DEAR DR. ROACH: I have a vaccine-related question for you that also might be of general interest. My sister and I are planning to go see my father on his birthday in Michigan. We have been vaccinated, and my father and his wife have been vaccinated. However, he’s about to be 94. My assumption is that if he were to get COVID-19, he would not survive. In addition, Michigan is in bad shape. Right now, it’s among the worst in the country in cases per day. Is there evidence that people who are vaccinated can transmit the virus, that their immune systems fight it off but they could pass it along to someone else? — W.A.

ANSWER: The most recent evidence is that vaccination dramatically reduces the risk of having asymptomatic COVID-19 as well as symptomatic COVID-19 infections. If you and your sister are vaccinated, and your father and his wife are as well, the risk to your father is very low. The most recent guidance from the Centers for Disease Control and Prevention would allow you to go and see them without the need to wear masks.

I do understand that he is at increased risk should he come down with COVID-19. I have had several patients in their 90s do very well with COVID-19 infection, despite my fears, so your assumption of a bad outcome for your father isn’t completely justified.

The fact that you all have been vaccinated means you can get together with little fear of infection. There is always a small risk — neither vaccines nor masks can reduce the risk to zero. You never know how many birthday celebrations you might be able to share, and there is certainly benefit in going to go visit.

DEAR DR. ROACH: About 10 years ago, I was diagnosed with benign frontal lobe epilepsy. My only symptom is that about once every four months, I get chills in the middle of the night. I have never met another person with this issue. Have you ever heard of this? — B.S.

ANSWER: Epilepsy, a condition of recurrent seizures, is an extraordinarily broad group of neurological conditions ranging dramatically in severity and symptoms. Epilepsy can be characterized many ways. First, by where in the brain the abnormal electrical signals begin; in your case, it is the frontal lobe. Seizures can be generalized, meaning people immediately lose consciousness, or focal, meaning people are aware of the onset of the seizure. Finally, we look at the seizure activity for abnormal movements versus no abnormal movements.

People with frontal lobe seizures usually have symptoms related to movement; however, a sensation of chills is occasionally heard in talking to people with a history of frontal lobe and temporal lobe epilepsy. It would take an EEG during an episode to be 100% sure that this is your epilepsy causing the symptom, and if you only get this symptom every four months, it would be hard to catch. Sometimes, neurologists provoke a seizure — through sleep deprivation, flashing lights, or other means — to catch it during the EEG, but I’m not sure this would be necessary in your case.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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