ArcaMax

DEAR DR. ROACH: I have notes from friends at home who are getting their COVID vaccines and high-dose flu shots on the same day in the same arm. They talk about being completely wiped out and the cons of having two sore arms. Does it matter if you get the shots in one arm or the other? I suspect that it's fine to do them both in one arm, and there's no advantage to dividing it over time or by arm. -- N.W.

ANSWER: Recent studies seem to suggest that getting the COVID-19 vaccine in the same arm as previous vaccines leads to higher short-term vaccine effectiveness; however, another recent study shows that getting a subsequent COVID-19 vaccine in the opposite arm leads to higher antibody levels, which are also longer-lasting.

I suspect that there is no major difference as to whether you get the vaccine in the same arm consistently or not. Personally, I always get my COVID vaccine in my nondominant arm, but I have colleagues who prefer the vaccine in their dominant arm (as they are convinced that moving more means a faster resolution to the sore arm that is very common after any vaccine).

Getting both your COVID and flu vaccines at the same time is convenient for people who have trouble getting to their provider or when there is no pharmacy near them that gives the vaccine. It's most efficient to get both at the same time, but when I have done so, I get one in one arm and one in the other. Again, it's a personal preference.

DEAR DR. ROACH: I have high blood pressure and a chronic heart condition that is treated with rosuvastatin and clopidogrel. I do not have high cholesterol. Even so, my cardiologist strongly recommends that I continue rosuvastatin as a precautionary measure. Does this make sense? -- T.L.

ANSWER: The goal of rosuvastatin and other statin drugs is to reduce the risk of heart disease complications, including heart attacks, strokes and death. Not everybody who gets these complications will have high cholesterol.

They might have other risk factors such as the high blood pressure you have, or they might have diabetes or less-common lipid issues like a high Lp(a). A high Lp(a) is a risk factor that is not always looked for, but it is important in a person with known heart disease or those who have a strong family history despite having no traditional risk factors.

In a person who is at a higher risk despite normal or even desirable cholesterol levels (and especially in a person with known blockages in their arteries), the benefits of treatment outweigh the risks for nearly everyone. There are several calculators your doctor can go over with you to estimate your risk -- with and without medicines like rosuvastatin.

It's critical to remember that statin drugs (and probably other medications that we traditionally call "cholesterol medicines") are effective in people who are at a high risk even if their cholesterol levels are normal.

You are on clopidogrel (Plavix), which is given to people to prevent blood clots, especially people who are at a high risk such as those with a stent or a history of a stroke. This suggests to me that your doctor thinks you are at a high risk, so the use of a potent statin like rosuvastatin is appropriate.

========

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.

(c) 2025 North America Syndicate Inc.

All Rights Reserved