creative ideas to help you do your job while managing your asthma.

Remember, wearing a face mask is only part of the strategy to prevent the spread of COVID-19. Getting fully vaccinated, physical distancing, improving air ventilation, and washing your hands often can also help protect you and other people from COVID-19.

What Are Other Benefits to Wearing Face Masks?

Pollen can trigger asthma. Wearing a mask can help keep pollen from getting into your nose and lungs. Even though a mask can help prevent symptoms, consider going outside when pollen counts are lower.

Cold weather can trigger asthma. When it’s cold, wearing a face mask can warm and humidify the air you breathe. And masks can reduce your exposure to air pollution.

Masks also can protect you from respiratory infections like the flu, COVID-19, and even the common cold.

Medical Review July 2022 by Mitchell Grayson, MD

References
1. Wearing a mask does not affect oxygen saturation in patients with or without asthma. American Academy of Allergy Asthma & Immunology. (n.d.). Retrieved October 6, 2021, from https://www.aaaai.org/About/News/News/mask.
2. Centers for Disease Control and Prevention. (n.d.). Science Brief: Community use of cloth masks to control the spread of SARS-COV-2. Retrieved October 6, 2021, from https://www.cdc.gov/coronaviru...anchor_1619456988446.
3. Gandhi, M., Beyrer, C., & Goosby, E. (2020). Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer. Journal of general internal medicine, 35(10), 3063–3066. https://doi.org/10.1007/s11606-020-06067-8

If You Have Asthma, Protect Yourself From Summer Heat and Smog

Summer heat is here. For some people, that may mean a rise in asthma flare-ups. Hot air, whether it’s dry or humid, may trigger asthma. But other heat-related factors may also worsen your asthma.

The U.S. Environmental Protection Agency (EPA) says ground-level ozone can harm your health. Ozone is a gas and contributes to what we typically see as smog or haze. It is the result of emissions from cars, manufacturing plants, and chemicals. It is common in the summer when there is more sunlight and low winds, especially in cities.¹

These ozone levels tend to increase as the temperatures get hotter.

Often, emergency rooms see more people seeking asthma-related care in summer. This is because ozone is very irritating to the lungs and airways. It can reduce your lung function. Ozone can make it more difficult for you to breathe deeply.

The lungs of people with asthma are more sensitive to the effects of ozone, according to the EPA.²

Other groups most at risk from high ozone levels:

• Children are at high risk of being affected by high ozone. Asthma is one of the most common chronic diseases in children. Also, kids may spend more time during the summer outdoors in camps, sports, or a park.
• Older adults can feel the effects of high ozone pollution.
• Active adults who work outdoors or exercise outdoors may be exposed to ozone.
• People with certain genetics or certain nutrition deficiencies may be at greater risk of being exposed to ozone.²
  
  

How Can I Protect Myself from Summer Heat and Smog If I Have Asthma?

• Check air quality alerts before planning outdoor activities.
• If the alerts show ozone is high, limit your time outside. Plan outdoor activities for early morning or evening when ozone is lower.
• Use air conditioning if you have it.
  
  

If you don’t have air conditioning:

• See if your town or city opens “cooling centers” on very hot days. These may be schools, community centers, libraries, or other places.
• Visit a museum, mall, or library.
• Some libraries have free passes to museums or show free movies in the summer.
  
  

Talk With Your Doctor

Talk with your doctor about the best ways to manage your asthma during the summer heat. Make sure you keep your asthma action plan up to date. Ask your doctor if you need to adjust your plan.

And always remember when you go out, keep your quick-relief medicine with you at all times. Do not leave it behind in the car or let it sit in the hot sun.

References
1. U.S. Environmental Protection Agency. (2015, May 29). Ground-level Ozone Basics | US EPA. https://www.epa.gov/ground-lev...vel-ozone-basics#wwh
2. U.S. Environmental Protection Agency. (2018, October 10). Health Effects of Ozone Pollution | US EPA. https://www.epa.gov/ground-lev...ects-ozone-pollution