Dear patients and friends,

Check out the side bars and below for most up to date information on Covid vaccines. Notably, as the Johnson and Johnson vaccine was authorized last week, becoming a distinctly different third option, many have asked which is best.

Which shot?

There are a few important notes on direct comparison of these vaccines. Though the effectiveness of the J&J shot seems to be a little lower then the Pfizer/Moderna vaccines there were no head to head studies. They were studied in different populations, with different mixes of viral variants, at different times in the pandemic.

Next, the single J&J shot gave essentially complete protection from hospitalization and death in the study. It was particularly effective in younger and healthier populations, and its ability to protect older sicker patients from moderate illness is still being studied.

Finally, there is no conclusive evidence yet of the any of the shots’ ability to prevent mild infection or so called “long Covid” where patients have brain fog, loss of taste or smell, muscle aching, fatigue etc. for months afterword. Both of these are important questions.

My take: I’d follow the lead of most infectious disease experts and get the vaccine as soon as possible, whichever is available. If I were young (under 60!) and healthy I’d definitely consider the single J&J vaccine if it was possible, as with a single vaccine immune protection is available more quickly. If I were older with underlying conditions that put me at higher risk of infection, and not in a huge rush to get out and about, I would prefer to get the Pfizer or Moderna vaccine. If there was more urgency to get the vaccine though I’d feel comfortable taking the J&J if it was available sooner.

As we start to look toward the future, I would like to share some information about another topic.

Brain Health

Some of you are aware that over the past two to three years I have been studying and in some patients applying, the approach to cognitive loss and dementia that is explained in Dr. Dale Bredesen's book "The End of Alzheimers Protocol." Dr Bredesen is a neurologist with an interest in chronic debilitating brain diseases, and views the current approach to dementia as one of medicine's greatest disappointments over the past 30 years. His approach, taken from the tenets of what is now called Functional Medicine, is to get at the core causes of inflammation and degeneration of the synapses of the brain.

More to come in future letters, but if you have a concern about your brain health or have a strong family history of dementia in first degree relatives, you might start by reading his book. Or, there is information about his program at Apollo Health (www.apollohealthco.com). I will only be working with my current patients as this program is fairly intensive and time consuming. The greatest thing going for the program is everything in it makes you healthier - does not involve prescriptions or any sort of invasive interventions.

I hope this update finds you well. Stay tuned for information as we learn more.

Sincerely,