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Diagnosis: Megaloblastic anemia due to B12 deficiency neurologic symptoms ( vibration = dorsal column) clinch B12 over folate Treatment: IM cyanocobalamin 1000 g not folate alone Teaching point: Neurologic findings + megaloblastic anemia = B12 until proven otherwise Vignette 2 Folate deficiency in an alcoholic Stem: A 55-year-old man with heavy alcohol use (34 drinks/day for years) presents with fatigue

Philadelphia-area pediatricians and family medicine providers say new federal policies for COVID-19 vaccines are leaving some of their patients confused about their future eligibility and insurance coverage for the shots

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