Coronavirus (1415) New evidence based advice from the International Primary Care Respiratory Group Q&A service

15 December, 2021

Dear colleagues

New evidence based advice for primary care from the IPCRG iQ&A service [ ] is now available. We encourage front line community care workers to join the IPCRG Sentinel Network [ ], to share your voice and experience of respiratory primary care needs.

Are new oral anti-COVID-19 drugs effective?

The oral antiviral agent molnupiravir has been approved for use in a number of countries to treat patients who are at the highest risk for hospitalisation. There are currently no other oral agents approved to treat COVID-19 patients in the community care setting (Siemeiniuk et al 2020). A number are currently under investigation including antiviral agents, oral steroids or prophylactic oral anticoagulants.

What should we advise people who have had a non-mRNA vaccine and who would like a different vaccine for their second dose?

Early data on mixing second doses suggest that mRNA vaccine following a non-mRNA vaccination approach may be effective and generates a robust antibody response. However, there is no indication whether it is more or less effective than a second dose with the same vaccine.

What is the risk and impact of myocarditis for young adults aged 16 to 18 years following a COVID vaccination?

Many countries have initiated vaccination programmes that include those aged 16-18 years.. An increased risk for myocarditis following vaccination with the Pfizer-BioNTech and Moderna mRNA-based vaccines have been reported. These events appear to be rare and are estimated to affect 70 boys aged 12 to 17 years out of 1 million vaccinations (CDC June 2021). This compares with a average rate of approximately 10 to 20 cases per 100,000 people per year in the US. COVID-19 illness is also associated with a higher rate of myocarditis following vaccination.

What are the distinguishing features of COVID-19 vs other respiratory illnesses?

COVID-19 illness is associated with a wide range of respiratory symptoms that are similar to those caused by other respiratory viruses, including influenza. Fever and dry cough and are the most common symptoms while new loss of smell or taste is one of the most important predictors of testing positive for COVID-19 and is a distinguishing symptom from other viral respiratory diseases.

Kind regards

Neil Fitch


Neil Fitch

Research Project Manager .

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The International Primary Care Respiratory Group is a clinically-led charity registered in Scotland working internationally (SC035056); company limited by guarantee (SC256268). IPCRG represents primary care on the WHO-GARD Planning Executive, is the Respiratory Special Interest Group of WONCA Europe and the Organisation in Collaborative Relations with WONCA World. Coordinator of Global Health Respiratory Network

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HIFA profile: Neil Fitch is Research Project Manager at the International Primary Care Respiratory Group, and is based in Belgium. Professional interests: Respiratory research, health and care; Project management; Dissemination; Information provision. Email: neil AT