The emergency use authorization for multiple coronavirus disease 2019 (COVID-19) vaccines came at a pivotal time for the USA. In January 2021, the country exceeded 400,000 deaths from COVID-19. The USA aimed to quickly distribute and administer the Pfizer and Moderna vaccines, with bright prospects for an additional emergency use authorization for Johnson and Johnson/Janssen’s single-dose vaccine on the horizon. Part of the National Strategy for COVID-19 Response and Pandemic Preparedness was to “mount a safe, effective, comprehensive vaccination campaign” so the administration set a goal to have 100 million fully vaccinated citizens after the first 100 days in office. In order to fuel the rapid administration of vaccines, the Department of Health and Human Services was tasked to stand up new, federally supported Community Vaccination Centers across the country. The Federal Emergency Management Agency (FEMA) was the lead agency entrusted to expedite financial assistance, allocate federal equipment and supplies, and deploy federal personnel to states, tribes, territories, and other eligible applicants for vaccination efforts. Early in the process of staffing sites, FEMA recognized the need to bolster the efforts with active duty military personnel and asked for manning assistance from the Department of Defense. As a result, 222 U.S. Air Force personnel were tasked with supporting the FEMA COVID-19 vaccination operations at NRG stadium, Houston, Texas. This reflection aims to cover the lessons learned and provide meaningful insight for future mass medical operations.

Key Clinical MessageCongenital Methemoglobinemia is a rare neurologic condition which can mimic other diseases such as epilepsy syndromes and leukodystrophies. The responsible gene, CYB5R3, is not typically included on commonly order neurologic and epilepsy panels. We recommend that laboratories include this gene on these tests which often precede larger‐scale genetic studies.

Nocardia species are ubiquitous soil-borne organisms that most commonly cause invasive disease in patients with defective cell-mediated immunity. We report a case of recurrent Nocardia sepsis in a patient with sickle cell disease and chronic iron overload, who was undergoing high-dose infusions of deferoxamine through a central venous catheter.

Cancer is the leading cause of death by disease past infancy. In 2014, nearly 16,000 children and adolescents 0 to 19 years of age will be diagnosed with cancer in the United States. More than 80% of those children will survive at least 5 years after their diagnosis. Much of the increase in survival has been seen in children diagnosed with acute lymphoblastic leukemia (ALL). Once cancer treatment ends, the real battle begins. Getting back to school helps cancer patients return to normal. Part 1 is a brief review of the diagnosis, prognosis, and treatment of ALL in children and adolescents with an introduction to Philadelphia chromosome positive ALL and is written in language that makes it ideal for use in teaching school personnel and other parents about ALL. Part 2 is a reflection of Abby Furco's transition to school after being diagnosed with this type of leukemia at 4 1/2 years of age. The accommodations and strategies employed for this student are likely to be useful and adaptable to assist other families and school communities as they work with children entering school with physical challenges.

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