It’s important to take action as soon as you feel able. Early treatment and planning can slow the disease and improve your quality of life.

We spoke with Andrea Bozoki, MD, a UNC Health neurologist specializing in cognitive and memory disorders, about what people diagnosed with Alzheimer’s or another dementia should do next. These tips are written for the patient but can also be helpful for loved ones and caregivers.

1. Talk with your doctor about medication options.

Once your primary care doctor or a neurologist diagnoses dementia, it’s important to begin medication as soon as possible in an effort to slow progression of the disease. The most common drugs used to treat dementia are cholinesterase inhibitors, including donepezil, galantamine and rivastigmine. These drugs work by preventing the breakdown of acetylcholine, a neurotransmitter in the brain. “I talk with my patients about the pros and cons of taking one,” Dr. Bozoki says. “Then, I ask if they are ready to start taking them.”

Many patients ask about a new drug recently approved by the FDA, aducanumab, branded as Aduhelm. While there is a strong desire to provide new options to patients, many physicians and pharmacists do not believe the research shows that this drug is effective. UNC’s Department of Neurology has posted an update for patients on its website.

2. Educate yourself about Alzheimer’s.

Receiving a diagnosis of Alzheimer’s disease is overwhelming. “I give my patients a list of educational and support resources,” Dr. Bozoki says, “and I schedule a follow-up appointment with them in a couple of months to review what they’ve found and what they still need help with.”

Take time to absorb the news, read about the disease and come back to your next appointment with questions for the doctor. You can also call whenever something comes up. “People are often shell-shocked at the first appointment,” Dr. Bozoki says.

Finding a therapist with experience with dementia might be helpful; your doctor can help you find the right person.

3. Find a new community to support your journey.

Individuals living with Alzheimer’s and their families can benefit from connecting with others in the same situation. Because of the nature of the disease, caregivers will need to adapt to changes in the person living with Alzheimer’s over time. It can be helpful to hear about the experiences of people who have been through the progression of the disease.

Dr. Bozoki recommends her patients connect with the following organizations: Dementia Alliance of North Carolina, Duke Dementia Family Support Program and the national Alzheimer’s Association.

4. Assess safety at home.

Depending on the progression of the disease, your doctor may recommend several things to implement immediately at home.

• • Medication safety: A caregiver may need to take on the responsibility of filling and organizing medication in a pill box, or even giving the medication.
  • Home safety: Think through daily needs in the kitchen and, if possible, replace old appliances with new ones that include safety features like automatic shutoffs. You may want to use stove locks or adjust the settings on a newer oven/stove so they can’t be used at night. Remove substances in the kitchen that might be mixed up or accidentally consumed as food. Take an inventory of hazardous materials, including cleaning supplies, sharp tools, and chemicals for indoor and outdoor use and consider securing or removing them. Make sure that fire alarms and carbon monoxide alarms are in good working order.
  • Other safety concerns: Depending on your cognitive status, other areas may need to be evaluated. The Alzheimer’s Association offers a complete list to review safety at home.

5. Plan how you will get around safely.

A doctor might tell you or your loved one that it’s no longer safe to drive or refer you for a driving assessment. Family members may need to provide support, or you may need to find community support.

As dementia progresses, it may also be difficult for you to get around without getting lost. Can you walk around the block or to the coffee shop safely? If not, you can arrange friends and family to serve as walking buddies. A medical ID worn on the wrist can explain to anyone you might meet that you have Alzheimer’s disease or another condition, in case help is needed.

6. Make changes where you can.

Unfortunately, there is not yet a cure for dementia. But medications can sometimes improve symptoms, and certain lifestyle changes can improve overall health and quality of life for people with dementia. These tips are also relevant for any older person, with or without dementia.

• Diet: Experts recommend a combination of two well-known plans, the Mediterranean Diet and the DASH Diet, for aging adults, including those with signs of dementia, referred to as the MIND Diet (Mediterranean–DASH Intervention for Neurodegenerative Delay). This mainly plant-based diet emphasizes vegetables, fruits, whole grains, legumes and fish and unsaturated fats. It encourages reducing sweets, red meat and eggs.
• Exercise: If you are not already engaged in a regular routine of strength training and cardiovascular exercise, now is a great time to start. Walking 30 minutes a day, joining a strength class for older adults, or choosing an online or video workout to do at home can be a great way to start if you’re not in the habit. There are options for varying ages and different levels of mobility, including routines that incorporate balance and fall prevention, an important element for older adults.
• Sleep: Experts recommend seven hours of quality sleep per night for adults. If you aren’t getting quality sleep, you may be sleeping more than the recommended amount but are tossing and turning. Many adults have sleep apnea that is not diagnosed or being treated. If you struggle to get quality sleep, talk to your doctor about a referral for a sleep study.
• Hearing aids: Hearing loss is a major risk factor for cognitive decline. It can be helpful to have your hearing evaluated and get hearing aids if needed.

7. Consider participating in a research study.

Healthy volunteers and people living with early stages of Alzheimer’s disease are needed to advance the study of treatments, including medications such as aducanumab. To participate as an Alzheimer’s patient, you must have a diagnosis of Alzheimer’s specifically, not just dementia. Talk to your doctor about studies you could join.

People in North Carolina can sign up for trials at the NC Registry for Brain Health. The National Institutes of Health awarded an Alzheimer’s Disease Research Center designation to the joint UNC-Duke program in summer 2021, which will bring more research opportunities to people living in North Carolina.

Talk to your doctor if you are concerned about the signs of dementia in yourself or a loved one.

The Food and Drug Administration (FDA) has expanded its emergency use authorization on COVID-19 vaccines to include booster shots of all three vaccines (Pfizer, Moderna and Johnson & Johnson).

“All three vaccines available in the U.S. continue to show high levels of protection against becoming severely ill with COVID-19. However, there are signals that some people vaccinated earlier may have increasing vulnerability to becoming infected with the virus,” says UNC Health infectious diseases specialist David A. Wohl, MD. “A booster dose bumps up immunity that may be weakening.”

Whether you’re eligible for a booster depends on which shot you got in the first place and specifics about your age, health and where you live and work. But don’t worry—we can make it simple.

Read on to find out if it’s your turn for a boost, and what public health officials are saying about mixing and matching vaccines.

If You Received the Pfizer or Moderna Vaccines

If you received a Pfizer or Moderna vaccine, and it’s been at least six months since your initial doses, you are eligible for a booster if you are:

• Age 65 or older
• Age 18 or older and living in a long-term care setting
• Age 18 or older with underlying medical conditions, such as diabetes, obesity, lung disease, heart disease, kidney disease and dementia; pregnancy is considered a high-risk condition, too
• Age 18 or older and working in a high-risk setting; includes first responders, healthcare workers, teachers and grocery store workers

People who have moderately to severely compromised immune systems because of cancer treatment, organ transplant, advanced HIV infection and other conditions who were fully vaccinated with either Moderna or Pfizer should receive a third Pfizer or Moderna shot at least one month after their second dose.

“For patients whose immune systems are compromised, the third shot is not so much a booster but is recommended to try to trigger their immune systems to make a stronger response,” Dr. Wohl says.

The Pfizer booster is the same dose as the original shots; the Moderna booster is a half-dose for those without moderately to severely compromised immune systems. For those who are immunocompromised, the Moderna booster dose is the same as the initial two doses.

“Moderna tested a booster of their vaccine at half the dose of each of the initial vaccination doses and found it worked well to bump antibody levels,” Dr. Wohl says. “Neither Pfizer nor Johnson & Johnson have presented data on boosting with doses other than those used in the initial shots.”

If You Received the Johnson & Johnson Vaccine

Anyone age 18 or older who received a single dose of the Johnson & Johnson vaccine is eligible for a booster dose of the Johnson & Johnson vaccine two months after their first dose.

If you received the Johnson & Johnson vaccine, and it’s been at least two months since your initial doses, you also are eligible for a booster with either the Moderna or Pfizer vaccines if you are:

• Age 65 or older
• Age 18 or older and living in a long-term care setting
• Age 18 or older with underlying medical conditions, such as diabetes, obesity, lung disease, heart disease, kidney disease and dementia; pregnancy is considered a high-risk condition, too
• Age 18 or older working in a high-risk setting; includes first responders, healthcare workers, teachers and grocery store workers

This is called a “mix and match” approach for boosters.

A recent study found that recipients of Johnson & Johnson’s single-dose shot who received a Johnson & Johnson booster had antibodies increase by four times. The antibody boost from the other vaccines was much larger: Antibody levels rose 35-fold with a Pfizer booster and 76-fold with a Moderna booster.

In other words, people who received the Johnson & Johnson vaccine produced stronger antibody levels after they got booster shots made by Moderna or Pfizer, compared to boosters from Johnson & Johnson. It is important to note study participants were given a full dose of the Moderna vaccine.

“Antibody levels are one important indicator of vaccine response, and people who receive two different COVID-19 vaccines have been found to generate very strong antibody responses.  Studies also show that side effects are not worse,” Dr. Wohl says. “Some people may decide to mix-and-match and the best data we have seen come from boosting with Pfizer or Moderna after initially receiving the Johnson & Johnson vaccine.”

People who have moderately to severely compromised immune systems because of cancer treatment, organ transplant, advanced HIV infection and other conditions who were initially vaccinated with Johnson & Johnson should receive a booster with a Pfizer or Moderna shot at least one month after their initial dose. These individuals also have the option of a second Johnson & Johnson vaccine, but most experts would recommend a booster with Pfizer or Moderna in the immunocompromised.

Also, people who initially were vaccinated with the Pfizer or Moderna shots can get a booster with either.

If You’re Not Eligible for a Booster Yet

If you received the Pfizer or Moderna vaccines and you’re young, healthy and at lower risk overall—keep practicing physical distancing and masking in public places and stay tuned for your turn.

“We’re all going to get boosters, eventually,” Dr. Wohl says. “Starting with the immunocompromised, those whose protection may be waning, and people with higher risk for severe COVID-19 makes sense.”

Visit unchealthcare.org/vaccine for the latest information on the COVID-19 vaccines.

1. Don’t eat treats while out and about.

Have your children wait to come home before eating any treats.

“The most important rule is that kids with food allergies should not be eating while they’re actually trick-or-treating,” says UNC Health allergist Edwin Kim, MD, MS. “Kids with food allergies should bring everything back home for their caretakers to take a look at and make sure that all these foods are safe.”

Once home, you can carefully read the labels. Many popular Halloween candies contain some of the most common allergens such as peanuts or tree nuts, milk, eggs, or wheat.

Throw out anything that does not have a label.

2. Accompany your children when they trick or treat.

Letting children with food allergies trick or treat on their own can be risky when it comes to food allergies.

“It’s really important to supervise when they go out because when they’re amongst each other, they’re going to be so tempted to just eat everything they see,” Dr. Kim says. “And folks who don’t live with food allergies don’t always appreciate that it doesn’t take a lot of the food to make somebody sick.”

3. Trade unsafe treats.

Have your children swap any unsafe candy for another treat such as a safe candy or a small toy.

“If your kid comes back and has a bunch of peanut-containing foods or milk-containing foods or something they cannot eat, have them trade those items so they don’t feel like they’re losing out,” Dr. Kim says.  “Take the unsafe treats out of their bag and replace them with snacks that you know are safe. That can be another way that the child doesn’t feel like they’re losing out.”

If your child isn’t feeling well, talk to your pediatrician or find one near you.

That might be true, but it doesn’t mean you don’t need to see an orthopedic surgeon. In fact, if you have joint pain, whether from aging, injury or overuse, an orthopedic surgeon can help you find relief. Orthopedic surgeons have an arsenal of nonsurgical and surgical treatments to help improve mobility and quality of life.

“Living with joint pain is not normal and should not be ignored,” says UNC Health orthopedic surgeon Derek Reinke, MD.

What Does an Orthopedic Surgeon Do?

An orthopedic surgeon is an expert who specializes in injuries to the musculoskeletal system: the muscles, tendons, joints, ligaments and connecting nerves. These specialists diagnose and treat orthopedic injuries, such as:

• Muscle strains
• Chronic joint or chronic back pain
• Arthritis
• Tendinitis
• Rotator cuff tears (shoulders)
• Meniscus tears (knees)
• Fractures
• Osteoporosis
• Nerve damage

No matter your age, any person who experiences pain in the hips, knees, shoulders, wrists, ankles or back should consider visiting an orthopedic surgeon.

“I see everyone from high school athletes with injuries to people in their 60s and beyond with degenerative conditions. All types of injuries can occur in a variety of demographics and ages,” Dr. Reinke says.

Acute injuries, from a sudden trauma such as a fall or a sports injury, require immediate treatment.

“When an athlete feels a pop and sudden onset of pain in a joint, such as a knee or shoulder, that’s when you should see an orthopedic surgeon,” Dr. Reinke says. If the pain is intense and the joint swells quickly, or if you experience extreme swelling, numbness and tingling, or a visible deformity of a bone, you’ll want to go to the emergency department.

Chronic pain can be progressive in nature, starting slowly and getting worse over time. Symptoms that last longer than 12 weeks also may necessitate a visit with an orthopedic surgeon, Dr. Reinke says.

Here’s how to know it’s time to see an orthopedic surgeon.

Signs You Should See an Orthopedic Surgeon

• Painful joints lasting more than 12 weeks. This type of pain often does not go away on its own and may benefit from orthopedic treatment.
• Bruising, soreness or swelling that doesn’t respond to rest, ice, elevation and over-the-counter pain medications.
• Limited range of motion, including difficulty using your shoulders, bending your knees or flexing any joints.
• Inability to bear weight or feeling unstable or off-balance while walking, sitting down or climbing stairs.
• Numbness and tingling in the extremities, such as the arms, hands, legs, feet or toes.
• Difficulty performing your daily routine—getting dressed, going shopping, seeing friends—or moving.

Take the Next Step for Relief

An orthopedic surgeon can diagnose the cause of your pain or other symptoms and talk with you about your treatment options. Noninvasive treatments include physical therapy, massage therapy, prescription medication or cortisone injections. If nonsurgical methods aren’t providing relief, surgery may be an option.

It’s always a good choice to speak with an orthopedic surgeon because the last thing you want is for your condition to worsen or for an injury, such as a rotator cuff tear, to become irreparable if untreated, Dr. Reinke says.

“For an example, if someone has a knee ligament injury that’s not addressed, it can sometimes lead to arthritis. These types of outcomes often can be prevented,” Dr. Reinke says.

“Joints can deteriorate over time, but if a condition is addressed quickly, we can take steps to prevent that from occurring.”

If you’re experiencing joint pain, talk with your doctor. If you don’t have a doctor, find a provider near you.

While no one can prevent every illness, most of us can make some simple changes that could improve our chances of avoiding infectious diseases and recovering fully when we do get them.

Here are eight tips from UNC Health family medicine physician Sarah Ruff, MD.

1. Get vaccinated.

No amount of healthy living can provide the protection against infectious disease that a vaccine can. Approved vaccines use tested, proven and safe technology to teach our immune systems how to fight off deadly viruses when we come in contact with them.

That’s why everyone who is eligible should get the COVID-19 vaccine as well as the annual flu shot, Dr. Ruff says. Taking a vaccine is like arming your immune system for future battle. Being vaccinated doesn’t mean you won’t ever get the flu or COVID-19, but it means that you’re much less likely to get seriously ill or die.

“There is a lot of talk about letting your body’s natural immunity take care of COVID-19 or the flu, but given what we know about these illnesses and how nondiscriminatory they can be as to who gets mild illness or severe illness or even dies, if there were a way to prevent death and hospitalization, why wouldn’t one choose that route?” Dr. Ruff says. “Vaccines help give your body’s natural immunity more weapons and strength to fight whatever might come its way.”

2. Eat a healthy, balanced diet.

Healthy foods provide nutrients, vitamins and minerals to keep us strong and well. Eat a varied diet that focuses on high-quality foods such as whole grains, nuts, and fresh fruits and vegetables. The more colorful your plate is, the better.

It’s better to get your vitamins and minerals from food rather than from supplements because your body uses and absorbs nutrients more efficiently when they come from whole food sources such as fruits and vegetables, Dr. Ruff says. But it’s worth asking your provider if there’s anything you might want to take in supplement form, such as vitamin D, which is critical for strong bones and teeth and difficult to get sufficiently from food.

3. Exercise regularly.

Good news if you flinch at the thought of super-intense workouts: Moderate exercise, rather than prolonged, vigorous exercise, is the real immune system booster. It’s just one of the physical and mental health benefits of being active.

“Recent studies have shown the benefits of moderate daily exercise over doing high-intensity exercise less frequently. Not only does moderate exercise improve blood sugar and lower blood pressure, thus preventing chronic disease, but it also helps to lower stress, which we know helps our immune system,” Dr. Ruff says.

Aim to do moderate exercise 150 minutes a week, which is about 30 minutes a day for five days a week. Examples of moderate exercise include jogging, swimming and walking at a brisk pace.

4. Maintain a healthy weight.

There is strong evidence that obesity negatively impacts the body’s immune system. In fact, obesity is a common risk factor in complications from the flu and COVID-19.

Having obesity does not automatically mean you will become sick with any illness, Dr. Ruff says, but “obesity, defined as a body mass index over 30, is associated with higher risk of chronic diseases like high blood pressure and diabetes, both of which increase your risk of complications from COVID-19.

5. Get plenty of sleep.

Not getting enough sleep can make you more susceptible to illness, and getting adequate sleep has been shown to be beneficial for immune function. That’s why you’re more likely to get sick when you’re exhausted.

Adults need seven to eight hours of sleep every night, teenagers need nine to 10 hours of sleep, and younger children usually need 10 or more hours of sleep.

The quality of your sleep matters, too.

“It’s not just a number but getting enough sleep so that you can feel rested. You need good sleep hygiene, so that the sleep that you get is restful and restorative,” Dr. Ruff says. A good first step is stopping screen use at least 30 minutes before bed; an hour is even better. Opt for reading a book or listening to music instead.

6. Minimize stress.

Long-term stress can cause imbalances in immune cell function. It can be difficult to reduce stress, but lifestyle measures such as exercise and adequate sleep can help, as can embracing mindfulness. If your stress feels unmanageable, talk to your doctor or find a therapist.

“Trying to minimize stress has so many different aspects, but my advice is to try to have good relationships and find calming activities,” Dr. Ruff says. “Most people also can lower their stress with exercise.”

7. Limit alcohol.

Research shows excessive alcohol consumption can have adverse immune-related health effects, including increasing a person’s susceptibility to pneumonia.

“Alcohol can disrupt the gut microbiome—the good bacteria that live in our gastrointestinal tracts and help our bodies fight off infection,” Dr. Ruff says, and that’s just one of the “mechanisms by which alcohol can affect the immune system negatively.”

If you choose to drink, do so in moderation. This means no more than one drink a day for women and no more than two drinks a day for men.

8. Don’t smoke.

Smoking, including vaping, harms the immune system and can make your body less successful at fighting disease. It compromises your lung health, which is especially dangerous for viruses that attack the respiratory system, such as COVID-19 and the flu.

“Smoking is proven to decrease your ability to heal and to decrease your ability to fight disease,” Dr. Ruff says. “Quitting smoking can be one of the best things you can do to help yourself not get really sick or to recover well from disease.”

Of course, the best way to avoid COVID-19 is to continue the safety measures recommended by public health officials: Get vaccinated if you’re age 12 or older. Wear a mask indoors or in outdoor crowds. Physically distance from people outside your household whenever possible and wear a mask when it’s not possible. For added protection from the flu and other illnesses, wash your hands often and clean high-touch surfaces.

Need a doctor? Find one near you

Something you can’t see on the field or court is what’s happening inside that player—and inside the body of everyone who breaks a bone. From the moment the bone fractures, the body is already at work repairing it. Amazingly, broken bones begin healing themselves immediately.

But that doesn’t mean the injured person won’t need the help of an orthopedic surgeon to get back on his or her feet.

Here’s how bones break and how they heal.

Symptoms of a Broken Bone

Bones can break in many ways. Sometimes bones crack, without breaking all the way through. When a bone breaks all the way, the two parts of the bone can stay in alignment, or the break might move apart. Bones can also shatter into three or more pieces. In some of the worst breaks, bones can pierce the skin, leaving the patient vulnerable to infection.

Broken bones typically cause swelling, pain, deformity and tenderness at the site of the break. Bruising and bleeding under the skin are common.

“Bones house cells that produce and make blood in our bodies. When you disrupt the architecture of the bone, it will bleed,” says Jeremy Miles, MD, UNC Health orthopedic surgeon.

Dr. Miles says people most often break bones in their shoulders, arms, wrists, hips and ankles. Hip fractures are more common in older people; those with osteoporosis are especially at risk.

If you’ve broken a bone, it’s important to make an appointment with an orthopedic surgeon soon after the break. This specialist can assess what type of fracture you have, offer the right treatment and track your healing process to make sure your bone is healing correctly. If a person with a fractured bone does not see a doctor, the bone could heal in an unusual position, which could cause a deformity or loss of function.

How Broken Bones Repair Themselves

If you’ve ever broken a bone, you know the pain typically comes quickly. Then, your nearby muscles tense as a protective mechanism.

“When a bone breaks, other muscles contract to decrease motion and try to stabilize the bone,” Dr. Miles says.

As this is happening, the body immediately springs into action to help heal the injury. The healing process is separated into three stages:

1. Hematoma formation: Stem cells from bone marrow, blood and surrounding tissue travel to the fracture to trigger the formation of a hematoma, similar to a bruise under the skin.

“Fracture hematoma is an incredible substance,” Dr. Miles says. “It has molecules to stop the bleeding, as well as signaling molecules and growth factors to direct the body to heal the fracture.”

2. Bone growth: The fracture hematoma or blood clot is gradually replaced by fibrous tissue, called soft callus. The soft callus becomes hard as it is replaced by bone. This new bony callus will fill the gaps between the broken ends of the bone, healing the fracture.
3. Bone remodeling: Over the next several weeks, solid bone continues to grow and remodel at the fracture site. In general, it takes between six weeks and three months for a broken bone to heal, but it can take longer for complicated fractures.

“This is a continual process. Some bones will continue to remodel for over a year after a break,” Dr. Miles says.

Medical Treatment for Broken Bones

To stop broken bones from healing in the wrong shape, it is important that they are realigned into their original position. Sometimes, a doctor has to move the bone back into alignment, known as setting the bone or reducing the fracture.

Treatment can be surgical or nonsurgical, depending on the severity of the fracture and the patient’s age, medications and health conditions. Bones that have not been displaced or moved out of alignment can often heal with nonsurgical methods, Dr. Miles says.

To help with the healing process, the bones must be held in the correct position and protected as they heal. The most traditional way to do this is by using a brace, splint or cast. These can sometimes be used on the ankle, foot, knee, wrist, elbow or shoulder.

“It’s an external stabilizer,” Dr. Miles says. “If the internal architecture is disrupted, then we put support on the outside for a period of time to provide stability as the bone heals and regains its strength.”

In some cases, fractures may require surgery. The decision to perform surgery is based on the type of break, the type of bone broken and the force that is on that bone. Surgeries can involve the implantation of rods, plates, screws or pins after the bone is put back in place.

“In surgery, we help to augment or support the bone’s internal stability with an artificial device, usually made of metal,” Dr. Miles says.

“For an example, for a fracture of the thigh bone, we often put a metal rod inside the bone and attach it up near the hip joint and down near the knee joint. It provides stability inside the bone and new bone can grow around it while allowing people to walk on the broken bone as it heals.”

If a bone is broken around the hip or shoulder and is unlikely to heal, joint replacement is sometimes necessary. In joint replacement, the broken part of the bone and adjacent joint is replaced with an implant.

Preventing Bone Fractures

Whether you’ve never broken a bone or you’ve broken several, you can take steps to prevent future fractures:

• Eat a healthy diet with adequate amounts of calcium and vitamin D.
• If you’re a woman age 65 or older or a man age 70 or older, talk to your doctor about a bone scan for osteoporosis.
• Limit alcohol.
• Exercise to improve strength and balance.
• Quit smoking. Smoking is bad for your bone health and impairs healing.

If you’re concerned about your bone health, talk to your doctor. If you don’t have a doctor, find one near you.

“It could be that detection of eating disorders in males is improving,” says Cynthia Bulik, PhD, founding director of the Center of Excellence for Eating Disorders at the UNC School of Medicine. “We hope that means the stereotypes around eating disorders are being broken down somewhat so that detection, referral and treatment are improving for men.”

For males of all ages, stereotypes and stigma around eating disorders can prevent them from talking about it or seeking help. In other cases, they don’t recognize that they have an unhealthy relationship with food and exercise, or a distorted view of their body.

That was the experience of Jacob Day, who had anorexia. The now-29-year-old from Ashe County, North Carolina, is sharing his survival story to cut through stereotypes and help support anyone who may need help.

Seeking Control as a Teenager

Day was overweight as a preteen and bullied by his peers for it.

“When I was around 14 years old, I decided I wanted to lose weight and be healthier,” Day says. “I started changing what I was eating, restricting calories and working out.”

Day started losing weight and receiving compliments from people around him for doing so. He started feeling good about himself and gaining confidence. He didn’t want that feeling to stop. His weight decreased to a healthy weight—but it didn’t last.

“It got to the point that the only thing that made sense to me was seeing the number on the scale go down,” Day says.

“We are seeing more and more that the fitness, cosmetic and diet industries are targeting men,” Dr. Bulik says. “Just as they have been doing with women for decades, they are trying to undermine men and boys’ body esteem by encouraging physical comparisons with models and actors who have six-pack abs and undetectable body fat.”

Dr. Bulik says that living in a society that praises specific physical ideals can make people feel bad about their own bodies and can damage self-esteem and body image on a daily basis. For Day, it meant wanting to be lean. And so he pushed himself, drastically limiting his caloric intake and working out for hours every day. By the time he was a junior in high school, he was dangerously underweight.

Dad Insists on Finding Help

Day didn’t think he had a disorder. He’d been told by society that exercise and weight loss were considered to be good things.

He was also going through a lot of changes in his life during this time. In addition to the normal emotional ups and downs of teenage life, there was a lot of change; his mother was going back to school and his father was starting his own business. Day felt like his eating, his exercise and his weight were the only things he could control. But when his weight plummeted, his father took action.

“I thought I was going to the doctor because I had shortness of breath,” Day says. “It actually turned out that my dad had done his own research into eating disorders and made an appointment with a physician for an evaluation.”

At the appointment with a doctor in Boone, they learned Day’s heart rate was around 20 beats per minute (bpm). The average heart rate for someone his age should have been between 60 and 100 bpm, or between 40 and 60 bpm for physically fit people. His low heart rate was a concern because it could be an indication that his heart’s electrical system wasn’t working properly. He was transferred by ambulance to Brenner Children’s Hospital at Wake Forest Baptist Health in Winston-Salem.

At Brenner, Day was evaluated and his father continued doing research on eating disorders. He decided to take his son to the UNC Center of Excellence for Eating Disorders in Chapel Hill, where experts could provide personalized medical, psychological and nutritional care.

Not Ready for Change

Day went into the program at UNC in denial—he didn’t think he needed to be there. After around three months of going back and forth between inpatient and outpatient treatment, he hit the goal weight set for him in the program. With an eating plan, recovery guidance and a therapist at his disposal, Day tried life without the program. He maintained his weight for about a month before he began restricting calories and excessively exercising again. And he tried his best to hide it from everyone around him.

“Stereotypes and stigmas around eating disorders still exist for everyone,” Dr. Bulik says. “Unfortunately, those stigmas have been and still are worse for males, and many men are hesitant to come forward to seek help.”

Day soon started college at the University of North Carolina-Chapel Hill. During his sophomore year, his health started to decline. He wasn’t eating enough to fuel his body and was exercising too much. He started losing weight again.

“I don’t consider myself to have been a good friend during this time,” he says. “I had such a strict schedule in high school and college when I was struggling with anorexia. I said ‘no’ to a lot of things with friends because I didn’t want to miss a workout, or I wasn’t sure if I could eat the food that would be there. I feel like I missed a lot of opportunities and experiences.”

Then, the last semester of his senior year, he’d had enough.

A Revelation

“I told myself, I either get better, or I won’t survive this.”

Day was starting to think beyond college. He realized how much of his life was in front of him, and how he would need to adapt to life outside of school. His set routine and particular eating habits wouldn’t work in the real world, he thought, and he didn’t want to make them work. So, he started opening up to his friends and family about his struggle.

“A major step in my recovery was just being open and talking to people about my anorexia,” he says. “For so long I hid my illness because I was ashamed. It was a big hindrance. Getting over that and starting my recovery was one of the hardest fights I’ve ever had, and I know that if I lost that fight, I wouldn’t be here.”

By leaning on friends and family, Day started making strides in his recovery. And he started feeling better physically, which helped his mental health. He began reworking his relationship with food and shifting his mindset around gaining weight and what his body should look like. Instead of spending one to two hours exercising every single day, he started taking rest days and worked to change the thought patterns that used to leave him feeling guilty.

Living a Healthy Life and Sharing Wisdom

Day graduated from college in 2014 and started working for the UNC School of Medicine as a genomics research technician. His recovery was ongoing; he considers 2016 to be the year he fully recovered from anorexia nervosa. Now, he wants to help others.

“I feel like there are men out there with eating disorders who don’t know they have one, and think what they’re doing is considered healthy,” he says.

If you recognize the signs of an eating disorder in a friend or family member, let them know you care, Dr. Bulik says.

“Have materials available to help them find treatment. Encourage them to take that first step and get an evaluation. Advocate for them if necessary and support them through recovery,” Dr. Bulik says.

Day says if you aren’t quite ready to schedule an appointment with a doctor, at the very least, talk to a loved one about what you are going through.

“This is something you shouldn’t have to face by yourself. Know that the process of recovery will be difficult, but it’s worth getting to the other side. Being recovered feels like saying ‘yes’ to life.”

 If you or a loved one is struggling with an eating disorder, learn more about treatment options. Telehealth services for eating disorders have increased significantly and are available for people who would like confidential treatment from the comfort of their own home.

If you’re a person of any gender who has experienced an eating disorder, you can read more about an international research study led by UNC, the Eating Disorders Genetics Initiative (EDGI). EDGI is designed to understand how genes and environment influence risk for developing an eating disorder to inform development of new treatments, improve outcomes and eliminate deaths from eating disorders.

For the second year in a row, parents and children will have to navigate trick-or-treating in the midst of a pandemic, now with an extra-scary mutant in our midst (the delta variant).

Fortunately, there are ways to make trick-or-treating safer.

“Trick-or-treating has some good things going for it,” says Emily Sickbert-Bennett, PhD, director of UNC Medical Center Infection Prevention. “One, it’s outdoors. And two, it’s over a prolonged time period and often covers a lot of ground, so it lends itself to physical distancing.”

Trick-or-treating carries some risk, especially if you live in a community with high case rates. Costumed children tend to congregate in groups and are too young to be eligible for a COVID-19 vaccine (though that should be changing very soon).

If your kids are trick-or-treating this year, follow these tips to reduce their risk.

• Trick-or-treat only with those in your household or in a small group. Coach your children to give space to others, such as waiting at the mailbox while another group rings the doorbell.
• Connect with neighbors to stagger start times so not everyone is out at the same time.
• If your children are going to spend any time indoors or you doubt their ability to physically distance, add a mask to their costumes that covers the nose and mouth. (Avoid full-face masks that are fun for dress-up but can impair vision and safety.)
• Wash hands thoroughly before eating any treats, and be sure to carry hand sanitizer while out and about in case your child is tempted to taste a treat before getting home.
• Set out candy on a porch step or driveway as opposed to handing it out. If you want to be sure nobody swipes the whole bowl, set up a chair and watch trick-or-treaters from a distance of at least 6 feet.
• If you think you may have COVID-19 or you may have been exposed to someone with COVID-19, do not participate in any in-person Halloween festivities and do not give out candy to trick-or-treaters.

Safety Tips for Other Fun Fall Activities

In addition to trick-or-treating, other fall activities include visiting pumpkin patches, haunted houses and fall festivals. This year, look for outdoor fall fun and avoid anything indoors, including haunted houses.

“Indoor group settings where lots of people are congregating are more risky than outdoor activities,” Dr. Sickbert-Bennett says.

Even with outdoor activities such as a visit to the pumpkin patch, be aware of how much space you have and how many people might be in that space. Wear a mask if it gets crowded, and stay at least 6 feet from others.

“Be aware of your health and wellness on days when you have an activity planned, and make sure that you’re only going out when you’re feeling well,” Dr. Sickbert-Bennett says.

Remember to use hand sanitizer when you get back to your car and wash your hands as soon as you get home.

For the latest information on COVID-19, visit the CDC website and the UNC Health COVID-19 Resources page, and follow UNC Health on Twitter, Facebook, Instagram and YouTube.

But for people with agoraphobia, these feelings aren’t pandemic-specific. This mental illness is marked by persistent fear and avoidance of certain places and situations. People with agoraphobia are fearful that if they are in a crowd or with a group of people, they might feel intense anxiety and not be able to escape.

UNC Health psychiatrist Mary Kimmel, MD, explains more about the disorder and its intersection with COVID-19.

What Is Agoraphobia?

Agoraphobia is an anxiety disorder in which a person has trouble feeling safe in places outside of his or her home, particularly in crowds. Anxiety can be triggered by going to a concert or sporting event, or by traveling in a car, bus or airplane. When the person with agoraphobia feels anxious or trapped, he or she could have a panic attack.

People with agoraphobia have a difficult time differentiating between a perception of fear versus actual danger, and they fear that a loss of control (as in, the ability to leave a space quickly) will make them unsafe.

Signs and Symptoms of Agoraphobia

People with agoraphobia commonly experience:

• Intense fear of crowds, enclosed spaces or wide-open spaces
• Worry
• Rapid heartbeat
• Rapid breathing (hyperventilation)
• Headaches
• Double or blurry vision
• Elevated blood pressure
• Sweaty or clammy skin

“It may be helpful to think of agoraphobia as a way your system is trying to protect you but may be doing so at times when it is no longer helpful. For example, if you have a history of trauma, your system may be reacting, even in some place like a grocery store, as if you need to be on guard and hypervigilant to protect your safety,” Dr. Kimmel says.

Agoraphobia Risk Factors and Causes

Diagnosable agoraphobia is relatively uncommon; just under 2 percent of the population has it. The symptoms usually emerge in adolescence or early adulthood, typically before age 35.

Risk factors may include:

• History of depression or social phobia
• Family history of anxiety or phobias
• Lack of access to a support system

The cause of agoraphobia is different for every person, Dr. Kimmel says. Anxiety disorders are known to have both genetic and environmental components; that is to say, the genes you inherit and the environment you inhabit both play a role in your mental health.

Sometimes a person has a panic attack in a given situation and then becomes afraid of that situation in the future. Negative childhood experiences, unhappy relationships, and stressful or traumatic events can also trigger agoraphobia.

Agoraphobia and COVID-19

Right now, because of COVID-19, people with agoraphobia may be under additional stress, and people with no history of agoraphobia could develop some of its features, Dr. Kimmel says.

“Going out has meant danger, you might get sick, you might bring it home to your kids, your family members … We’re all sort of trying to figure out what is the normal amount of going out? What is the amount of going out that you need to do?” Dr. Kimmel says.

For some people with agoraphobia, the coronavirus has validated the urge to stay home.

“For some patients, it’s been kind of a relief,” she says. “It’s been sanctioned that it’s OK not to go out.”

This period we’re in now, where the pandemic is ongoing and case rates remain high but children are back in school and some aspects of daily living are mostly back to normal, is confusing for people with or without agoraphobia, Dr. Kimmel adds.

“This hybrid space has been particularly difficult,” she says.

Treatment for Agoraphobia

It’s important to treat agoraphobia because it can impair a person’s quality of life and may worsen without treatment. In severe cases, a person can become housebound for years. Being under chronic stress causes overproduction of the hormone cortisol, which has been linked to diabetes and heart disease.

Treatment options include:

• Cognitive behavioral therapy: This type of treatment involves a person meeting with a therapist to discuss fears of leaving home and not being safe. The person with agoraphobia and the therapist will work together to discuss the fears and plan careful, gradual exposures.
• Medication: Antidepressants, particularly selective serotonin reuptake inhibitors, or SSRIs, help reduce the symptoms of anxiety and mood changes.

“Often, you need both. You need more than one tool,” Dr. Kimmel says. “It’s about gradually building up confidence and seeing that when you go out, even if you have a panic attack, you can handle it and move through it. You can accomplish the things you want and need to do.”

If you are struggling with symptoms of stress or mental illness, talk to your doctor. If you don’t have a doctor, find one near you.

We talked to UNC Health allergist Kathleen Wang, MD, about common indoor allergies and what to do about them.

“There are multiple allergens that lurk within the home, and the most common ones are dust mites, pet dander, usually from cats and dogs, mold and cockroaches,” Dr. Wang says.

Regardless of how clean your home is, everyone has these allergens lurking around.

“There’s this myth that if my house is really clean then I don’t have a lot of allergens, and that’s actually not true. Allergens will hide in every nook and cranny of every home that has people living in it,” Dr. Wang says. “But there are steps you can take depending on what type of allergen you’re trying to reduce.”

Here are tips for reducing your exposure to common indoor allergens.

1. Reduce moisture in the air to combat dust mites and mold.

Dust mites live on soft things such as couches, curtains, pillows and carpets, and they thrive on moisture.

“Dust mites are everywhere if you have humans or pets living in your home and moisture in the air,” Dr. Wang says. “They’re all around us.”

Although you cannot completely get rid of dust mites, there are a combination of things you can do to minimize them. The best way to keep dust mites at bay is to reduce moisture in your home.

Remove humidifiers and use air conditioning in the summer to lower the humidity in your home. Put pillows and mattress pads in dust mite-proof cases and “make sure you wash your linens in hot water and dry them in a hot dryer at least once a week,” Dr. Wang says.

For the little ones, their beloved stuffed animals are a haven for dust mites.

“Try to keep stuffed animals out of the bed, but as a lot of kids love to snuggle with their stuffed animals while going to sleep, try to wash the stuffed animals with your linens every week,” Dr. Wang says.

If your child’s stuffies aren’t machine-washable, you can put them in a plastic bag in the freezer for 24 to 48 hours once a week to kill dust mites.

2. Don’t let pets into your bedroom.

More than 50 percent of people in the United States have a cat or a dog, but for those who are allergic to pet dander, the best kind of pet—if you don’t already have one—is a pet that does not have fur, such as fish or a turtle.

If you already have a furry pet, there are things you can do to try to reduce your exposure to pet dander. Dr. Wang suggests combining all these strategies together for the most relief.

First, try to keep your pet out of your bedroom, because that’s a place you’re spending hours every night. Provide a comfortable place for your dog or cat to sleep in another part of your home. If you must have a pet in your bedroom, keep your furry friend off the bed.

Dander is present on your pet’s skin, saliva and urine, so washing your pets once a week is proven to be helpful, too. (Of course, many pets won’t tolerate such frequent bathing, especially cats.)

Finally, running a HEPA filter in a room where a pet spends a lot of time can be helpful. However, there are some downsides to using a HEPA filter, starting with the fact that they can be expensive.

“Depending on the HEPA filter, it has a very specific square footage it can cover, so you can’t expect one HEPA filter to clean the entire house. The other thing is that it really has to be run continuously, so that can definitely increase your electricity bill,” Dr. Wang says.

3. Limit access to water and food to keep cockroaches at bay.

Allergies to cockroaches are less common, but still problematic for many. And you don’t need to see cockroaches in your home to have them living there.

“Cockroaches really like food and water, so to reduce them coming into your home, you have to make sure that you seal any cracks in your walls or other ways they can enter your home and then limit the water and food that cockroaches can access,” Dr. Wang says.

Locate and fix any dripping faucets or leaks in pipes. Seal food in containers and wipe up spills promptly.

“Counters and stoves are areas where you can have little food crumbs that may be hidden that cockroaches like,” Dr. Wang says. “Leaving dishes in the sink for a long time is a way for cockroaches to access a food source. And make sure you’re emptying out the trash regularly. If you have a trash can with a lid, that can be helpful as well.”

4. Call mold removal experts to remove mold.

Like dust mites, minimizing moisture in the air also helps if you are allergic to mold.

“Indoor mold hangs out in moist areas such as showers, damp basements and in the soil of plants,” Dr. Wang says.

If you see visible molds, you can remove them with a bleach solution. Mix one cup of bleach in a gallon of water, apply to the surface and don’t rinse.

“But mold is one of those things that if you have a lot of it, it’s probably best to leave it to the professionals,” Dr. Wang says. Mold removal services can remove mold and advise you on preventing future mold growth.

If indoor allergies are still making you miserable, you can try taking over-the-counter allergy medications such as Zyrtec, Claritin, Allegra or their generic equivalents. If you feel drainage from your nose down the back of your throat (postnasal drip), use Flonase, an over-the-counter nasal spray. Eyedrops can help for itchy eyes. If your symptoms persist, talk to your doctor or see an allergist.

“If you’re not finding relief, it’s time to see an allergist,” Dr. Wang says.

An allergist will start with more conservative measures, such as over-the-counter antihistamine medications, but can offer immunotherapy in the form of allergy shots if needed.

“If you’re still not feeling better, or you are wanting more long-term relief, your allergist may recommend allergy shots, which are really amazing for a subset of people who may not be getting a lot of relief from their current regimen,” Dr. Wang says.

If you experience indoor allergies, talk to your doctor about the best treatment for you. Need a doctor? Find one near you.

The overwhelming majority of people who have been hospitalized with or died from COVID-19 over the past few months, since vaccines became widely available, were unvaccinated.

That’s why it’s so important for people who are eligible for a booster shot, notably those 65 and older, to get one. A supplemental shot for at-risk populations will continue to protect against hospitalization and death.

“Your body’s immunity to many viruses, whether acquired naturally or through a vaccine, declines over time,” says UNC Health infectious diseases specialist David A. Wohl, MD. “A booster shot is an additional dose of a vaccine that gives a ‘boost’ to your immunity and provides better protection from disease. With a booster, the immunity that has already been established by a vaccine or through prior infection is stimulated again. So, in a way, the booster serves as a reminder to the immune system’s memory, which can fade over time.”

Why Do Vaccinated People Get COVID-19?

You’ve likely heard about “breakthrough infections,” when someone who is fully vaccinated gets the virus. While breakthrough infections garner a lot of attention, they’re expected.

Here’s why: While the COVID-19 vaccines are very good, no vaccine is perfect. Some people will get infected and some of these people may get sick even though they got the shot. The goal of a vaccine is not to eliminate all infections but to minimize severe illness, and in that regard, the COVID-19 vaccines are a huge success.

“First thing to understand is that the risk of even getting infected is reduced by vaccination. Among those who do get infected despite being fully vaccinated, there is not only a reduced risk of progressing to severe COVID-19 but also a short time that the virus can be found in the nose or throat—meaning a lower likelihood to spread the infection to others,” Dr. Wohl says.

Statistics from the Centers for Disease Control and Prevention (CDC) bear this out: Since the delta variant became dominant in the United States, unvaccinated people have been about 10 times more likely to be hospitalized or die than people who have been fully vaccinated. Studies from across the country also continue to show hardly any change in the protection against severe illness provided by the three COVID-19 vaccines, even as the protection against infection has slipped due to the delta variant.

Boosters Protect the Vaccinated

Most of the fully vaccinated people who have been hospitalized with or died from COVID-19 were ages 65 and older, according to CDC statistics. This is unfortunate, but not completely unexpected as older people may not make as strong a response to vaccines as those who are younger. The same is true for those with weaker immune systems. While there has not been evidence of a drop in protection provided by the vaccines against severe illness in the United States, the concern for waning immunity along with data showing a bump in antibody levels in those with a booster shot has led the CDC to recommend a booster for certain people.

If you’re eligible for a booster shot, get one. People who are eligible include:

• Those who initially received two doses of either the Pfizer or Moderna vaccines at least one month ago and are moderately to severely immunocompromised. Pfizer recipients must be age 12 or older, and Moderna recipients must be 18 or older.
• Those who initially received the two doses of the Pfizer vaccine at least six months ago and meet one of the following criteria:
• Age 65 or older
• Age 18 or older and have an underlying health condition that increases risk, such as cancer or chronic kidney disease
• Age 18 or older and live or work in high-risk settings, including health care, schools, nursing care facilities and grocery stores

Right now, people who initially received the Johnson & Johnson vaccine are not yet eligible for a booster. There are study data expected shortly that will help the Food and Drug Administration (FDA) determine how best to boost people who received this vaccine. Similarly, for those who initially were vaccinated with Moderna and are not immunocompromised, a booster dose has not been authorized by the FDA but may be soon.

Receiving a booster when you’re eligible is the best way to make sure the vaccine continues to work its best for you.

Visit unchealthcare.org/vaccine for the latest information on the COVID-19 vaccines.

“In clinical studies of outpatients with COVID-19, a one-time treatment with monoclonal antibodies reduced hospitalization by as much as 70 to 80 percent,” says UNC Health infectious diseases specialist David A. Wohl, MD.

What exactly are monoclonal antibodies and how are they helping those diagnosed or exposed to COVID-19? We asked Dr. Wohl. Here are four things we learned.

1. Monoclonal antibodies are copies of antibodies we know can attack the COVID-19 virus.

When we get an infection, several parts of our immune system fight against the invading pathogen. In the case of COVID-19, one part of the immune response makes a neutralizing antibody, a protein the body makes that latches onto the spike protein that coats the surface of the coronavirus. Once the antibody neutralizes the virus, other parts of the immune system swoop in to dispatch the virus. This general process is part of how people recover from COVID-19.

In the absence of a strong neutralizing antibody, the virus enters the body’s cells and replicates. The more this replication process is allowed to happen unhindered, the sicker an individual will get as the virus spreads within the body.

When the pandemic first began—before vaccines were available—scientists evaluated the antibodies of patients who recovered from COVID-19 to determine which ones best neutralized the virus. They were then able to construct look-alike antibodies in the lab—and now those antibodies can be injected into patients in a one-time treatment.

“We know that some people make incredibly good antibodies to fight the virus, and we’ve been able to copy those antibodies,” Dr. Wohl says.

The antibodies aren’t taken from one person and put in another, like a transfusion. They’re produced in a lab and then given one time as an infusion through an IV to someone who has COVID-19. Studies have also shown that monoclonal antibodies can protect people exposed to COVID-19, such as from an infected household member.

For people with COVID-19, the antibodies get into the circulation before the body can make its own antibodies, which gives a kick-start in fighting the virus. For those exposed but not yet infected, antibodies can be a line of defense that prevents the virus from gaining a foothold in the body.

2. Anyone with COVID-19 at higher risk for progressing to severe disease is eligible for monoclonal antibody treatment.

To receive monoclonal antibodies for treatment, you must have a positive test for COVID-19, have symptoms of COVID-19, and be within 10 days of when your symptoms began.

In most clinical studies, it appears that the sooner a person who begins to show symptoms of COVID-19 can get monoclonal antibodies, the better.

“The value of this may be in the very early days before our body has a chance to make a response, which can take as long as 10 days to two weeks, so if we can jump-start the process, we can start fighting the virus early,” Dr. Wohl says.

In addition, to be eligible to receive monoclonal antibodies you cannot be hospitalized for COVID-19. You also must be age 12 or older and have a higher risk for severe COVID-19 infection due to any of the following:

• Age 65 years or older
• Overweight or obese (may include a body mass index of 25 or greater for adults or the 85th percentile or greater for children)
• Pregnancy
• Diabetes (type 1 or type 2)
• Chronic kidney disease
• Immunosuppressive disease or medication that suppresses the immune system
• Cardiovascular disease (including congenital heart disease) or hypertension (high blood pressure)
• Chronic lung disease such as chronic obstructive pulmonary disease (COPD), moderate to severe asthma, cystic fibrosis or pulmonary hypertension
• Sickle cell disease
• Neurodevelopmental disorders such as cerebral palsy
• Medical-related technological dependence (tracheostomy, gastrostomy or ventilation not related to COVID-19)

“The FDA has authorized use of monoclonal antibodies in a pretty broad swath of the population,” Dr. Wohl says.

3. If you have been diagnosed with COVID-19, people in your household may be eligible to receive monoclonal antibodies to prevent infection.

For those exposed to COVID-19 such as by a household member, the criteria for getting a monoclonal antibody treatment include being at higher risk for severe COVID-19, as listed above, plus either not having been fully vaccinated against COVID-19 or having a condition, such as a weakened immune system, that reduces response to the vaccine. Also, the exposure must have been within the previous four days.

“It is a best-kept secret that monoclonal antibodies can be given to people in the same household as a person with COVID-19 to reduce their chance of becoming infected or getting sick,” Dr. Wohl says. “If they do get COVID-19 and have received this treatment, it can actually lower the amount of virus they have and abbreviate their COVID-19 course.”

This is called post-exposure prophylaxis, or PEP, and it’s something that’s used in other diseases such as the flu, hepatitis B and HIV when people are exposed to a virus and receive treatment to prevent them from getting sick or infected.

4. Monoclonal antibodies are not a substitute for a COVID-19 vaccine.

While monoclonal antibodies offer hope to patients at high risk for COVID-19 if they get the virus, a COVID-19 vaccine still offers better protection against hospitalization or death.

Skipping the vaccine because monoclonal antibodies might be available “would be a very foolhardy way to approach this. That would be like saying, ‘I’m not going to use smoke alarms because I have a fire extinguisher,’” Dr. Wohl says. “Forty-six percent of all of the global population has now received at least one dose of a COVID-19 vaccine. When half of humanity has now received the vaccine, I don’t understand how one cannot say the safety of the vaccines is incredible.”

Visit unchealthcare.org/vaccine for the latest information on the COVID-19 vaccines.