JAMA Clinical Reviews

Tom Shimabukuro, MD, MPH, MBA, is the Deputy Director of the Immunization Safety Office at the CDC, specializing in vaccine safety. He discusses the rare allergic reactions linked to the Pfizer-BioNTech vaccine, emphasizing the low incidence of anaphylaxis and reassuring those with allergies about vaccine safety. Shimabukuro breaks down the protocols for managing anaphylaxis and the rigorous testing that underpins mRNA vaccines. He addresses public concerns while underscoring the importance of vaccines for healthcare workers and patients.

Patent foramen ovale (PFO) is an often overlooked cause of acute ischemic stroke. JAMA Associate Editor Jeffrey Saver, MD, professor of neurology at UCLA, discusses new recommendations from a 2020 AAN Practice Advisory about use of mechanical PFO closure and anticoagulant vs antiplatelet therapy to prevent subsequent strokes in patients with a PFO and an initial event. Related Article: Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA

New therapies have greatly improved outcomes for patients with Crohn disease. Peter Higgins, MD, from the University of Michigan, discusses advances in management and treatment protocols. Related Article: Management of Crohn Disease

Adam Lauring, MD, PhD, from the University of Michigan Division of Infectious Diseases, an expert on the evolutionary biology of RNA viruses, explains the new genetic variants recently found in SARS-CoV-2 and their importance. Related Article(s): Genetic Variants of SARS-CoV-2—What Do They Mean?

Elderly persons and residents of nursing homes have been the hardest hit in the COVID-19 pandemic. Harvard geriatrician Sharon Inouye, MD, discusses the effect COVID-19 has had on nursing homes and what should be done about it. Related Article: Association of Nursing Home Ratings on Health Inspections, Quality of Care, and Nurse Staffing With COVID-19 Cases

Homeless patients with chronic medical conditions who need long-term care often repeatedly present to emergency departments to receive treatment. Following a performance improvement analysis, clinicians at UCSF developed an emergency department–based team who work with the community to provide care for this challenging population. Hemal Kanzaria, MD, and Jack Chase, MD, discuss how UCSF has addressed this clinical problem. Related Article(s): Caring for Emergency Department Patients With Complex Medical, Behavioral Health, and Social Needs

JAMA Fishbein Fellow Kristin Walter, MD, interviews Craig Garfield, MD and Richard Weissbourd, EdD, about parental relationships during the COVID-19 pandemic. Related Article(s): Considerations for Young Children and Those With Special Needs as COVID-19 Continues

Lockdowns resulting from COVID-19 have had a devastating effect on everyone's personal lives and the economy. What factors in people's daily lives are most associated with SARS-CoV-2 transmission between people? Manish Patel, MD, team lead of the CDC's Influenza Prevention & Control Team, discusses a study they conducted examining what sorts of activities might be associated with COVID-19 disease transmission. Related Article(s): Community Outbreak Investigation of SARS-CoV-2 Transmission Among Bus Riders in Eastern China

It is well known that alcohol use severely affects driving ability, but does cannabis? There are many fewer traffic crashes related to cannabis than alcohol intoxication. Johannes Ramaekers, PhD, of the University of Maastricht in the Netherlands, discusses his study examining the relationship between vaping THC and driving safety. Related Articles: Effect of Cannabidiol and Δ-Tetrahydrocannabinol on Driving Performance Driving Under the Influence of CBD or THC—Is There a Difference?

Closing businesses during the COVID-19 pandemic has had devastating consequences for individuals and the economy in general. Proper air handling combined with the use of masks and physical distancing can greatly improve the safety of indoor spaces. Joseph Allen, DSc, MPH, assistant professor of exposure assessment science at Harvard T.H. Chan School of Public Health, and Andrew Ibrahim, MD, assistant professor of surgery and architecture and urban planning at the University of Michigan, discuss air conditioning standards that can substantially reduce the risk of disease transmission in indoor spaces. Related Article(s): Turbulent Gas Clouds and Respiratory Pathogen Emissions