No universally accepted level for post-melanoma monitoring
E for enlargement or evolution of color, change, shape or symptoms.
Any new darkly colored skin lesion that looks different from the others a person has should be evaluated.
DEAR DR. ROACH: I have a question about the coronavirus vaccines. My mother is 79 and has allergies. I have PBC, an autoimmune disease. Which type of coronavirus vaccine is better for each of us? -- R.Z.
ANSWER: Most autoimmune diseases, such as primary biliary cirrhosis, where the immune system attacks bile ducts, or autoimmune thyroid disease (which many people write me about), won't keep you from getting vaccinated. There is controversy about some autoimmune diseases, such as multiple sclerosis. Here there is a theoretical risk that the increase in immune system activity due to the vaccine could trigger a worsening of the autoimmune condition. This appears to be rare, while the benefit from vaccination is large and proven.
In the current coronavirus pandemic, the vaccines do not have any long-term safety data. However, given the choice between a risk that is at best possible but unlikely, and a benefit that is large not only for the person getting the vaccine but their family and close contacts as well, my opinion is that the vaccine has far more benefit than risk and should be given. Of course, you need to consult your own physician to be sure.
Any available COVID-19 vaccine is appropriate, and I would recommend you get the first one that is available to you.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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