DEAR DR. ROACH: I am an 80-year-old healthy woman (who is 5 feet, 3 inches tall and weighs 118 pounds). I have no underlying health issues except slightly high blood pressure. I have had all the COVID vaccines that have been offered. I did have a slight case of COVID in 2022.

I received the 2024-25 COVID vaccine on Aug. 1. Then they came up with an updated version for 2025-26. I would need to wait two months to get another vaccination. Is it worth getting the updated version to protect me this coming winter, or would this be “overkill”? — C.R.

ANSWER: The 2024-25 vaccine has activity against the variants of the COVID vaccine that are circulating now, so you did get some benefit from the vaccine. The 2025-26 vaccines are intended to provide better protection against the strains that are expected to circulate in the near future.

At age 80, you are at an increased risk from COVID-19, but the fact that you have had all the vaccines, including the most recent one in August, does mean that you have protection from severe COVID. If you had an immune system disease, chronic heart/lung disease, or other conditions, I would definitely advise that you get the new vaccine.

The downside of getting the new vaccine as soon as possible is a sore arm and maybe foregoing additional protection in early 2026. You could get it now or in a few months if the amount of the virus is high in your community.

DEAR DR. ROACH: What do you think of the Sinclair Method for dealing with an alcoholic? — M.D.

ANSWER: Naltrexone is approved for the treatment of alcohol use disorder under the Food and Drug Administration. (The terms “alcoholic” and “alcoholism” aren’t used in a medical sense anymore. They seem to be judgmental and downplay the fact that this condition can be successfully treated).

The Sinclair Method uses naltrexone, a medication that is often used for the treatment of opioid use disorder, to reduce the enjoyment people get with consuming alcohol, which makes for less cravings and more control over drinking. A major advantage of this method, which is used by many programs, is that it does not require total abstinence.

This can be beneficial for some people who feel awkward in social situations where drinking is considered normal. The treatment only works as long as people are using naltrexone. In the Sinclair Method, naltrexone is not necessarily given every day, only when a person is going into a situation where they will be drinking. This can be especially helpful in a person who intends to have one drink but ends up drinking more than they want to, especially when they “binge” (4 or more drinks for a woman, 5 or more for a man).

Naltrexone can be given every day by mouth or as an injection every four weeks. Although most people have few side effects, some side effects and liver problems can occur, so monitoring blood tests periodically is recommended when people are using naltrexone daily.

Naltrexone cannot be given to people who are being treated with opiates for pain as it will make the opiates ineffective. Naltrexone is also given to people with opioid use disorder for the very same reason it is used for alcohol: to reduce the pleasure “reward” from using it. It has been used in other situations as well, such as gambling and overeating.

In my opinion, medication therapy is underused for people with moderate or severe alcohol use disorder. The long-term consequences of continued heavy drinking are immense for a person’s physical and mental health, their social and family life, and employment. Naltrexone is one of several medications that are effective at helping people reduce or stop excess alcohol use.

Many regular doctors are comfortable prescribing medication treatment for alcohol use disorder, but an addiction specialist is the expert in this case.

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. (c) 2025 North America Syndicate Inc. All Rights Reserved