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1,5 years into the pandemic, SARS-CoV-2 remains a dynamic and evolving disease. Growing proportions of the population have been vaccinated, but what degree of protection does vaccination actually offer, particularly in the face of an evolving virus and the emergence of viral variants? Here we explore the limits of vaccine protection -providing an overview of emerging data on how well vaccines protect against mild and asymptomatic disease, vaccine effectiveness against the backdrop of variants such as the Delta, and the implications for SARS-CoV-2 transmission. We assess the continued risks for our vulnerable elderly and immune-compromised patient populations, and whether emerging literature should impact our diagnostic strategies.

Many people question if the current microbiome research trend really does have medical implications for patients or if it is just hype to generate research funding. Cumulative funding for the microbiome likely runs into hundreds of millions and over the last five years there has been rapid and exponential growth of microbiome-related publications. Here we examine if the microbiome has any real relevance in current clinical practice.

In order to provide adequate healthcare to ethnic minority patients, healthcare professionals must use professional interpreter services to effectively overcome language barriers. Many ethnic minority patients have low health literacy, i.e. they have difficulty obtaining, understanding and implementing health information. They therefore have a higher risk of poorer health outcomes. Health care professionals need to adapt their communication to patients with low health literacy by checking whether the patient has understood them, avoiding use of medical jargon and tailoring information to the patient's perspective. Various practical strategies have been developed to support health care professionals to communicate effectively with patients with low health literacy. Scientific research is needed to investigate the effectiveness of such strategies in various populations and to systematically develop, implement and evaluate new strategies.