For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Palpitations and shortness of breath while waiting for COVID-19 booster vaccine
Palpitations and shortness of breath while waiting for COVID-19 booster vaccine

Consultant cardiologist Chris Ellis discusses the case of a colleague who, like many, is feeling the strain of COVID-19 – as a front-line healthcare worker, he will regularly meet COVID-positive patients, yet he is one of those least protected by the Pfizer–BioNTech COVID-19 vaccine
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
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1. Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. Lancet 2021;398(10309):1407–16.
2. Barda N, Dagan N, Cohen C, et al. Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study. Lancet 2021; 29 October online.