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Used to be that moms would intentionally expose their children to chicken pox so they would develop immunity. Now some are wondering if they’ve already had Covid-19 or have had an immunization or two, would exposure ramp up their immune response? Johns Hopkins physician Sherita Golden answers emphatically no.

Golden: There is the question about, well, I’ve gotten Covid or I got my first two shots, but I haven’t gotten a booster. Should I just go and try and get Covid, and then I have like superimmunity. We don’t want to do that. There’s something called long Covid where people are still having trouble with breathing, trouble with their heart, trouble with their physical endurance and energy, months and months and months after getting Covid-19. If you have had Covid previously, a mild case, long Covid isn’t necessarily linked to how severe the case of Covid was.  :33

Golden says following vaccine recommendations is by far your best strategy. At Johns Hopkins, I’m Elizabeth Tracey.

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Seems like we’ve barely made it through third doses of Covid vaccines for many, and now a fourth dose is in the offing for some groups of people. Lisa Maragakis, an infectious disease expert at Johns Hopkins, explains why.

Maragakis: We’re not sure exactly how far out but a number of months later you’re going to be less protected than you were shortly after getting the vaccine, and that’s where the boosters come in, so I would encourage everyone who’s eligible to get a booster to get a booster, if you’ve gotten the two initial ones and a booster should you get another one? And that’s where some people, particularly those who are older individuals or who are at highest risk for severe disease, go for it if you’re in one of those higher risk groups.  :31

Maragakis notes that only the Pfizer and Moderna vaccines were authorized as a fourth or booster dose of vaccine, for those 50 years of age or older or who have health conditions that may put them at higher risk for severe infection. At Johns Hopkins, I’m Elizabeth Tracey.

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Even as some people continue to avoid vaccination against Covid-19 altogether, others are weighing whether they should have a fourth dose, as the FDA has recently said is okay for some groups of people. Johns Hopkins infectious disease expert Lisa Maragakis explains why a fourth dose may be a good idea.

Maragakis: This question about the fourth booster is a burning question that a lot of people have. Vaccines are incredibly helpful to protect people, even though sometimes you can still get the virus, what we do know is being vaccinated protects you from getting severe illness, from ending up in the hospital, and dying, unfortunately, as so many people have from this virus. The boosters come into play because we know that even though the vaccine teaches our immune system to fight the virus, that effect seems to go down or decline over time.  :35

Maragakis recommends asking your primary care doctor if you’re a candidate. At Johns Hopkins, I’m Elizabeth Tracey.

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Wear a mask, don’t wear a mask. Avoid crowded places, dine outside. Go ahead and dine inside…it seems like recommendations are a moving target, so what should you do? Lisa Maragakis, an infectious disease expert at Johns Hopkins, feels your pain.

Maragakis: One factor is that we are learning all together about this new virus. No one had ever seen it before. Now we’re two years in, so we’ve learned a lot, but you have seen things change, recommendations change, over time because information changed and we learned more about the virus and then even the virus has changed. And we’ve seen different versions of it coming and going. There are other factors in the complex world of trying to take that scientific information and then make public policy from it.  :34

Maragakis predicts continued changes as more evidence accumulates, and urges flexibility. At Johns Hopkins, I’m Elizabeth Tracey.

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Covid-19 transmission rates continue to fall around the country, and many states are rolling back mask mandates as well as other restrictions. Johns Hopkins physician Sherita Golden says while this is encouraging news, we need to all take a measured approach.

Golden: The fact that mask mandates are lifting is not a sign that the pandemic is over. It’s really a sign that some of the transmission rates in the community are much lower than they have been in the past, so some of the mask mandates will be rolled back as community spread significantly declines. That being said I am a firm believer that if you are in crowded situations where you’re unclear about the vaccination status of other people, those are situations where you should still feel compelled to wear a mask.  :31

Golden says she carries along a mask everywhere attached to a chain around her neck, so if she feels the slightest bit uncomfortable she is ready to don it, and she encourages others to do the same. At Johns Hopkins, I’m Elizabeth Tracey.

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When someone of any age has a stroke, it’s really important to find out the cause or causes. That’s according to Johns Hopkins stroke expert Michele Johansen.

Johansen: Why, as stroke neurologists, do we spend a long time thinking about the cause of the stroke? Well, it’s important because stroke mechanism dictates treatment. If I know what caused your stroke then we can really work on either modifying that risk factor, for example high blood pressure, or thinking about procedures that can be done to fix the problem. If I can’t find the cause or if the cause is never found, it’s risky for the patient. How do we know that you’re not at risk for having another stroke if the cause of the stroke is never found?  :30

Johansen cites the most recent data indicating that while strokes are generally declining in the US, for those aged 18 to 50 the rate is actually increasing. This is especially concerning because those who have a stroke at an earlier age may live with years of disability, so finding out why is paramount. At Johns Hopkins, I’m Elizabeth Tracey.

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While it’s not really known why rates of stroke are increasing in those in the 18 to 50 year old age group, some factors are understood. Michele Johansen, a stroke expert at Johns Hopkins, says the good news is many of them are modifiable.

Johansen: Modifiable risk factors. You know if we could change some of these risk factors we would people like me out of business. If we could increase physical activity, if we could emphasize the importance of getting your blood pressure treated. Hypertension is a silent killer, a lot of people don’t even know that they’re hypertensive, which is why it’s important to see a primary care physician. Heavy episodic alcohol consumption certainly leads to an increased risk of stroke. Cigarette smoking, and then cardiovascular risk factors are also really important in stroke in the younger adult, and in the older adult.  :31

Johansen says you can’t change your genes since they run in your family, but many other risk factors for stroke early in life are squarely in your control. At Johns Hopkins, I’m Elizabeth Tracey.