Ideal to wait for 3 months post recovery before getting vaccinated: Dr Rajesh Malhotra - The Daily Guardian
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Ideal to wait for 3 months post recovery before getting vaccinated: Dr Rajesh Malhotra




‘If you have a healthy immune system but administer a trigger too soon after the first infection, your immune system will not respond as effectively as it should. Delaying it too long, on the other hand, may result in re-infection, which could be fatal. As a result, it’s best to get vaccinated three months following the initial infection, because an infection during this time isn’t deemed dangerous’, Dr Rajesh Malhotra explains when asked about the optimal time for vaccination of Covidrecovered patients.

Following are a few snippets from the discussion with the AIIMS Trauma Centre Chief:

What is the co-relation between Covid Immunity and the vaccination?

Dr. Rajesh Malhotra: The level of immunity is different in each individual and the robustness of the response may vary across ages, comorbidities, sex, etc. Natural infection mounts immunity and vaccination but the immune response mounted by vaccine is much more robust because the infection manipulates immune system in order to thrive in the body, as per a study conducted by a University in London. 

People who developed immune response after getting infected by Sars in 2003 carried circulating Antibodies in their bodies in 2020. Therefore, some people may carry the immunity against coronavirus for a lifetime whereas some may get reinfected due to their weak immune system. Another cause for recurrence is the variant, which goes unidentified by the body. Third reason could be if a person’s immune system is fully compromised and has got the persistent infection for months together, the virus inside his body may mutate and come out as a variant which can cause a reinfection. Fortunately, these possibilities are rare.

Can someone, who has developed a mutation, spread the infection while in recovery stage?

Dr. Rajesh Malhotra: A healthy person can recover from Covid in 14-17 days but may spread virus which is dead cannot multiply. On the other hand, an immunocompromised person who has virus multiplying in his body can spread live virus. They may also land up with a mutant due to its prolonged stay because it is a known fact that mutations occur during the prolonged stay of a virus.

What should the immunosuppressed person do in such a condition?

Dr. Rajesh Malhotra: They must wear mask at all times as they may shed mutants. Secondly, they must get vaccinated and if they are vaccinated, various agencies have recommended a booster response in order to control the infection. But the most effective way out is early administration of monoclonal antibodies which can mitigate the persistence of the virus and also the emergence of the variants in their bodies. They should also be isolated from their family members and the family should be vaccinated which will cause an important epidemiological intervention.

Is it a right approach to get vaccinated right after the recovery?

Dr Rajesh Malhotra: The right approach is to get vaccinated which reduces the risk of infection by half. The period between two infections is roughly around hundred days which means that the safe time to get vaccinated is within three months of recovering from the first infection.

I would not worry about antibodies in an immunocompetent people. The other fact that people forget that T-Cells are the most important among the four forces that fight the infection (Antibodies, B-Cells, T-Helper Cells and Killer T-Cells), while antibodies are only ammunitions.

Are you saying that a recovered Covid patient need not get an antibody test right away and can wait 90 days before getting vaccinated?

Dr Rajesh Malhotra: There are no such drugs that can counter the virus, just some drugs that reduce replications. If you have a competent immune system and give a trigger too early after the first infection, the response will not be as robust as intended. On the other hand, delaying it too long may cause re-infection that may be fatal. Thus, it is ideal to get vaccinated after 3 months of the first infection because having an infection in this period of time will not be considered harmful.

Question: Everyone is talking about the third wave. What is the status actually, is it still impending or is it already here?

Dr Rajesh Malhotra: Epidemic has not checked off. Secondly, virus has not been conquered. There is always a risk that it could come back in a way that it could escape the immune system and the vaccination. UK and USA are going through fourth wave, Japan is going through the fifth wave while many countries like South Africa and Bangladesh are suffering from third wave. Many states of India, like Kerala are already going through the third wave. Think Globally, Nationally and Locally. Every area and state needs to have its own plan of action but keep a check on what is happening in other nations and learn from their experience. Nobody should feel secure depending on the number if cases in their states and the strategy should be locally relevant.

Is the healthcare infrastructure of India prepared to face the similar number of cases like the second wave?

Dr Rajesh Malhotra: I would agree that each hospital is better prepared because there are very competent healthcare professionals in our country. Every state is making position for ICU care, thrust on pediatric care and augmenting their healthcare infrastructure. 

Herd immunity is being approached, which is why we may not have such a huge a surge. We were caught off guard during the second wave because after the first wave, serosurvey showed high seropositivity. Firstly, since we did not have vaccines at that time, the natural immunity weenedoff gradually. Secondly, the variant emerged causing huge distinction between the first and second waves. 

On the contrary, now we have vaccines as a boost. The variant strain will be kept in mind. A lot of people who are vaccinated or immune due the previous infection can develop asymptomatic or minimally symptomatic re-infection and thus become spreaders. Hence, it is being insisted to follow the Covid protocols.

How important it is for children to get vaccinated?

Dr Rajesh Malhotra: We keep on saying that this virus will eventually become an endemic like HIV AIDS. It’s mortality will reduce. In the coming times, children will go for Covidvaccination like any other vaccine. About now, only children with serious comorbidity should be protected. It is now being said that Delta variant is as contagious as chickenpox or measles and as you know children cannot comply with mask in schools or social distancing. They may therefore spread it rapidly among themselves and people as well, which is why we are encouraging vaccination among children. Although, the mortality is very low among them.

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Medically Speaking





Weight-loss medications and surgical procedures show promise for reducing the long-term effects of high blood pressure (also called hypertension) in people who are overweight or have obesity.

This finding was suggested by a new American Heart Association scientific statement published today in the Association’s journal Hypertension. A scientific statement is an expert analysis of current research and may inform future guidelines. “Weight loss achieved through dietary changes and increased physical activity are the cornerstones of treatment for high blood pressure that’s related to being overweight. However, these lifestyle behaviours are often not sustained over the long term. Subsequently, reductions in blood pressure aren’t maintained over time,” said Chair of the statement writing group Michael E. Hall, M.D., M.S., FAHA, associate division director for cardiovascular diseases at the University of Mississippi Medical Center in Jackson, Mississippi.

He added, “The new scientific statement suggests medical and surgical strategies may help with long-term weight and blood pressure improvement, in addition to a heart-healthy diet and physical activity.”

Previous scientific statements from the American Heart Association have addressed the impact of diet, physical activity and weight control related to blood pressure. The new statement is focused on obesity-related high blood pressure. Overweight or obesity is a weight that is higher than what is considered healthy for an individual’s height.

Specifically, a body mass index (BMI) of 30 or greater is considered obese, and a BMI of 25 to 29 is classified as overweight. The writing group for the scientific statement included experts in the fields of obesity and high blood pressure, and they reviewed existing research to provide the latest guidance on weight-loss strategies to reduce high blood pressure.


National guidelines recommend a heart-healthy diet to help manage weight and control blood pressure. These guidelines emphasize dietary patterns rather than individual foods and nutrients. The most well-established healthy eating patterns are the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH).

The diets are similar in emphasizing eating more fruits, vegetables, legumes, nuts and seeds with moderate amounts of fish, seafood, poultry and dairy, and low quantities of red and processed meats, and sweets.

“There’s no doubt that eating healthy foods has beneficial effects on both weight and blood pressure,” said Hall. “Numerous weight-loss diets are often successful in the short term; however, eating healthy foods consistently and long term, and maintaining weight loss are challenging.”

Intermittent fasting, an approach that alters the timing of eating and fasting during the day or each week, produced some weight reduction and modest reductions in blood pressure in a few studies involving people with metabolic syndrome — a group of five conditions that can lead to heart disease, including high blood sugar, low levels of HDL cholesterol, high triglyceride levels, large waist circumference and high blood pressure.

Metabolic syndrome is diagnosed when someone has three or more of these conditions. However, analyses of several studies found that intermittent fasting had a weak impact on blood pressure and was no more effective than other diets in reducing weight.

Increasing physical activity as well as improving cardiovascular fitness and reducing the amount of sedentary time can help lower body weight and reduce blood pressure.

The statement suggests exercise is critical to reduce weight and lower blood pressure, as supported by the Association’s June 2021 statement on first-line treatment for elevated blood pressure and cholesterol.


If lifestyle modifications have not been successful in achieving weight reduction and blood pressure control, the statement suggests prescription medications may be considered for people who have obesity or who are overweight and have a weight-related health issue such as high blood pressure.

“Currently, only a fraction of eligible individuals are prescribed medicine or referred for metabolic surgery,” said Hall.

He added, “We often don’t consider medications or metabolic surgery until after there has been target organ damage, such as heart injury or having a stroke. However, we may be able to prevent these complications. When combined with lifestyle changes, anti-obesity medicines and surgical procedures can be effective long-term solutions for weight loss and blood pressure control in select individuals who are overweight or have obesity.”

A newer class of medications called GLP-1 receptor agonists has been shown to help with sustained weight loss and significantly reducing blood pressure, according to the statement. GLP-1 agonists, such as liraglutide and semaglutide, are synthetic hormones, self-administered in a daily or weekly injection, that reduce appetite and help people to feel full.

Both medications were initially approved to treat type 2 diabetes because they lower blood sugar by stimulating the release of insulin.

The U.S. Food and Drug Administration recently approved both medications for weight management and weight loss in individuals classified as overweight or obese.


Metabolic surgery (also called bariatric surgery) can aid weight loss in people with severe obesity, defined as people who have a BMI of 40 or higher, or if they have a BMI of 35 or higher along with an obesity-related health condition including hypertension. The statement includes a research review on metabolic surgery. High blood pressure was resolved in 63 percent of people who had metabolic surgery, and several studies showed less use of blood pressure-lowering medicines after surgery.

“Metabolic surgery techniques are continuing to evolve, and they are getting less invasive and less risky,” said Hall. “For select individuals, medications or metabolic surgery or both may be considered in addition to a healthy diet and increased physical activity.”

The statement also highlights questions and gaps in research data on the use of medications and surgery to prevent and treat obesity-related hypertension. These issues include whether these strategies will have the intended outcome of preventing organ damage, how effective they are for individuals who already have kidney disease or heart failure, and comparing the effectiveness of medications, surgery, or a combination of both to determine the best approach for long-term blood pressure reduction. “There are still many unanswered questions and many opportunities for research that can help people live healthier, longer,” said Hall.

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Right light on mother’s belly may be important to foetus: Study




A new study has found that there may be a link between exposure to light during pregnancy and foetal brain development.

The findings of the study were published in the journal ‘eNeuro’. These findings by researchers at Umea University, Sweden, working in collaboration with American colleagues, may provide a better understanding of certain neurological diseases later in life. “Ultimately, this discovery may open up possibilities for using the right kind of light stimulation during pregnancy to reduce the risk of neurological disorders in adulthood,” said Professor Lena Gunhaga at Umea Centre for Molecular Medicine, Umea University.

The research group at Umea University, together with researchers in the group of Professor Richard Lang in Cincinnati, USA, now demonstrate that a light receptor called Opsin 3 is already expressed in parts of the central and peripheral nervous systems during the early stages of foetal development.

The Opsin 3 molecule has a broad but distinct expression that suggests an important role in the formation of various neurons, neural pathways and areas of the brain and spinal cord. Opsin 3 expression can be linked to a number of motor and sensory neural pathways that regulate movement, pain, vision and olfaction, as well as memory, mood and emotion. While the idea that light may affect cells inside the body, even in the unborn fetus, may seem peculiar, both calculations and experiments have previously shown that light can pass through skin, soft tissue and the skull to activate photoreceptors. Opsin 3 detects light in the blue range at a wavelength of approximately 480 nanometres.

The Umea researchers’ discovery of the expression pattern of this receptor suggests that light plays a vital role in the development and subsequent function of the brain. This might explain why the risk of certain neurological and psychiatric diseases varies depending on the seasonal time of birth. So far, this unexplained correlation has been observed in diseases such as Parkinson’s, Alzheimer’s, multiple sclerosis, bipolar disorder, autism, schizophrenia and epilepsy. That said, time of birth is only one of several risk factors for the diseases in question.

“Although more research is required before we can issue recommendations about specific light therapies for pregnant women, we are clearly on an exciting track that may eventually prove highly significant,” said Lena Gunhaga.

While the new findings are based on observations of the brain and nervous system of mice, the function is deemed to be similar in humans. The researchers continue with more detailed studies of how Opsin 3 affects the development and function of the brain.

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It has been seven months since India started the world’s largest vaccination drive against coronavirus. Slowly and steadily, we as a nation are making every effort to win our war against Covid-19. Currently, statistics say about 9% of India’s population have received two doses and are fully vaccinated. The country has administered a total of 55.7 crore doses midway through August 2021. However, multiple data show that compared to men, fewer women have received their vaccine.

Figures imply that vaccine hesitancy in women is higher than in men. This can become detrimental in our battle against Covid-19. Approximately 65% of India’s inhabitants live in rural areas where myths around the vaccines’ efficacy are widely prevalent. There’s plenty of misinformation floating around about the side effects of vaccination in women. At present, our only weapon to fight Covid-19 is immunisation, and therefore every individual must prioritise their vaccine shots.

Healthcare practitioners and Epidemiologists have already warned against the perils of an unvaccinated population. Post the brutal and crippling second wave; we must ensure that this episode doesn’t repeat. Hence, increasing awareness and debunking myths about vaccination among women is a must.


A common misconception is that the vaccine makes a woman infertile, which is false. There is evidence that shows women have become pregnant post-vaccination. Some say women should avoid getting jabbed while menstruating as it will disrupt the cycle. Many also fear that the vaccine will cause death or that Covid 19 won’t harm them. People in urban areas have also let such myths influence their minds, but it is more widespread in villages.

It is crucial to understand there is absolutely no basis for such information. People mustn’t get influenced by rumours, as vaccines are pivotal to save lives. A vaccine is a critical biological preparation to battle against a particular infectious disease that encompasses an immune system improvement. Moreover, it is essential to note that pregnant women with underlying health conditions such as high blood pressure and obesity are more likely to contract Covid-19. Hence, they must get vaccinated to stay protected. There are no known hazards for vaccines in breastfeeding women either. In the case of a vaccinated lactating woman, the mother’s antibodies may go through the breast milk to the baby and only serve as protection. Thus, not getting immunised against Covid-19 increases health risks and is not the other way around.

The side effects of getting vaccinated are minor and can be felt by any individual. One may experience a fever, fatigue, headache, dehydration, muscle pain at the injection site, etc. These side effects are common in all.


When we’re looking at India, we cannot wholly ignore societal conditioning. Women here in conservative households are taught from a young age to care for their families first. Often, they’re not in charge of making their own decisions. If the man of the family advises against vaccination, thinking it may affect their fertility; the woman will follow what he decides. This is not the case for every woman, but a percentage of women in India deal with such scenarios.

Access to vaccination is another problem. For underprivileged women, accessing the portal also becomes a task. Despite free vaccines available at government health centres, slots aren’t always available. With all these challenges in the backdrop, the only way to spread awareness and reduce vaccine hesitancy is a behavioural and mindset change.

It is of paramount importance to clear your doubts. Here is what you can do. If you are confused about vaccination, please consider speaking to your doctor about: your risk of exposure to Covid-19, the dangers of severe illness, the known benefits of vaccination, understand when to take it, and the limited but growing evidence on the safety of vaccinations during pregnancy.


If a woman is bleeding more than usual, or experiencing a long delay in periods, or is undergoing drastic changes in the menstruation pattern for more than two cycles, or during menopausal woman is experience bleeding

Therefore, as a community, it is imperative to educate and encourage both men and women to get the vaccination. Remember, the health of the nation in many ways depends on the health of our women too. Let’s make sure we’re not engaging in rumour-mongering. If you are eligible to get the vaccine, register on CoWin, get the shot and encourage others around you to do the same. Every vaccine is safe!

The author is the head of Emergency Medicine & Surgical ICU, SL Raheja Hospital Mahim- A Fortis Associate.

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Medically Speaking




Statistically overweight children who follow a healthy eating pattern significantly improve their weight and reduce a variety of cardiovascular disease risks suggests the findings of a Cleveland Clinic-led research team.

The study, which was published in the Journal of Clinical Pediatrics, paired parents and children together throughout the trial. According to the Center for Disease Control and Prevention, obesity now affects 1 in 5 children and adolescents in the United States. Children who are obese are more likely to have high blood pressure and high cholesterol which are risk factors for cardiovascular disease. Adult obesity is associated with an increased risk of several serious health conditions including heart disease, type 2 diabetes, and cancer.

For one year, researchers studied changing cardiovascular disease risk markers associated with three healthy eating patterns in 96 children between the ages of 9 and 18 years old with a body mass index (BMI) greater than 95 percent. BMI is calculated by dividing a person’s weight in kilograms by the square of height in meters, but for children and teens, BMI is age and sex-specific and is often referred to as BMI-for-age.

The three healthy eating patterns studied were the American Heart Association Diet, Mediterranean Diet, and Plant-based diet. All three emphasised whole foods, fruits and vegetables and limited added salt, red meat and processed foods. Parent and child pairs attended weekly educational sessions for four weeks which covered suggested foods to eat and avoid how to read package labels, proper portion sizes and shopping tips.

Fasting blood tests were used to access biomarkers of cardiovascular risk. All three diets were associated with improvements in weight, systolic and diastolic blood pressure, total cholesterol, and low-density lipoprotein.

“This study helps show the importance of starting healthy eating patterns as young as possible. We know that cardiovascular disease begins in childhood, and children’s eating patterns are easier to mold than adolescents and adults,” said lead author Michael Macknin, M.D., Professor Emeritus of Pediatrics of Cleveland Clinic Lerner College of Medicine.

The American Academy of Pediatrics Committee on Nutrition recommends that healthy children age 2 and older follow a diet low in fat (30 percent of calories from fat). These are the same recommendations for healthy adults. In the study, dietary compliance rates averaged 65 percent in week 4 and 55 percent in week 52 suggesting small improvements in diets can still be very beneficial.

“Because the process of heart disease begins in childhood, prevention should begin there as well,” said W.H. Wilson Tang, M.D., study author and research director in the section of heart failure and cardiac transplantation medicine in the Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute at Cleveland Clinic.

“A large majority of heart disease is due to modifiable or controllable risk factors, so it’s important for children to understand that they are in large part responsible for their health,” added Tang.

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With the administration of 96,46,778 vaccine doses in the last 24 hours, India’s Covid-19 vaccination coverage exceeded 81.85 crores (81,85,13,827) as per provisional reports till 7 am on Tuesday, informed the Ministry of Health and Family Welfare.

The ministry said that this has been achieved through 80,35,135 sessions. As per the data, as many as 1,03,69,386 healthcare workers have been inoculated with the first dose of the Covid vaccine while 87,50,107 have been inoculated with both doses. The number of frontline workers vaccinated stands at 1,83,46,016 (first dose) and 1,45,66,593 (two doses).

According to the health ministry, 33,12,97,757 vaccine doses were administered as the first dose and 6,26,66,347 vaccine doses were given as the second dose in the age group 18-44 years.

Also, in the age group of 45-59 years, 15,20,67,152 people have received the first dose and 7,00,70,609 have received the second dose whereas 9,74,87,849 vaccine doses were administered as first dose and 5,28,92,011 vaccine doses given as the second dose to the people over 60 years. Meanwhile, India reported 26,115 new Covid-19 cases in the last 24 hours.

Sustained and collaborative efforts by the Centre and the states, UTs continue the trend of less than 50,000 daily new cases that are being reported for 86 consecutive days now.

“The recovery of 34,469 patients in the last 24 hours has increased the cumulative tally of recovered patients (since the beginning of the pandemic) to 3,27,49,574,” the ministry said.

The active caseload is presently 3,09,575 which constitutes 0.92 percent of the country’s total positive cases while the recovery rate stands at 97.75 percent. The testing capacity across the country continues to be expanded. The last 24 hours saw a total of 14,13,951 tests being conducted. India has so far conducted over 55.50 crores (55,50,35,717) cumulative tests. The weekly positivity rate at 2.08 percent remains less than 3 percent for the last 88 days now. The daily positivity rate was reported to be 1.85 percent. The daily Positivity rate has remained below 3 percent for the last 22 days and below 5 percent for 105 consecutive days now.

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‘Robotic lab’ at AIIMS has capacity to conduct 2 lakh tests in a day



Amidst the prevalence of the Covid-19 pandemic, the country’s renowned hospital, All India Institute of Medical Sciences (AIIMS) here has prepared a ‘robotic lab’ that has the capacity to conduct more than two lakh general tests in a single day.

AIIMS “robotic smart lab” has the capacity to conduct two lakhs tests in a single day. This hi-tech lab was started last year in July and inaugurated by Former Union Health Minister Dr Harsh Vardhan. Union Health Minister Mansukh Mandaviya on Monday also visited this lab and spent more than 20 minutes to see the working of this robotic lab which is fully IT and digitally enabled. Currently, this lab is conducting 3,000-4,000 tests per day but it has a capacity to conduct 8,000 tests per hour and two lakh tests in a single day.

“As of now, we are conducting 3,000-4,000 sample testings in a single day via this lab. The capacity is almost 8,000 tests per hour and 2 lakh tests in a day,” said Dr Tushar Sehgal, Assistant professor, Department of Medicine at AIIMS, Delhi.

This AIIMS smart lab is providing high-quality diagnostics and reduced time in producing lab reports here. The lab is doing more than 70- 270 advanced tests and some of them are free of cost for the patients, the official said.

Elaborating further, Dr Sehgal told ANI, “The testing involves a few stages. It primarily involves three main stages i.e. pre-analytical, analytical and post-analytical stage.” “We have three different types of sample testing methods as well. Haematology, Coagulation, Chemistry are the methods,” he added. AIIMS Hi-tech robotic lab is also providing some free-of-cost tests like the D-Dimer test that costs around Rs 1,000 in private labs. “There are some tests which we do free of cost. Our vision is to provide most of the tests free of cost like LFT, CBC, D-Dimer test etc.”

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