Personal Physicians
David Katzman, MD & Jennifer DeLaney, MD Internal Medicine Specialists
Should I Check for Antibodies After Vaccination?
We have received several calls asking about the utility of checking antibodies after vaccination to determine the vaccine's effective. At present, the CDC does not recommend checking antibodies to determine vaccine efficacy, and here’s why.

When one is infected with Covid, the body naturally makes antibodies to the virus to help fight the infection. The body makes antibodies that attach to the “nucleocapsid” wall of the virus and also other ones that attach to the now infamous “spike” protein. Whereas, all of the vaccines induce an antibody response only to the “spike” protein. So, if one has both nucleocapsid and spike antibodies, it would suggest prior infection - with or without vaccination. Rather if one has only the “spike” antibody, then it's generally thought that this was induced by the vaccine.

Unfortunately though, the immune system is complicated. At present, the presence or even the quantity of any antibody does not guarantee immunity and should not be used as a guide to adopt less protective health measures. Given that there are other unmeasurable immune mechanisms such as T cells, a negative antibody result does not mean that you are unprotected either.

What about the immunocompromised? This may be one scenario where checking the Spike protein antibody may have some utility. A total absence post vaccination may suggest no vaccine response and warrant continued extreme lifestyle precautions.
Until more data is obtained, the best recommendation is to get the Covid-19 vaccine and to continue to follow the standard mitigation procedures to avoid exposure to the virus.
Vaccinations Continue!
Thank you to our staff and our volunteers for enabling our practice to smoothly administer the Moderna COVID-19 vaccine. We will be finishing our vaccine clinics by mid-May and in the end will have vaccinated over 500 people. We are grateful we could offer this service to both our patients and the St. Louis community. Each person vaccinated brings our community that much closer to putting this pandemic behind us! Thank you for your patience as our staff is working double time to manage both our practice and the vaccine clinics.
Johnson and Johnson Update: 
After a brief pause for a safety review after six women were found to have developed blood clots within 2 weeks of receiving the vaccine, the use of the Johnson and Johnson vaccine has been reinstated by the FDA. With the pause lifted, Missouri began administering it again this week. The review found 15 women, mostly between the ages of 18-49 had developed the blood clots. In this age group, this accounted for only seven cases per million vaccinated - 0.0007%. In comparison, the risk of blood clots for patients who contract COVID is 10%, and the risk of death from COVID is substantially higher than the risk of death from any of the vaccines. While the risk is extremely rare, if you get vaccinated with Johnson and Johnson, the CDC recommends calling your doctor if you develop severe headaches, abdominal pain, leg pain or shortness of breath within three weeks of vaccination.
With all of this in mind, since there is an ample amount of all three vaccines available, we recommend avoiding the Johnson and Johnson vaccine if you are a pre-menopausal woman. 
Powered Air-Purifying Respirator (PAPR) Update
Our PAPR project is evolving into a global life-saving device that has exceeded our original intentions.

As you recall, we passed the rigorous NIOSH standards, one of only a few respiratory PAPRs that received their approval for emergency use in the pandemic.

Since that time, we have delivered 50 PAPRs to the ICUs at Barnes-Jewish and Missouri Baptist Hospitals where they are being used to protect health care workers from Covid-19.
Both institutions have requested additional devices for their emergency rooms as well. We are also excited to be beginning a pilot project with Missouri Baptist to allow family members to use the PAPRs to safely visit patients in the ICU with COVID-19.
Given their strong manufacturing presence and ties to the community, Hunter Engineering, our pro-bono partner, has also provided another 50 PAPRs to hospitals in Jackson, Mississippi. 

In addition, we are looking to donate an additional 200 PAPRs to countries in need in Central and South America, Eastern Europe, South Africa and India where the pandemic continues to rage on with limited PPE. Supplying them with these life-saving devices that are reusable and sharable will help maintain healthcare staffing for systems on the verge of collapse.

This past Friday, we learned we won the 2021 “Most Innovative Business” award from the City of Creve Coeur, which recognizes a “business or organization that has demonstrated innovation, unique achievements, or significant advancements in their field.” We are very honored to be recognized through this award and would like to thank our generous donors, Hunter Engineering and Washington University. With their support we have been able to not only protect healthcare workers in our community but soon the most vulnerable abroad as well.  
Office Restrictions Easing a Bit
Since the majority of our patient population are now vaccinated, we feel comfortable lifting a few of the COVID policies we had put into place. We feel it is no longer necessary to be taking temperatures at the door. In addition, we are okay with having one patient per provider in the waiting area again. However, we still request that you call our office from the parking lot before coming in. One family member or caregiver may sit in on your appointment with you as long as he/she is fully vaccinated. All other family members or caregivers will need to wait outside as we would still like to avoid having a large amount of people in the office at once. Thank you for your patience with this process!
Appointments for Yearly Physicals
Since many of our patients had to delay their physicals over the last year, we have had a recent influx of patients scheduling appointments. We are trying to accomodate everyone the best that we can, but please be advised your appoinment may be scheduled farther out than expected. We apologize for the inconvenience as we catch up with the demand.
Please visit our website if you have missed any past newsletters. The newsletter archives can be found by hovering your mouse over the "Medical Links" tab.

11709 Old Ballas Rd. Suite 101, St. Louis, MO 63141

Unsubscribe | Manage Subscription | Forward Email