The Food & Drug Administration (FDA) first granted Emergency Use Authorization to the Pfizer-BioNTech COVID-19 vaccine earlier this month, with Moderna’s COVID-19 vaccine shortly gaining the same authorization very shortly thereafter. There have been many questions asking how these two vaccines stack up against one another, but a huge question remains largely unanswered: how do they both stack up against the Invincibility Stars or Starmen from Super Mario Bros.?

TARGET POPULATION: Not medical students. An Invincibility Star is reserved only for Mario, maybe Luigi.

EFFICACY: The Pfizer and Modern COVID-19 vaccine were >90% effective at preventing symptomatic COVID-19, the former 7 days after the second dose and the latter 14 days after the second dose. An Invincibility Star is immediately effective at preventing not only symptomatic COVID-19 but also any attacks by Bowser’s henchmen.

DURATION OF PROTECTION: Unclear, but the hope is both Pfizer & Moderna vaccines will convey protection on the order of several months. Sadly, Invincibility Star convey protection only for a few seconds.

BACKGROUND MUSIC: The Invincibility Star is accompanied with a musical theme. The COVID-19 vaccines do not come with a musical theme, something which has drawn the ire of healthcare personnel and gamers alike.

SIDE EFFECTS: The most common side effects from the COVID-19 vaccines are pain at the injection site, headache, muscle pain, fatigue, hope, relief, and optimism. The most common side effect of the Invincibility Star is post-Invincibility Star depression.

PREGNANT OR LACTATING WOMEN: The Covid-19 vaccines or Invincibility Stars have not been studied in pregnant or lactating women.

STORAGE: The Pfizer vaccine must be kept at -94 Fahrenheit and used within 5 days of thawing. The Moderna vaccine must be kept at -4 Fahrenheit, and can be stored in the refrigerator for 30 days or room temperature for 12 hours. Starmen must be used before it exits the screen.

PURCHASE: Both the Pfizer and Moderna vaccines can be purchased from the companies directly; a minimum order of 100 and 975 doses, respectively. An Invincibility Star cannot be purchased; it must be found through sheer determination and luck after breaking lots and lots of bricks.

ATLANTA, GA – Commenting their status as backline healthcare workers, the Centers for Disease Control & Prevention (CDC) has recommended medical students get vaccinated against COVID-19, but only after the general population, cacti, several species of toads, and humpback whales do so first.

The Pfizer-BioNTech COVID-19 vaccine was the first in the United States green-lit for Emergency Use Authorization by the Food and Drug Administration, with the Moderna vaccine earning approval shortly thereafter. The initial rollout of the first dose of the Pfizer-BioNTech vaccine has targeted two main groups: residents of long-term care facilities & health care personnel. Definitely not medical students.

The next targets would include people with underlying medical conditions that put them at significantly higher risk, older adults living in crowded settings, teachers, child care workers, and essential workers, with the eventual hope that the general population would get access to vaccines as Pfizer & Moderna continue to mass-produce them. But definitely not medical students.

“Once we have vaccinated the general population, we will then turn our attention to the next highest risk groups: fauna including cacti, amphibians including several species of toads, and aquatic life starting first with humpback whales,” explained CDC spokesperson Cazzie Barnes. “Only once every living creature in the United States has been vaccinated will the country’s medical students be next up in the queue.”

A statement released by the American Medical Student Association (AMSA) was optimistic and surprisingly upbeat. “We may be last but at least this time we’re not forgotten.” The nation’s cohort of frontline healthcare workers look forward to the day medical students get vaccinated so that they can help their medical and surgical teams with the essential task of obtaining a family history.

What are the ingredients in the Pfizer-BioNTech vaccine?

The ingredients include mRNA, lipids, sodium chloride, potassium chloride, sucrose, black pepper, rosemary, and sage.

How is the vaccine administered?

With pleasure.

I just received my first dose of the Pfizer-BioNTech COVID-19 vaccine. What I should look out for?

Side effects: injection site pain or swelling, fatigue, headache, muscle pain, chills, joint pain, fever, limb detachment, rectal prolapse, sudden aversion to Dua Lipa, sudden affinity for Nickelback.

What should I do about side effects?

Ignore them and power through. Unless you develop sudden affinity for Nickelback, in which case call 911 immediately as this is a life-threatening emergency.

I can’t believe the Falcons blew such a huge lead and lost to the Buccaneers. Is the vaccine to blame?

Absolutely.

I’m an ER physician, and my arm is a little sore from the shot and I’m worried if I have to intubate a patient my ability do so might be compromised. Any advice?

Use BIPAP.

I’m a gastroenterologist. I have mild arm soreness. I have several routine colonoscopies to perform tomorrow. What should I do if I can’t complete them due to the pain?

Leave the colonoscope in place and have the patient return in several days once you are asymptomatic and able to retrieve it.

Any advice on how to manage pain at the injection site?

As a general rule, it is always better to prevent a condition than to treat it once it has been acquired. Tylenol or NSAIDS may do the trick, but there is always the risk of experiencing side effects with these medications. Therefore, we recommend amputation of the affected to arm to prevent progression of symptoms.

I just got my first dose of the COVID-19 vaccine. Is it okay to have a beer?

Though there haven’t been any known interactions between alcohol and vaccines, proper technique during a keg stand, shotgunning, or flip cup might be compromised due to arm pain. According to the Centers for Disease Control & Prevention, beer helmets were made for situations just like these.

I received the shot several days ago and haven’t experienced a single side effect. Should I be concerned?

Yes. It is very likely you received a placebo vaccine or, worse, you might have been injected with live unattenuated COVID-19. Initiate quarantine immediately.

What should I do with my COVID-19 vaccination card?

Laminate it, frame it. When you return for your second dose of the vaccine, you will be applauded for your arts & crafts skills. Way to cultivate a hobby during a pandemic!

What happens if I don’t receive the second dose of the Pfizer-BioNTech vaccine exactly 21 days after the first dose?

You will die.

ATLANTA, GA – The most common side effect or adverse reaction healthcare workers are experiencing after the first dose of the Pfizer-BioNTech COVID-19 vaccine is hope, Gomerblog reports.

“The Vaccine Adverse Event Reporting System (VAERS) has been overwhelmed by thousands of reports from emergency medical technicians, doctors, nurses, nurse practitioners, physician assistants, pharmacists, and other healthcare personnel who are experiencing uncomfortable mild but new symptoms such as hope, relief, and optimism,” explained Cazzie Barnes, a spokesperson for the Centers for Disease Control & Prevention (CDC). “These symptoms have ceased to exist since the start of the coronavirus pandemic, so it is indeed alarming. We need to be cautious and methodical as we process these data, and continue to encourage everyone to report these issues as they arise.”

VAERS was established in 1990 for the purpose of detecting any safety issues for vaccines licensed in the United States. It is co-managed by both the CDC and the Food and Drug Administration (FDA). There are no licensed vaccines for COVID-19; however, both Pfizer-BioNTech and Moderna received Emergency Use Authorization earlier this month.

Based on a Gomerblog poll of 5,000 healthcare workers who have already received their first dose of the Pfizer-BioNTech vaccine, hope was more common than arm injection site pain or headache. Troubling indeed.

In a joint statement today, the CDC and FDA wanted to remind vaccinated healthcare workers should they develop a sudden onset of positivity or an acute facial defect known as a smile to seek medical attention immediately.

MIAMI, FL – August medicine intern Austin Moss asked his attending on rounds, “What’s Covid?” Residency program leadership has already been alerted to this major red flag.

“I keep hearing about this Covid. Like, it keeps coming up over and over again since maybe February but I haven’t really taken the time to figure out what it is everyone’s talking about,” Moss confided to his team. He would’ve noticed all of their jaws dropped to the floor if not for their masks. “Every patient of mine today asked if I have Covid, do I have Covid. So, what’s Covid? Is that a Miami thing? I’m not originally from here. By the way, why are we all wearing masks?”

“July and August interns are generally clueless, it’s expected,” explained Dr. Erika Hill, the internal medicine attending on Austin’s team. “But this just takes it to a new level. I mean, wow.”

Program leadership is leaning towards sending Moss home for a two-week quarantine, not because he is symptomatic with coronavirus, but to protect his patients and allow him to “read up” and “catch up, big time.”

LOS ANGELES, CA – A recent survey found that 90% of healthcare workers in the UCLA Health system were unaware that their N95 masks had partially if not completely eroded into their skulls.

“It is both surprising and not surprising,” explained UCLA neurosurgeon Dr. Sean Feuerstein, who says that is rather commonplace to be consulted for a N95 extraction. “It is not surprising because we’re wearing masks just about every minute of every day at work since the beginning of the Covid-19 pandemic. What is surprising is how health care workers have become so used to them they are unaware of the trauma it’s causing. In fact, we only realize it when a colleague points out that our face is falling off or a piece of our skull is showing.”

More often than not, Feuerstein says, it is a mild case where either an otolaryngologist or an oral-maxillofacial surgeon can perform a bedside maskectomy. But in severe cases where the mask has been worn for an entire day and the straps have pulled the mask into the eye sockets and cranium, it can be a 12-hour operation involving neurosurgery, plastics, ENT, and maxillofacial surgery for not only mask extraction but total head & neck reconstruction.

“The most interesting case was an N95 eroded so deep into the head it sat atop the occipital lobe like a yarmulke,” Feuerstein told Gomerblog.

ATLANTA, GA – Beloved father, mother, son, daughter, friend, foe, and hospitalist Dr. Brent Hammersley, 46, died in heroic fashion at work today when he attempted to climb three flights of stairs with both his N95 and surgical mask on. He leaves behind 14 unseen patients, as well as his wife and two children.

He was also the brother of well-known orthopedic surgeon Brock Hammersley.

Hammersley was waiting for an elevator but when it arrived four healthcare professionals were already inside. Not wanting to overcrowd the elevator an in effort to respect social distancing, he smiled under his masks and simply told them, “That’s okay, I’ll take the stairs.” Those were his last words. One minute later, he was found dead inside the stairwell. The N95 and surgical mask perfectly fitted over his nose and mouth immediately pointed toward the cause.

“If there is one thing more dangerous than stepping into the room of a Covid-positive patient without any personal protective equipment, it is climbing up the stairs double-masked,” said pulmonologist Dr. Evelyn Wu, who has avoided the hospital stairwells since the spring of 2012. According to Wu, a double-masked healthcare professional, especially if one of those two masks is an N95, typically gets short of breath after climbing one flight of stairs, begins to tripod and use accessory muscles after two flights, and is most certainly dead by the third flight.

“You know what I’ll miss most?” asked Brock Hammersley, lifting weights in his brother’s memory. “His biceps. His big brotherly biceps.”

Wu was very adamant in his caution to fellow healthcare professionals. “You just can’t take the stairs, you can’t. It’s a death wish. Do the right thing: keep the mask on and wait for an elevator. We need you on the front lines.”

NEW HAVEN, CT – A patient and her inpatient medicine team at Yale Medical Center are relieved to report that her nasopharyngeal swab for Covid-19 has come back positive, negative & indeterminate. This marks a huge diagnostic win for healthcare professionals who are now six months into the pandemic.

“Just think about it, six months ago we didn’t have any tests or if we did the turnaround time took anywhere from 5 to 7 days,” explained Yale hospitalist Dr. Trevor Monahan. “But fast forward to today. It took only 12 hours to get this test result back. It really is a game-changer.”

“I’m relieved to say the least,” explained patient 37-year-old Alexandra Chin, who wished to remain nameless. She has been improving every day and says her team is thinking about discharging her home in the next 24 to 48 hours. “I was really worried that I came down with coronavirus. Thank goodness that swab helped clear things up.”

BOSTON, MA – A landmark, peer-reviewed study published earlier today in the New England Journal of COVID-19 suggests that the cure for novel coronavirus, better known as Covid-19, is most likely in the same elusive vortex, parallel universe, or alternate dimension that contains all of our missing pens. That’s bad news considering we haven’t found our pens. STILL.

In less than a year, there has been tremendous progress made in our understanding of Covid-19: the hyperexaggerated immune response in the form of cytokine storm, macrovascular and microvascular thrombi associated with a virus-induced hypercoaguable state, and the role of non-mask-wearers in contributing to human extinction. But despite those things, treatments are few, and a cure doesn’t yet exist.

“It’s the same thing with our pens,” explained infectious diseases physician Maryanne Rex, who has been paged every 26 seconds since the Covid-19 pandemic started. “We know so much, about how we can prevent the loss of pens by not sharing them, by protecting ourselves by carrying lots of pens, but we still aren’t any closer to a finding those pens even after decades and decades of searching.”

Many healthcare professionals believe that the shortage of pens has directly impacted the chase for a cure. “Doctors and scientists may get inspired or have an epiphany when they least expect it, not dissimilar to artists and musicians. I’m afraid that many potential cures for Covid-19 have been thought of, but because they didn’t have a pen to write it down the cures were forgotten and as a result the pandemic continues.”

We are more than 6 months into the pandemic caused by novel coronavirus Covid-19. Let us review how to appropriately obtain a nasopharyngeal swab.

Before entering into the room, be sure to call your parents and tell them you love them.  Wash your hands with soap & water or alcohol-based sanitizer for at least 30 minutes.  If someone else has gowned up and beat you to collecting the specimen, your job is done.  If not, sigh. Sigh once more, but this time more dramatically for all to hear. Put on a N95 mask and eye protection, and enter the room. Alternatively, quit medicine.

Your patient should already be wearing a mask.  If not, kindly remind them to put on a mask while you find your supervisor and say you’ve been exposed and need to be quarantined for 6 months.

If the patient doesn’t wish to be swabbed, respect their wish for a few seconds then smack a little sense into them; it’s a pandemic for Pete’s sake.

Remove the swab from the packaging.  Save the packaging because hoarding is appropriate during a pandemic. Ask the patient to pull their mask down and tilt their head back.  If your patient’s neck snaps back completely exposing Pez, please take one and enjoy.

The swab should be inserted into the nostril, but it’s not uncommon to accidentally end up in the rectum or vagina. 

Advance the swab along the nasal floor and septum until you feel resistance.  Plant and steady your back foot, and drive the swab past the resistance; this will ensure pathology has an adequate brainstem sample.

According to the Centers for Disease Control and Prevention, the swab should be placed for several seconds, rotating the swab for the entire duration.  According to Infection Prevention at Gomerblog, the swab should be placed for several days, with a medical student rotating the swab for the entire duration.  If you have several medical students available, hold the swab steady and rotate the patient for the entire duration.

Open the collection tube and place the swab into the tube, while repeating saying, “OHGODOHGODOHGODOHGOD.” Immediately run out of the room in a panic and throw it at the first person you see. It is now a game of Hot Potato; don’t lose! Place both the collection tube and the person holding the collection tube into a biohazard bag. Walk the swab down to Pharmacy. There, they will tell you that you are in the wrong department. Walk the swab down to Laboratory Services.

Wait anywhere from 24 hours to 7 days for the result to come back as indeterminate.