NEJM 4.14.2022 第四針新冠疫苗和MDS病例

NEJM 4/14/2022
1. Fourth Dose of BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting

Facts: 
1/2022-2/2022 Israel data, 60+, 4m after 3rd dose ->4th dose
182K paired analysis, 55% protection against symptomatic infection, 74% protection against death
The 4th dose is effective, in the context of omicron variant

Take-home:
60+ for sure should consider. 

2. Case 11-2022: An 80-Year-Old Woman with Pancytopenia
This is a MDS case. BM should be done on the 2nd day of consultation, EB-2. Haptoglobin was never low, so no hemolysis, I don't understand why they were treating as TTP. Schistocytes can be seen in MDS. 

3. The Tobacco Wars’ Lessons for the Vaccination Wars
吸煙的男人的不吸煙的太太，壽命低於那些家裏都不吸煙的女生。吸煙害己，害人。 接種疫苗和禁煙有類似之處。