New booster guidelines for adults over 50

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Hello again, dear readers, and welcome back to the monthly letters column. Virus-related mail, which once required a column of its own, has slowed down. That means we can once again fold those questions in with the general letters. Speaking of which ...

-- Recommendations regarding COVID-19 booster shots have caused some confusion, including for a reader from North Carolina. “Do you know if a second booster will be available soon for elderly persons with no severe autoimmune problems?” she asked. “I had the first booster more than five months ago.” You are indeed eligible for a second booster. As of March 29, the CDC recommends a second booster for adults over the age of 50 whose previous booster was four or more months ago.

In addition, all adults who had the Johnson & Johnson vaccine and first booster are eligible for a second booster using an mRNA COVID-19 vaccine. Again, the timing is four or more months after the most recent shot.

-- On the topic of supplements to deliver omega-3 fatty acids, a reader wondered about dosage. “I’ve been a vegetarian for 40 years and use flaxseed oil to supplement my intake of omega-3 fatty acids,” they wrote. “The FDA recommends a maximum of 3 grams per day, but my flaxseed oil has 8 grams per serving. Is that too much?”

For adults 51 and older, the recommended daily intake of omega-3 fatty acids is 1.1 grams for women and 1.6 grams for men. The reason for the cap of 3 grams per day is that when taken in high doses, omega-3 supplements can cause blood thinning, lead to excessive bleeding and interact with prescription drugs that affect blood clotting. Unless your doctor has recommended the dosage you are now taking, it’s a good idea to find a product that meets the recommended guidelines.

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Elizabeth Ko, MD and Eve Glazier, MD

-- We heard from a reader whose prescription medications frequently change shape and color, which led to a dangerous mix-up. “I recently had a scary episode after mistakenly taking two doses of one blood pressure drug instead of one each of two different drugs, and it made me quite ill,” they wrote. “In the 15 years I have taken these drugs, they have come in five different colors and four different shapes. Does the FDA pay attention to the risks of color and shape changes?”

While the FDA oversees the contents of medications, the shapes and colors are chosen by each manufacturer. And due to patent laws, manufacturers of generic versions of brand-name drugs are not allowed to copy appearance of the originals. Because pharmacies sometimes change suppliers, the same generic medication from a new manufacturer can suddenly come in a different color or shape. This can be confusing and, as happened to you, even dangerous. While it’s not a perfect answer, some patients find using pill organizers can make things less complicated.

As always, thank you to everyone who took the time to write. Our mailboxes are overflowing, so we’ll be adding a bonus letters column in the next few weeks.

To learn more about the vaccines and for the latest information visit UCLA Health's COVID-19 Vaccine Info Hub.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)