The Role of Respiratory vaccines as part of your healthcare strategy

The Role of Respiratory vaccines as part of your healthcare strategy.  FAQ’s    

Our role as healthcare providers is to educate our patients regarding their health care.  As a pulmonologist I am a strong advocate for vaccination as a cornerstone of treatment to help prevent respiratory illness.  It is always easier to prevent disease, then to treat it.  We as a practice, also recognize that the decision to receive vaccination is personal and we respect that decision.

Why are vaccines so important?

Simply put, vaccines have saved more lives than any medical intervention in history.  COVID aside, the best examples of this include smallpox, polio, meningitis, measles, mumps and rubella.  These diseases carried high mortality rates and have basically been eradicated due to vaccines.


 If I am healthy, why should I get a flu vaccine?

The flu shot reduces the likelihood of serious symptoms from the flu by about 50 to 60% but does not mean you cannot get the flu. In children, 80% of children who died from the flu did not get the flu vaccine. The number of deaths each year from the flu varies.  In 2011/12 about 12,000 people died from the flu, but in 2017/18 it is estimated 52,000 people died

The flu also is associated with comorbidities.  The risk of having a heart attack in patients with underlying heart disease is increased by 600% within the first week of the flu.  There is also a significant increased risk of having a stroke.  This risk is significantly reduced by getting a flu vaccine.

Can I get the flu from the vaccine?



How many lives were saved by the Covid vaccines?

In the U.S. it is estimated 3.2 million lives were saved, globally estimates range from 14-19 million. It is estimated hospitalizations in the U.S. were reduced by 18 million. 

With the milder omicron variants now circulating should I still get a Covid booster?

Yes.  Hospitalization rates are relatively high 13,000 (Oct 19, 2023). 240,000 people died from Covid in 2022. 62% of these patients were over age 65.  The main benefit for most of us however is preventing complications from COVID illness.  Complications can include stroke, myocardial infarction, atrial fibrillation, pneumonia, and long COVID.  The vaccine helps prevent complications, long COVID symptoms, and severity of long COVID symptoms.

How long should I wait since my last booster to get the new Omicron booster?

A minimum of 2 months

Have we achieved herd immunity from Covid?

No!  It generally takes about 10 years to achieve herd immunity from a novel virus like Covid.  Vaccines have certainly accelerated this process.  During the polio epidemic 80% of the population had to be immunized to achieve herd immunity.  However, because of the multiple mutations that occur with COVID at such a rapid pace it is unclear if we will ever achieve true herd immunity.

Can the Covid shot affect my DNA?



 What is RSV?

RSV is a respiratory virus that tends to affect children up to age 5 as well as adults over age 65.  Particularly vulnerable are infants up to 1 year, children with underlying lung disease, and adults who have underlying respiratory disease, cardiac conditions, or weakened immune systems.  Nursing home patients are particularly vulnerable.  It tends to cause pneumonia, bronchitis, and asthma-like symptoms with mucous plugging and wheezing.  RSV is a leading cause of hospitalization in infants.

Who should get the RSV vaccine?

Adults over age 60 are eligible, but particularly those at risk should be immunized.  The best way to immunize infants is for pregnant women to be immunized between weeks 32 and 36 of pregnancy.  In the future, those who are exposed to infants may be recommended to have the vaccine much as we do today with pertussis but this is not a current recommendation.

Which RSV vaccine should I get?

Currently there are 3 options.  The GSK vaccine is a more traditional vaccine.  Pfizer and Moderna have both received FDA approval for their messenger RNA versions of the vaccine as well.  They currently are not as available.

Is a booster going to be recommended?

At this time this is unknown.  These clinical trials are ongoing.

Pneumococcal Vaccine

Who should get this vaccine?

This vaccine protects against the most common form of bacterial infections of the respiratory tract which can include the lungs, sinuses, and inner ear.  Over the years there have been different variants of this vaccine.  The first was the Prevnar 13, then the Prevnar 15, and now the Prevnar 20 vaccine.  Initially it was recommended you get a Prevnar 13 and then a year later the old pneumococcal vaccine which was the PPSV23 vaccine.  Current recommendations are for only the Prevnar 20 vaccine.  It is indicated for people over age 65, or people with chronic respiratory conditions or immunosuppression that predispose them to pneumonia or chronic sinus infections.  There is no downside to getting a newer version of the vaccine if you have had a previous version.

Richard Bernstein M.D. F.C.C.P.

Pulmonary Medicine

Medical Director Privia Clinical Research Mid-Atlantic                                         10/30/2023 RAB


*The main contraindication to vaccination, is a history of anaphylaxis or severe allergic reaction to vaccines or its components.  If you have a history of this please discuss with your physician prior to receiving vaccination.

Patient Forms

Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.


Stay Connected with Dr. Bernstein

Subscribing to our Social Media Networks is a great way to become more educated about health topics of interest to you! Join today and begin receiving updates from our practice, useful tips for healthy living and much more!

Dr. Bernstein’s Blog

Follow Dr. B on Twitter

Become a fan of our Facebook Page

Dr. Bernstein’s YouTube Channel

External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

The 8 Week Challenge

The 8 Week Lifestyle Challenge

Welcome to our eight-week lifestyle challenge! The goal here is for you to start making positive lifestyle changes in your life which you can continue to do over a lifetime. This is not a traditional weight loss or exercise program. This challenge involves doing simple things each week to benefit your physical and emotional health.

In order to be successful here are a few basic guidelines you should follow as part of this challenge:

  1. If you drink alcohol, you should try to cut back to an average of no more than one drink per day and no more than 3 drinks on any day.
  2. Try and prepare as many meals at home as possible. It is very hard to eat healthy if you don’t cook, prep and plan ahead.
  3. Find a partner who is positive and work with them. You can coach each other and support each other.
  4. If you smoke, cut back and eventually, quit smoking altogether.

Here’s how the challenge works–each week, there will be 3 new challenges presented to you: a healthy eating challenge, an exercise challenge and an emotional challenge. Some of these challenges will seem easy to some and difficult to others. Doing any of them will improve your health in some way. The goal is to complete all 3 challenges during the given week. Some examples of possible challenges: (Exercise Challenge) Walk for 15 Minutes, 3 times this week. (Emotional Challenge) Make a list of five things that you like best about yourself. (Healthy Eating Challenge) Prepare a dish using lentils for one of your meals.

Below you will find some hints and strategies for being successful during the 8 Week Lifestyle Challenge. Just like preparing for a test in school, in order to succeed, you have to prepare. Taking a few simple steps in advance of Day 1 of the Challenge will allow you to be more successful. The best thing to do is make your home a safe and encouraging environment.That means out with the bad and in with the good! Here are a few suggestions:

Get rid of:

  • All breakfast cereals with greater than 5 grams of sugar per serving
  • Salad dressings that include sugar, soybean or canola oils as an ingredient
  • Chips, cookies, pretzels and most snack foods
  • Corn and other vegetable oils
  • Soda and Juices

Below is a suggested shopping list:

Low glycemic vegetables: These should be the mainstay of your diet. We recommend six servings per day.  A serving size is half a cup.  A half cup serving has approximately 10 to 25 calories. Examples of low glycemic vegetables include: artichokes, asparagus, bamboo shoots, brussels sprouts, bell peppers, broccoli, broccolini, bean sprouts, cabbage, cauliflower, celery, chives, onions, cucumber, pickles, eggplant, green beans, bok choy, chard, collard greens, spinach, mustard greens, kale, beet greens, lettuce, romaine lettuce, green leaf lettuce, spinach, arugula, watercress, mushrooms, okra, radishes, kelp, snow peas snap peas, sprouts, tomatoes, vegetable juice, water chestnuts, zucchini and summer squash.

Medium glycemic vegetables: These include vegetables like white potatoes, sweet potatoes, beets, carrots, winter squash and corn. Serving sizes need to be small as these vegetables have a relatively high glycemic index. We recommend no more than one small serving per day. The serving size is approximately half a cup or ½ of a medium-sized baked sweet potato.  As a general rule, I recommend avoiding corn and white potatoes. Corn has an extremely high glycemic index, and corn oil is an Omega 6 food which contributes to an unhealthy ratio of fatty acids in our body. If you want to get really fat, eat corn, potatoes, drink beer and go to sleep.

Fruit: Two to three servings per day. Each serving of fruit has approximately 80 calories. Examples include a medium apple, three medium apricots, a half cup of blackberries and blueberries, 1 1/2 cups of raspberries and strawberries, 1/2 small cantaloupe, 15 cherries, one whole grapefruit, 15 grapes, one quarter of a small honey dew melon, one half of a mango, two small nectarines, one orange, two small peaches, one slice of cantaloupe, two small tangerines. Avoid high glycemic fruits such as pineapple, bananas, raisins, and dates. Eating fruit helps satisfy our sweet tooth, provides fiber, vitamins and minerals and prevents us from indulging in the foods we should not indulge in.

Proteins and Legumes: Ideally, I recommend three servings of protein, and two servings of legumes a day. Legumes contain some protein and are more positively associated with longevity than more traditional protein sources. A serving size of protein is approximately three ounces which is the size of the palm of your hand. Legumes such as beans, kidney beans, black beans, peas, and lentils have a serving size of approximately a half cup.  Other sources of protein include 3 ounces of fish, 3 ounces of poultry, 3 oz of lean cuts of beef, 3 oz of baked tofu, organic soy burgers, two eggs and three quarters of a cup of cottage cheese. A serving size of legumes will equal approximately 110 calories and a serving size of protein will equal approximately 150 calories. Low/no sugar, protein shakes (rice protein, whey protein or organic soy protein) are an excellent alternative if you travel frequently and need a substitute. Try and focus on fish and legumes as your main sources of protein.

Nuts and Seeds: These are a great source of protein, but they are also very high in calories. I find that this is where a lot of people get into trouble. They eat nuts because they enjoy them and like the fact that they are a low glycemic food. However, nuts are extremely high in calories so be aware of what a serving size of nuts is and enjoy nuts accordingly.  A serving of nuts includes: 10 to 12 whole almonds, 7 to 8 walnuts or pecans, eight peanuts, two tablespoons of sunflower seeds, pumpkin seeds or sesame seeds, one tablespoon of nut butter. We recommend 1 serving of nuts or seeds a day, or you can substitute one nut serving for a legume serving.

Grains: One serving equals 75-100 calories. I recommend 1-3 servings a day, the goal being 1 or 2 versus 3. Good grain choices include: a 1/2 cup cooked, brown rice, amaranth, quinoa, buck wheat, millet or bulgur wheat, 3/4 cup cooked oatmeal, one slice of whole wheat bread, 1/3 whole wheat tortilla.

Dairy:  I have reservations about recommending dairy because of some literature that suggests that casein, a dairy protein, may be atherogenic (contributes to heart disease). If you must consume dairy, my recommendation is one to three servings per week.  Keep in mind that many people are lactose intolerant and don’t realize it.  We have a number of patients in our practice whose muscle aches and/or allergies become better when they stop consuming dairy. One serving of dairy has 80-100 calories. Examples include: 8 oz of low fat organic yogurt, 1 cup of organic milk. Choosing dairy alternatives like organic soy milk and organic almond milk are wise choices.

Beverages: water, flavored water, seltzer water (if no reflux issues), decaffeinated coffee, decaffeinated tea, herbal tea or green tea. Alcohol in moderation (approximate 150 calories per drink). Red wine is the best choice; beer and whiskey are the worst choices.

Fats & Oils: I recommend four teaspoons per day. Good sources: olive oil (cold pressed virgin), safflower oil mayonnaise and organic butter in limited amounts. I am also including 1/4 of an avocado in this list as it is primarily a fat. Olive oil is always the preferred oil. Canola oil and soybean oil would be okay if they were certified organic but the fact that non-organic canola and soybean oils are genetically modified causes me to not recommend them. Using a little ghee, if made using organic butter, is okay too.

Herbs and Condiments: Recommended: mustard and soy sauce, lime, lemon, vanilla and almond extracts, cinnamon, ginger, basil, oregano, sage, rosemary, cumin, turmeric, garlic and curry.

Sweets and Sweeteners: I recommend eating fresh fruit if you need to satisfy a craving for sweets. As for sweeteners, I am not a big fan of Stevia and other sugar substitutes because their sweetness still helps maintain the sugar addiction, regardless if the source is sugar or not.

We will also be providing recipes on our Facebook Page and Blog that incorporate these approved ingredients as part of the 8 Week Lifestyle Challenge. Happy Grocery Shopping! Here’s to your good health!

~ Dr. Bernstein

Week One Challenges

Healthy Eating Challenge:
Cut Back Sugar
Eliminate table sugar and artificial sweeteners from your diet.
Do not consume any food with more than 4 grams of sugar in a serving.
Enjoy a low glycemic fruit when a sugar craving hits.

Exercise Challenge: Exercise for 10 minutes a day

Emotional Challenge: Write down 5 things that you are grateful for. Post the list in a place where you can see it or keep the list in your wallet for days when you need a pick me up.

Week Two Challenges

For Week Two, continue our recommendations on sugar (consume only foods with 4 grams of sugar or less, do not use table sugar or artificial sweeteners). If you need a reminder about the negative effects of consuming sugar, watch my video here.

Healthy Eating Challenge: Consume 3 Servings of Vegetables a Day. Corn, potatoes and V8 juice do not count. Remember – a serving of vegetables is only a 1/2 cup, so consuming 3 servings is not that difficult. Eating one salad a day could easily complete this part of the challenge but try to vary the vegetables you are consuming to obtain the greatest nutritional benefits.

Exercise Challenge: Increase the amount of exercise you are doing a day to 15 – 20 minutes. Keep in mind that this does not have to be accomplished in one session. You can break up your exercise time, completing say 10 minutes in the morning and 10 minutes in the evening, or whatever works best for your schedule. If you are thinking of doing any form of strenuous exercise, please check with your doctor first.

Emotional Challenge: Incorporate 10 deep breathing exercises in the morning and evening. You will be amazed at what an impact this simple routine can have in reducing stress. You can view a video to guide you through this exercise here.

Week 3 Challenges

Healthy Eating Challenge: Eliminate corn products from your diet. Most corn available today is genetically modified which in of itself raises some concerns. An important note here – read your labels! Corn is in more processed foods than you think. I would also ask you to cut back on potato consumption to no more than once a week. Carbohydrates such as potatoes, corn, and sugars, which have rapid uptake, contribute to insulin resistance and obesity. I want you to continue to eat 3, 1/2 cup servings of vegetables a day.

Exercise Challenge: I simply want you to do something physical at lunchtime that involves getting out of the office or away from your desk. Ideas? Take a walk around your office building, climb some stairs, do some squats etc. Breaking up your work day by getting up from a sitting position and doing a little bit of exercise will really help you get in the habit of staying active.

Emotional Challenge: I want you to give a meaningful complement to someone you care about each day. In addition, I would like you to refrain from talking negatively about people. Maintaining a positive focus and staying in a positive state of mind will reinforce positive thoughts, and contribute to a state of well-being.

Week 4 Challenges

Healthy Eating Challenge: If you didn’t already do so as was recommended in our “Let’s Get Grocery Shopping” post, eliminate vegetable oil and corn oil from your diet. Use olive oil as your primary oil. Butter is ok, but in scant amounts.

Exercise Challenge: Start to make flexibility and stretching part of your daily routine while continuing to do 20 minutes of exercise each day. Enjoy this video link to learn three basic stretches.

Emotional Challenge: Do not watch any cable news this week (i.e. MSNBC, CNN etc.). Going forward, consider taking a cable news free week once every two months.

Week 5 Challenges

Healthy Eating Challenge: We are going to do two things this week. The first is to limit your intake of simple sugars. While we did ask you to cut out artificial sweeteners initially, the primary goal was to avoid sugar, thereby eliminating your cravings for its sweetness. Recent data suggests that simple sugars, which include fructose, lactose, and artificial sweeteners, particularly those used in chewing gum, all cause irritable bowel symptoms. So in addition to avoiding sugar, we are going to ask you to avoid fructose, lactose, and all artificial sweeteners. The second part of the Healthy Eating Challenge is to add a legume to your diet at least twice a week. Legumes include peas, lentils or beans.

Exercise Challenge: Increase your exercise to a total of 30 minutes a day. This can include walking, going to the gym, swimming, etc, but the total amount of exercise should be 30 minutes a day.

Emotional Challenge: Avoid talk radio and increase your deep breathing exercises to 3 times a day.

Week 6 Challenges

Healthy Eating Challenge: I want you simply to continue eating with the changes incorporated into this challenge from prior weeks. Most importantly, I want you to continue avoiding sugar, fructose, lactose, corn, etc. and continue consuming lots of vegetables.

Exercise Challenge: I would like you to pick one day a week that you will commit to 45 minutes of exercise. This can be a Monday or a Sunday – the actual day makes no difference. You can also break up the exercise, taking say a 15 minute walk in the morning and then working out at the gym or taking a yoga class for 30 minutes in the evening. One day a week – 45 minutes of exercise. Continue engaging in 30 minutes of exercise on all of the other days.

Emotional Challenge: Continue doing your deep breathing exercises 3 times a day. For those of you who are completing your deep breaths while in the car or otherwise actively engaged in an activity, I want you to make sure that at least one set of deep breaths is taking place in a quiet spot where you can close your eyes and be by yourself.

Week 7 Challenges

Being that it is Week 7, I have a little treat for you. There will only be ONE new challenge this week! I simply want you to increase your consumption of vegetables to 5 servings a day. Remember, a serving is only 1/2 cup. Also legumes, with the exception of peanuts, count as vegetables as well as protein servings. Click Here to see 10 Easy Ways to Eat More Vegetables Every Day.

Continue your current exercise program and deep breathing exercises to meet the Exercise and Emotional components this week.

The Final Week: Week 8 Challenges

Healthy Eating Challenge: Review the blog post, “Why How You Eat Matters”. Focus on eating more slowly, deliberately chewing your food and savoring each bite. You will find that taking the time to enjoy your meal will inevitably result in you consuming less overall. Also, continue to make vegetables and legumes the mainstays of your diet. Focus on whole foods and avoid processed foods.

Exercise Challenge: I want you to continue to make exercise a priority; exercising every day for at least 30 minutes and 1 day a week for 45 minutes. You may recall that in Week 4, we asked you to make flexibility and stretching part of your exercise routine. In the final week of this challenge, I would like you to incorporate a renewed focus on stretching and flexibility in your cool down routine. Lack of flexibility is the key reason why many of us develop injuries. Click Here to see a list of easy stretching and flexibility exercises. If you have a medical condition, you should always discuss any changes to your exercise regime with your physician. For those of you with prior injuries to your knees, shoulders, etc. it might be helpful to also consult a physical therapist to develop an exercise plan that is specifically tailored to your needs.

Emotional Challenge: I want you to start being “mindful”. Being mindful means staying in the moment. If you choose to go out for a walk, enjoy the walk. Think about the smell in the air, the color of the sky, the sound of a bird’s singing. Do not focus your mind on your to do list, the argument you had with your sister or how you are going to resolve issues at work. Take the time to be in the moment and find enjoyment in the simple act of putting one step in front of the other and taking it all in. The breathing exercises that we have given you will also be very helpful to you in trying to help you stay in the moment.

External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Office Policies

Office Policies

Arrival Time

We recommend arriving 30 minutes before your appointment to fill out new patient paperwork.

Prescription Refills

Please allow 24 hours for prescription refills.

Missed Appointments

  • Office appointment cancellations require 24 hours notice: If proper notice is not given a $50 missed appointment fee will be charged
  • Allergy testing cancellations require 48-hour notice: If proper notice is not given, a $100 missed appointment fee will be charged

Follow-up Visits and Lab Results

Follow up visits are an important part of the interaction between patient and physician. They facilitate communication, allow us to review labs and other diagnostic tests and give us the opportunity to make sure medications are being used properly. Regular follow-ups are the best way to ensure good quality care. Dr. Bernstein and his staff are committed to providing you the best quality care possible.

After an annual exam, Dr. Bernstein generally recommends a follow-up visit to review lab results. This gives us an opportunity to explain the lab results to our patients and make recommendations that can have an impact on preventing disease down the road. After lab tests are performed, you may receive a call to schedule a follow-up visit. This is not a reason to panic but usually, means that there are some minor abnormalities in the lab results that Dr. Bernstein would like to discuss with you. Generally, all lab results are received within two weeks. X-ray results are usually available within 48 hours.

Patient Education

Patient Education & Useful Links

The word ‘doctor’ was originally an agentive noun of the Latin verb docēre >[dɔˈkeːrɛ] ‘to teach’. 

We believe strongly that patient education is the cornerstone of medical care. As such, we provide a variety of educational tools for our patients.

Join the discussion on Facebook to receive updates from the practice. View educational videos on Dr. Bernstein’s YouTube Channel and through our Educational Video Slideshows. You can also join Twitter to follow Dr. B’s Tweets about topical items of interest and ways to live longer healthier lives.

A preventive medicine manual, written by Dr. Bernstein and entitled, May You Live a Long and Healthy Life: A Personal Guide to Optimal Health and Healthy Aging is available through our front office.

Asthma and Allergy Fact Sheet

Allergic Rhinitis

  • Allergic Rhinitis is the fifth most costly health condition in the United States. It trails only hypertension, heart disease, mental illness and arthritis.
  • Allergic Rhinitis affects 25% of the population
  • Symptoms of Allergic Rhinitis include a runny nose, itchy nose, sneezing, and nasal congestion
  • Allergic Rhinitis is associated with the following diseases: asthma, sinusitis, otitis media, and recurrent respiratory tract infections.
  • Allergic Rhinitis is associated with the following: decreased attention span and reaction times, decreased cognitive function, fatigue, impaired sleep, decreased productivity at work


  • 7.7% of the population is currently diagnosed with asthma
  • Over 12 million people have an asthma attack each year
  • Over 500,000 people are hospitalized annually due to asthma
  • Over 4,000 deaths a year is attributed to asthma
  • The keys to controlling asthma as identified by the NIH guidelines include: proper diagnosis, identification and treatment of environmental triggers, proper use of medication, patient education
  • Asthma is a disease of both airway inflammation and spasm of airways
  • Airway inflammation causes changes to the basement membrane of the airways which predispose the patient to further asthma attacks. These changes can be controlled with medication but never go away.

Useful Links

Internal Medicine:

Preventive Medicine:


Asthma and Allergy:

Smoking Cessation:

Aesthetic Services:

External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.