Fall Wellness Checkup with Dr. Eric Lella of the Edie Windsor Healthcare Center

Fall is such a beautiful season out east — warm, sunny skies, less traffic, more room at the beach, and plenty of apples and pumpkins for the picking.

It’s also a good time for a wellness check-in — because once the fall officially kicks in September 22, the cold and flu season isn’t far behind. With COVID-19 and now Monkeypox still a year-round concern, even more reason to manage your healthcare.

We checked in with Dr. Eric Lella, director of the Edie Windsor Healthcare Center (EWHC) in Hampton Bays for a fall wellness checkup to find out the latest updates on Monkeypox, the COVID Omicron boosters and what the flu season will look like this year.

East End Health Update: Dr. Eric Lella

So many concerning health headlines. What is the latest on Monkeypox?

The cases in Suffolk County continue to occur over previous weeks and overall for New York State. However, new cases are trending downward. Suffolk County has the third highest number of Monkeypox cases in the state, after New York City and Westchester County.

The clinic received supply of the vaccine this summer (on July 25), and as of September 9, 2022, the Edie Windsor Healthcare Center has vaccinated 1,140 individuals.

What is the current status of supply of Monkeypox vaccines at the EWHC clinic?

The change now is anyone can schedule for a first dose and/or a second dose, even if they got it somewhere else and are out here and need a second dose.

We recently received Emergency Use Authorization from the FDA to use a smaller volume of vaccine. When placed in the superficial layers of the skin, that smaller volume was studied to be just as effective as the previous dosing and route of administration.

One vial used to contain one dose; now we can get five doses out of one vial. The number of doses has now increased five-fold, so we have sufficient supply to offer shots for anyone who needs a first and/or second dose.

Our upcoming dates for scheduling for Monkeypox vaccines are Fridays (September 16, 23 and 30) with more available. To schedule an appointment, go to stonybrookmedicine.edu/monkeypox/vaccinations.

How effective is the Monkeypox vaccine and who is being treated for it?

The vaccine is thought to be about 85% effective, so some breakthrough infections can be possible but hopefully if they occur, more mild.

The new cases show infections are almost exclusively related to sexual encounters between men who have sex with men (MSM). Most of the cases are seen in those in their mid-20s to mid-40s. The number of cases in female patients is vanishingly low.

Why are Monkeypox cases almost exclusively in MSM?

Many in this demographic tend to have more frequent new and sometimes anonymous sexual partners. Monkeypox is not a “gay disease.” Anyone could theoretically get it — it is just the close, prolonged skin-to-skin contact and friction on sensitive areas during sex that creates the perfect opportunity and environment for the infection to spread very easily.

It is possible that people can get it from other skin-to-skin contact, say if someone is grinding shirtless on a dance floor, but the cases are almost exclusively related to sexual encounters with men having sex with men

How can people lower their risk of contracting Monkeypox?

A lot of gay men are changing their sexual practices to lower their risk. The CDC (Centers for Disease Control) did a study between August 5 and August 15, 2022 that found about 50% reduction in the number of sexual partners people were having, a 50% reduction in one-time encounters — like a hookup — and a 50% reduction in sexual encounters related to people meeting on dating sites and at parties. Basically, people have changed their behaviors, which is helping.

Based on previous studies it is thought that the highest level of immunity is two weeks after the second dose of the vaccine.

Switching gears: What can you tell us about the new COVID Omicron boosters?

The FDA just approved the updated boosters made by Pfizer and Moderna, which included added protection against the Omicron strains. The Omicron variant is the predominant strain that has been the circulating strain in the population.

This updated Omicron booster is a bi-valient — which means there are two strains in this vaccine, so it has some of the strain from the original vaccine and some of the two strains related to the Omicron variant (BA.4 and BA.5).

Is the new COVID Omicron booster safe?

Some people may say, “Well this one didn’t get full FDA approval,” or “They didn’t study it for a while.” We were able to update the instructions that were inside of this mRNA vaccine. It is similar to the updated flu vaccine every year. We don’t run a trial on the flu vaccine every year. We know that the vaccine is safe. We can update it for the strain of flu we think we’re going to be seeing every year and the same concept with this updated Omicron booster.

Who is eligible for the updated Omicron booster?

Anyone who has not had a COVID infection or an mRNA booster in the past two months is eligible. Some experts are saying hold off on the booster until about four to five months after a recent Omicron infection or a previous mRNA booster shot to allow the immune system to respond more robustly to the new updated booster.

Pfizer’s booster is approved for individuals aged 12 years and older. Moderna’s updated booster is approved for those for individuals aged 18 and older.

There are no updated forms of the Johnson & Johnson or the Novavax vaccines yet.

There is a CDC vaccine eligibility app on their website, click on it and answer questions for individual eligibility on when you should get your booster. It’s called “Stay Up to Date with COVID Vaccines Including Boosters” at cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

Do you expect people to be coming in soon for the updated Omicron booster, and does the clinic have supply?

The hospital has received supply of the Omicron booster and Stony Brook Southampton Hospital will be posting dates and opening bookings for appointments on their website very soon.(southampton.stonybrookmed.edu)

This booster is so important. The Omicron strain, the current dominant strain, is so different than the original strain that it is getting around the original vaccines, so even if you had gotten your previous two boosters — the previous boosters were based on the original strain — we’re several strains away now, so that’s likely a factor why people are getting breakthrough infections with Omicron.

Now that we have an Omicron-specific booster, hopefully we will see fewer breakthrough infections, and if we do see breakthrough infections they will be even more mild than the current breakthrough infections. We will know more from the data as time goes on.

How long will this new Omicron booster be good for?

It’s difficult to say when that immunity may start to drop. Just like in the beginning (of COVID), we didn’t know when we would need a first booster, with time and looking at the date we figured that out. Some experts expect that these boosters will be an annual vaccine along with an annual flu shot, or they may come out and say you have to get it twice a year. If a newer strain splits off and become the predominant COVID infection, then we might see this updated booster’s efficacy drop. This is all difficult to predict.

What might flu season look like this year?

In the first year of COVID we saw almost no flu cases, it was shockingly low because everyone was inside. People weren’t around each other, people were wearing masks, everyone was very careful, and there was no global travel, so the flu kind of got stopped around the globe.

I think because people are now wearing masks less frequently and they are traveling similar to the way they were before the pandemic, flu cases are probably going to be higher and possibly closer to pre-pandemic levels.

Given that flu season took a back seat to COVID in recent years, is it strongly recommended that people get their flu shots, as in past years?

In a typical year there are about 40,000 to 60,000 flu-related deaths in the United States.

Some people will still die from flu-related causes, so if you want to reduce your risk, wear masks indoors around large groups, wash your hands and, yes, people should get vaccinated. Probably the best time to get the flu shot is in the second week of October, that way your highest immunity will be during peak flu season and even if a breakthrough case does occur, much like a breakthrough COVID case, hopefully the illness will be less severe.

How do you time your flu shot with the COVID booster — can you get those close to each other or should you space it out?

There is no recommendation to space it out. The CDC says you could get them on the same day.

If you are concerned about getting flu-like symptoms from the flu shot and side-effects from a COVID booster, maybe you want to space them out. Some experts have said to give it about two weeks in between the vaccines.

The Edie Windsor Healthcare Center, providing LGBTQ+ healthcare and HIV/AIDS care and prevention services via Rose Walton Care Services, is located at 182 W. Montauk Highway, Building B, Suite D, Hampton Bays. Office hours are Monday–Friday, 8 a.m.–4 p.m. They have bilingual English and Spanish language staff. For Monkeypox vaccine updates and availability, visit suffolkcountyny.gov/monkeypox.

Scheduling future Monkeypox vaccines at EWHC will only be available online. For eligibility requirements and more, visit southampton.stonybrookmedicine.edu/services/LGBTQ-and-HIV-healthcare.

Dr. Eric Lella will be speaking about LGBTQ+ healthcare at the Quogue Library on Tuesday, October 11 from 4–5 p.m. for Coming Out Day. For more info, visit quoguelibrary.org.