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In the second turbulent year defined by a global pandemic, 2021 provided an abundance of topics for authors seeking to right wrongs, offer direction, make the world a better place, and sometimes just to tell a story. STAT published nearly 600 First Opinion essays this year, written by more than 750 authors from the biopharmaceutical industry, health care, academia, government, and private life in the United States and beyond.

It’s no surprise that many of the essays focused on Covid-19 and responses to the pandemic. But First Opinion authors also tackled other issues, like lessons learned — and forgotten — from the horrific epidemics of the U.S. Civil War; the ongoing overdose crisis; the hazard of stifling biopharma mergers; the Food and Drug Administration’s controversial approval of Aduhelm for early-stage Alzheimer’s disease; living through deep despair during and after pregnancy; the “diagnosis” of excited delirium; burnout among health care workers; and much, much more.

Here are the five most widely read First Opinions of 2021. If you didn’t get to them when they first appeared, they are still worth reading:

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1. It’s easy to judge the unvaccinated. As a doctor, I see a better alternative  Emergency physician Jay Baruch starts his essay, published as vaccination rates in the U.S. lagged behind expectations, like this: “I don’t ask ‘Why?’ when a patient with Covid-19 tells me they are unvaccinated for the same reason I don’t ask why someone whose alcohol level is four times the legal limit decided to drive, or why the badly burned grandmother with emphysema lit a cigarette with oxygen prongs below her nose.”

2. Catching Covid-19 after being vaccinated isn’t a myth. It happened to me  Two months after he was fully vaccinated, psychiatrist Stephen M. Tourjee noticed mild, Covid-19-like symptoms — stuffy nose, chest congestion, and an upset stomach. He chalked them up to seasonal allergies, but they weren’t.

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3. How a ‘fatally, tragically flawed’ paradigm has derailed the science of obesity  The central dogma of obesity science — people get fat because they take in more calories than they expend and stay lean when they don’t — needs to be overhauled, wrote Gary Taubes, who is part of a growing movement arguing that obesity is a “hormonal or constitutional disorder, a dysregulation of fat storage and metabolism, a disorder of fuel-partitioning.”

4. Shattering the infertility myth: What we know about Covid-19 vaccines and pregnancy  During trying times, “myths and falsehoods sprout like mushrooms after rainfall,” wrote reproductive endocrinologist and infertility specialist Eve C. Feinberg, dispelling the myth that vaccines against Covid-19 cause infertility in women.

5. With the first dose, I need to be at peace with the vaccine. And let my body do the work  When pediatrician and hospitalist Sharon Ostfeld-Johns got her first Covid-19 vaccine, she wanted to “help” it by taking vitamins and doing other things that might boost her immune system. Then she realized there was a better way: “Be at peace with the vaccine. Wait for the next dose. And let my body do the work.”

We launched the weekly “First Opinion Podcast” in February 2021. Of the 43 episodes we have published so far, all produced by the amazing Theresa Gaffney, this one garnered the most downloads and listens: Two physicians on breakthrough Covid-19 cases. In it, Stephen Tourjee (see #2 above) talks about getting Covid-19 after being fully vaccinated against it.

A new year brings new opportunities, along with new crises and challenges. My aim is for 2022’s First Opinion essays to reflect all of those, and more. Please keep reading, and when the muse strikes, send submissions to [email protected].

Judith Miller, a First Opinion Podcast listener, wrote me this year that “the very nature of our times is, and will continue to be, one of permanent white water rather than some strange aberration from which we should expect to emerge.” That’s a good description of the flow of time. Be well in the year ahead, and may you have good luck navigating the white water.

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