Covid Vaccine – Now Available!

Finally, some concrete information about how to get COVID vaccine.  

PLEASE be patient – I have only 2 staff members and limited vaccine supply, although I can request more.  We will get everyone vaccinated.

I am vaccinating healthcare providers this week and next.  When San Diego County changes to Phase 1B (likely over the next couple of weeks) my first priority is to my patients.  After they are vaccinated, I will vaccinate the public at large. I will send an email Newsletter and post on the blog each time we enter a new phase of vaccination.

Since this is a new process, things are likely to change over time, but the current plans are as follows:

  • I have Moderna vaccine.  I do not have Pfizer vaccine because I do not have the equipment to store it at ultra-cold temperatures.
  • The vaccine is free for everyone, compliments of the US Government.
  • Vaccines will be administered on Wednesdays, Thursdays, and Fridays from 2:30 to 5 pm in the office BY APPOINTMENT ONLY.
  • This vaccine is a little difficult logistically because you must use all doses within 6 hours of opening the vial.  That means we need to schedule people in groups of 10 and if someone misses their appointment, we’ll have extra doses which might go to waste.
  • To prevent wasting any doses, I have established a “Quick Call” list of high risk patients who are willing to come to the office on short notice (be here within 30 min).  If you’d like to be added to that list, please email us

San Diego County is following CDC recommended phases for vaccine priority.  They have an excellent page that they update frequently that shows the breakdown.  BE WARNED – the criteria change frequently.

When you see “Vaccinating Now” under your tier, then you can call my office for a vaccine appointment at : 858-724-1313

Why I Recommend The COVID Vaccine

I recommend the COVID vaccine for the vast majority of patients because the benefits are huge, and risks are small.  I have to admit, I was quite a skeptic in the beginning.  I didn’t think anyone could do good science in that short a time frame.  And I am generally not someone who jumps in when new medications come out.  But this circumstance is different.

  • The studies were very large (Moderna 30K and Pfizer 43K) and well designed.  I wish they had more people of color (approx 20%)
  • Both vaccines are 94% effective in preventing COVID infection
  • There were no deaths related to the vaccines.  
  • Mild side effects are common – including injection site pain, redness or swelling.  Moderate side effects occur in about 20% of people including fever, headache, fatigue, body aches and chills, most resolve within 48 hours.  If you had more symptoms after the first shot, you’re more likely to have them after the 2nd shot as well.
  • Since side effects are not uncommon, schedule your vaccine on a day you could be uncomfortable or “out of commission” for 48 hours if needed.
  • What about long-term side effects?  We just don’t know.  There has not been enough time since giving the vaccines to see what happens.  The trials are still ongoing, and they are collecting that data, but it takes at least 2 years.  Other vaccines have a very good track record for serious long time side effects, so I’ve decided to be comfortable with the uncertainty.
  • Pfizer vs Moderna – either is good, similar efficacy, similar side effects.  The differences between them have more to do with logistics – ultra-cold storage for Pfizer, 3-week interval for Pfizer and 4-week interval for Moderna.
  • Speaking of logistics – a HUGE problem is that once we open the vial, we must use all doses in the vial (10 for Moderna and 5 for Pfizer) WITHIN 6 HOURS!  That means you cannot just get it because you’re in the neighborhood.  We need to schedule people in groups of 10.  If someone doesn’t show, then we have a potentially wasted dose.  Most of the cases in the news of people getting vaccine ahead of high-risk people are because it’s a potentially wasted dose.  IT’S MUCH BETTER THAT IT IS GIVEN TO A PATIENT THAN THROWN DOWN THE DRAIN!
  • To prevent wasting any doses, I have established a “Quick Call” list of high risk patients who are willing to come to the office on short notice (within 30 min).  If you’d like to be added to that list, please email us
  • No fetal cells are used in the manufacture or Moderna and Pfizer COVID-19 vaccines.
  • Vaccines in the pipeline – Janssen Pharmaceuticals in partnership with Johnson & Johnson have a vaccine that is very promising, but it’s too early to tell if it actually works.  It requires only 1 shot (rather than 2) and is kept at typical refrigerated temperatures so should be easier from a logistics standpoint.

Risks of Deferring Healthcare During a Pandemic

Afraid to go to the doctor or get your blood drawn because you might get exposed to COVID?  Two things I want you to consider:

  1.  Medical facilities can be some of the lowest risk places to visit during the pandemic due to strict sterilization, social distancing and mask wearing practices.  We cannot afford not to. 
  2. Delaying healthcare can have serious consequences in the future.
  • Nearly half of the public says they skipped or postponed medical care because of the Coronavirus outbreak.
  • Cardiologists have seen a resurgence in severe cardiac complications and damage during the pandemic that occur when a heart attack goes untreated.  These complications were common in the 1960’s and 1970’s, but we’ve not seen them in decades.
  • The National Cancer Institute predicts an excess of 10,000 deaths due to breast cancer and colorectal cancer because of missed screening in the year 2020.
  • You may get sicker with COVID-19 if your chronic medical problems (e.g. diabetes, heart disease, high blood pressure) are not well controlled.
  • Waiting to get care until you are really sick makes hospitalization more likely.  And right now hospital staff are stretched very thin, and your hospital care may suffer.
  • When COVID is finally under control, everyone who delayed care will return to their doctor, but they may have trouble getting an appointment because of pend up demand.

Activities for a Stay at Home Order

Given the new lockdown orders in California, we need to get creative again to stay connected and engaged. Here are some of my favorites from a great article

Check out this article for more options.  Which are your favorite?

ABC’s of Telemedicine

Telemedicine is basically a video visit with your doctor and has many benefits. 

  • More personalized than a phone call
  • Less time away from work
  • No travel expenses or time
  • Less interference with child or elder care responsibilities
  • No exposure to other potentially contagious patients

My Electronic Health Record system uses an encrypted version of Zoom so your privacy is protected.  Many conditions are easily treated via video visits:

  • follow up on chronic conditions like high blood pressure, diabetes, gout and high cholesterol.
  • Minor acute issues like upper respiratory infections, urinary tract infections or pink eye. 

Some issues, however, are not able to be addressed with telemedicine like chest pain, shortness of breath, abdominal pain, deep cuts or possible fractures.

Please call the office today to schedule a telemedicine visit.  An email with a link is automatically sent when the appointment is scheduled.  When it’s time for your appointment just click the link.  If you can’t find the original email, another one will be sent automatically about 5 minutes prior to the appointment.  You can use a desktop or laptop computer, a smart phone, iPad or other tablet.  If you are unable to connect at the time of your appointment, I’ll call and we’ll get it set up.  No worries!