Infections after vaccination
Of some 4100 healthcare workers at an Israeli hospital who received their first dose of the Pfizer-BioNTech vaccine, 0.54% were diagnosed with SARS-CoV-2 infection 1-10 days after vaccination, researchers report in Emerging Infectious Diseases. Roughly two thirds had COVID-19 symptoms, such as fever, chills, cough, headache, myalgia, and sore throat. Half the cases noted community-related exposures, including four with exposures before or on the day of vaccination. The researchers advise, “Clinicians should not dismiss postvaccination symptoms as vaccine-related and should promptly test for COVID-19.”
https://wwwnc.cdc.gov/eid/article/27/4/21-0016_article
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Emerging Infectious Diseases article on post-vaccination infections (Free) MMWR article on vaccinations across the U.S. (Free) MMWR article on vaccinations in skilled nursing facilities (Free) NEJM COVID-19 Vaccine Resource Center (Free) NEJM Journal Watch COVID-19 page (Free)
Stimulants’ Mortality Rate Tripled Over the Past Decade By Joe Elia Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
Stimulant-associated deaths, although fewer in number than opioid-related deaths, seem on a steep upward climb, according to a JAMA Internal Medicine research letter. Researchers examined data from a federal database that compiles deaths involving drugs. The data include some 1.2 million records with drugs mentioned as a causal factor on death certificates between 2010 and 2017. Roughly 11% named stimulants — primarily the illicit stimulants cocaine and methamphetamine. Mortality rates involving stimulants rose from about 3 per 100,000 population to 10 per 100,000 during the period studied. In light of this increase, the authors express concern that “there are currently no medications approved to treat stimulant use disorder nor a reversal agent for stimulant-induced overdose.” JAMA Internal Medicine research letter (Subscription required) Background: Physician’s First Watch coverage of 2019 MMWR article on rise in stimulant deaths (Free)
By the Editors
Here are today’s top picks from NEJM Group: NEJM Resident 360: Curbside Consults: Sodium–glucose cotransporter 2 (SGLT2) inhibitors are known to improve cardiovascular and renal outcomes in patients with type 2 diabetes. Until recently, less was known about their effects on heart failure. In this episode of Curbside Consults, Dr. John McMurray, Professor of Cardiology and the lead investigator of the DAPA-HF trial, discusses the benefits of SGLT2 inhibitors in patients with heart failure. NEJM Journal Watch: Guideline Watch: An evidence-based guideline offers practical recommendations for managing von Willebrand disease. NEJM CareerCenter:
NEJM Resident 360 Curbside Consults (running time, 20 min.) (Free) NEJM Journal Watch Guideline Watch (Free) NEJM CareerCenter gastroenterology listing (Free) NEJM CareerCenter nephrology listing (Free)
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