Background: Large clinical trials have demonstrated the overall safety of vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, reports have emerged of autoimmune phenomena, including vaccineassociated myocarditis, immune thrombocytopenia, and immune thrombotic thrombocytopenia.Case Presentation: Here we present a novel case of a young woman who developed life-threatening autoimmune hemolytic anemia (AIHA) after her first dose of a SARS-CoV-2 mRNA vaccine. Notably, initial direct antiglobulin testing was negative using standard anti-IgG reagents, which are "blind" to certain immunoglobulin (IgG) isotypes. Further testing using an antiglobulin reagent that detects all IgG isotypes was strongly positive and confirmed the diagnosis of AIHA. The patient required transfusion with 13 units of red blood cells, as well as treatment with corticosteroids, rituximab, mycophenolate mofetil, and immune globulin. Conclusion:As efforts to administer SARS-CoV-2 vaccines continue globally, clinicians must be aware of potential autoimmune sequelae of these therapies.

Community health workers (CHW) are often trained through a series of initial classes followed by continuing education opportunities. While this classic structure is invaluable for ensuring that the CHW has access to the right knowledge so that they can develop the right skills and attitudes to do their job, this chapter argues that this is insufficient. An equally as important and influential determinant of how the CHW will work will be the quality of the job and the quality of the health system to which they contribute. This is part of the ‘hidden curriculum’, and it is too often underappreciated when planning to train CHWs. CHWs are often seen as a cheaper solution to help meet the human resources for health crisis, but this chapter argues that if they are only given medical tasks, and if their role is medicalized to the point of removing them from how their communities function, then health systems will lose access to important opportunities to improve quality and healthcare outcomes.

A. Baseline characteristics, type of surgery and indications for video capsule endoscopy in patients with normal anatomy and surgically altered gastrointestinal anatomy (SAGIA) Variable Group SAGA Normal anatomy P value Hypothyroidism. (%) 18 (23.4) 23 16.5) 0.277 Scleroderma. (%) 3 (3.9) 1 (0.7) 0.131 Diabetes (%) 26 (33.8) 60 (43.2) 0.194 Parkinsonism. (%) 0 (0.0) 4 (2.9) 0.299 Indications for VCE Abdominal pain (%) 9 (11.7) 3 (2.2) 0.009 Concern for IBD (%) 2 (2.6) 1 (0.7) 0.29 Iron deficiency anemia (%) 23 (29.9) 33 (23.7) 0.335

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