<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
</head>
<body bgcolor="#FFFFFF" text="#000000">
I'm sure you'll be hearing this elsewhere, but maybe not as clearly
stated. This is the best summary of the findings on which COVID
vaccine booster people should get I've seen so far. The clear winner
in the booster races is Moderna.--Manny<br>
<br>
Summary of the key findings:<br>
<br>
"<font size="+1"><strong><code>Which combination works best? </code></strong></font>To
me, this was the most interesting…
<ul style="margin-bottom: 1em; margin-top: 1em;">
<li style="margin-bottom: 3.75px; margin-left: 7.5px;
margin-right: 0; margin-top: 3.75px; mso-special-format:
bullet;">
<p style="color: #1a1a1a; font-size: 16px; line-height: 26px;
margin: 0;">The most benefit, by far, was for those with a
primary J&J shot. A Moderna booster gave the greatest
benefit to J&J folks (56.1 fold increase in IgG; 76.1 fold
increase in neutralizing antibodies). Pfizer also worked very
well (32.8 fold increase in IgG; 35 fold increase in
neutralizing antibodies). There was minimal increase with a
J&J booster (4-fold increase).</p>
</li>
<li style="margin-bottom: 3.75px; margin-left: 7.5px;
margin-right: 0; margin-top: 3.75px; mso-special-format:
bullet;">
<p style="color: #1a1a1a; font-size: 16px; line-height: 26px;
margin: 0;">After the primary Moderna series, there was
benefit from either a Moderna or Pfizer booster. There was
really no difference between the two. </p>
</li>
<li style="margin-bottom: 3.75px; margin-left: 7.5px;
margin-right: 0; margin-top: 3.75px; mso-special-format:
bullet;">
<p style="color: #1a1a1a; font-size: 16px; line-height: 26px;
margin: 0;">After the primary Pfizer series, the greatest
benefit was from a Moderna booster. But a Pfizer booster
helped a lot too."<br>
</p>
</li>
</ul>
<br>
<br>
<pre class="moz-signature" cols="72">"What is essential is invisible to the eye."
—Antoine de Saint-Exupéry </pre>
<div class="moz-forward-container"><br>
<br>
-------- Forwarded Message --------
<table class="moz-email-headers-table" cellspacing="0"
cellpadding="0" border="0">
<tbody>
<tr>
<th valign="BASELINE" nowrap="nowrap" align="RIGHT">Subject:
</th>
<td>Mixing vaccines: The study we've all been waiting for</td>
</tr>
<tr>
<th valign="BASELINE" nowrap="nowrap" align="RIGHT">Date: </th>
<td>Wed, 13 Oct 2021 23:43:13 +0000</td>
</tr>
<tr>
<th valign="BASELINE" nowrap="nowrap" align="RIGHT">From: </th>
<td>Katelyn Jetelina from Your Local Epidemiologist
<a class="moz-txt-link-rfc2396E" href="mailto:yourlocalepidemiologist@substack.com"><yourlocalepidemiologist@substack.com></a></td>
</tr>
<tr>
<th valign="BASELINE" nowrap="nowrap" align="RIGHT">Reply-To:
</th>
<td>Katelyn Jetelina from Your Local Epidemiologist
<a class="moz-txt-link-rfc2396E" href="mailto:reply+pc45q&a13t&&ac104d91585fc19bb71f00312477e434486fd68bb02ab49b5acc63f421e12d02@mg1.substack.com"><reply+pc45q&a13t&&ac104d91585fc19bb71f00312477e434486fd68bb02ab49b5acc63f421e12d02@mg1.substack.com></a></td>
</tr>
<tr>
<th valign="BASELINE" nowrap="nowrap" align="RIGHT">To: </th>
<td><a class="moz-txt-link-abbreviated" href="mailto:manny@ratafias.com">manny@ratafias.com</a></td>
</tr>
</tbody>
</table>
<br>
<br>
<title>Mixing vaccines: The study we've all been waiting for</title>
<style>
@media all and (-ms-high-contrast: none), (-ms-high-contrast: active) {
.typography .markup table.image-wrapper img,
.typography.editor .markup table.image-wrapper img,
.typography .markup table.kindle-wrapper img,
.typography.editor .markup table.kindle-wrapper img {
max-width: 550px;
}
}
@media screen and (max-width: 540px) {
.typography .markup iframe.spotify-wrap,
.typography.editor .markup iframe.spotify-wrap,
.typography .markup a.spotify-wrap,
.typography.editor .markup a.spotify-wrap {
width: auto !important;
}
}
@media screen and (max-width: 540px) {
.typography .markup div.youtube-wrap div.youtube-screen,
.typography.editor .markup div.youtube-wrap div.youtube-screen,
.typography .markup div.vimeo-wrap div.youtube-screen,
.typography.editor .markup div.vimeo-wrap div.youtube-screen {
display: none !important;
}
}
@media screen and (max-width: 540px) {
.typography .markup div.embedded-publication-wrap .embedded-publication.show-subscribe,
.typography.editor .markup div.embedded-publication-wrap .embedded-publication.show-subscribe {
padding: 28px 24px;
}
}
@media print {
.typography .markup .button-wrapper,
.typography.editor .markup .button-wrapper {
display: none;
}
}
@media screen and (min-width: 481px) {
.share-button-container {
height: 38px;
}
}
@media screen and (min-width: 481px) {
.share-button-container a.comment {
height: 38px;
line-height: 38px;
padding-right: 10px;
}
}
@media screen and (max-width: 480px) {
.share-button-container .separator {
display: block;
margin: 0;
height: 8px;
border-left: none;
}
}
@media screen and (max-width: 480px) {
.share-button-container a.share.first img {
padding-left: 0;
}
}
@media screen and (min-width: 481px) {
.share-button-container a.mobile {
display: none !important;
}
}
@media screen and (max-width: 1000px) {
.congrats-box {
flex-direction: column;
}
.congrats-box .congrats-box-right {
margin-left: 38px;
margin-top: 16px;
}
}
@media screen and (max-width: 500px) {
.congrats-box {
display: none;
}
}
@media screen and (min-width: 768px) {
.post {
padding: 15px 0;
}
}
@media screen and (max-width: 540px) {
.post-contributor-footer .post-contributor-bio-table {
display: block;
}
.post-contributor-footer .post-contributor-bio-table-row {
display: flex;
flex-direction: row;
}
.post-contributor-footer .post-contributor-bio-userhead-cell,
.post-contributor-footer .post-contributor-bio-body-cell {
display: block;
}
.post-contributor-footer .post-contributor-bio-body-cell {
flex-grow: 1;
}
.post-contributor-footer .post-contributor-bio-body-table {
display: block;
}
.post-contributor-footer .post-contributor-bio-body-table-row {
display: block;
}
.post-contributor-footer .post-contributor-bio-copy-cell,
.post-contributor-footer .post-contributor-bio-controls-cell {
display: block;
}
.post-contributor-footer .post-contributor-bio-copy-cell {
margin: 0 0 16px 0;
}
.post-contributor-footer .post-contributor-bio-controls-cell {
width: auto;
}
.post-contributor-footer .post-contributor-bio-controls {
margin: auto;
}
.post-contributor-footer .post-contributor-bio-controls .button.primary {
width: 100%;
}
.post-contributor-footer .post-contributor-bio-text {
font-size: 14px;
}
}
@media screen and (min-width: 768px) {
.post-silhouette {
padding: 15px 0;
}
}
@media screen and (max-width: 540px) {
.post-silhouette .post-silhouette-title {
margin-top: 10.44225025px;
height: 120px;
}
}
@media screen and (max-width: 540px) {
.post-silhouette .post-silhouette-meta {
width: 75%;
}
}
@media screen and (max-width: 540px) {
.post-silhouette .post-silhouette-meta.with-byline-image {
margin: 20px 0;
}
}
@media screen and (max-width: 370px) {
table.post-meta tr td.post-meta-item {
font-size: 12px;
}
}
@media screen and (max-width: 540px) {
.post-preview > .post-preview-image {
display: none;
}
}
@media screen and (max-width: 540px) {
.post-preview-silhouette .post-preview-silhouette-image {
display: none;
}
}
@media all and (-ms-high-contrast: none), (-ms-high-contrast: active) {
body .markup table.image-wrapper img,
body .markup table.kindle-wrapper img {
max-width: 550px;
}
}
@media screen and (max-width: 540px) {
body .markup iframe.spotify-wrap,
body .markup a.spotify-wrap {
width: auto !important;
}
}
@media screen and (max-width: 540px) {
body .markup div.youtube-wrap div.youtube-screen,
body .markup div.vimeo-wrap div.youtube-screen {
display: none !important;
}
}
@media screen and (max-width: 540px) {
body .markup div.embedded-publication-wrap .embedded-publication.show-subscribe {
padding: 28px 24px;
}
}
@media print {
body .markup .button-wrapper {
display: none;
}
}
@media screen and (min-width: 500px) {
body .header a.logo {
width: 42px;
height: 42px;
border-radius: 6px;
}
}
@media screen and (max-width: 420px) {
body .subscription-receipt table:first-of-type .subscription-amount .subscription-discount {
width: 72px !important;
}
}
@media screen and (min-width: 481px) {
body .share-button-container {
height: auto;
}
}
@media screen and (max-width: 480px) {
body .share-button-container .separator {
display: block !important;
margin: 0 !important;
height: 8px !important;
border-left: none !important;
}
}
@media screen and (max-width: 540px) {
body .footer {
outline: 8px solid #f8f8f8 !important;
}
}
@media screen and (max-width: 540px) {
.digest .item .post-meta-item.audience {
display: none;
}
}
@media screen and (min-width: 500px) {
.digest-publication .logo img {
width: 42px;
height: 42px;
border-radius: 6px;
}
}
@media screen and (min-width: 541px) {
.user-profile-modal {
padding-left: 12px;
padding-right: 12px;
}
}
@media screen and (max-width: 540px) {
.subscribe-widget form.form .sideBySideWrap button.rightButton {
padding: 10px 12px;
min-width: 112px;
}
}
@media screen and (min-width: 541px) {
.pub-icon:hover .logo-hover,
.feed-item-icon:hover .logo-hover {
display: block;
}
}
@media screen and (max-width: 768px) {
.file-embed-wrapper {
padding: 0;
}
}
@media screen and (max-width: 768px) {
.file-embed-wrapper-editor {
padding: 0;
}
}
@media screen and (max-width: 768px) {
.file-embed-wrapper-editor:active {
padding: 0;
}
}
@media only screen and (max-width: 630px) {
.file-embed-button.wide {
display: none;
}
}
@media only screen and (min-width: 630px) {
.file-embed-button.narrow {
display: none;
}
}
@media screen and (max-width: 540px) {
.audio-player-wrapper .audio-player .audio-player-progress {
border-left-width: 16px;
border-right-width: 16px;
}
}
@media screen and (max-width: 540px) {
.audio-player-wrapper .audio-player .audio-player-progress .audio-player-progress-bar .audio-player-progress-bar-popup {
top: -54px;
}
}
@media not all and (min-resolution: 0.001dpcm) {
}
</style><img
src="https://mailgun.substack.com/api/v1/email/open?token=eyJtIjoiPDIwMjExMDEzMjM0MzEzLjIuNTI0YjY5NWI4MjhmNDM5Zi51djdidHJvZ0BtZzIuc3Vic3RhY2suY29tPiIsInUiOjQ2Nzk5MywiciI6Im1hbm55QHJhdGFmaWFzLmNvbSIsImQiOiJtZzIuc3Vic3RhY2suY29tIiwicCI6NDI1NTU2NjIsInMiOjI4MTIxOSwiYyI6InBvc3QiLCJmIjp0cnVlLCJpYXQiOjE2MzQxNjg2MzUsImlzcyI6InB1Yi0wIiwic3ViIjoiZW8ifQ.9I8iOemN76FIr36Qoe75oPlG03yMHaHNp9G2CwCPZfg"
alt="" style="height:1px !important;width:1px
!important;border-width:0 !important;margin-top:0
!important;margin-bottom:0 !important;margin-right:0
!important;margin-left:0 !important;padding-top:0
!important;padding-bottom:0 !important;padding-right:0
!important;padding-left:0 !important;" moz-do-not-send="true"
width="1" height="1" border="0">
<div
style="display:none;font-size:1px;color:#333333;line-height:1px;max-height:0px;max-width:0px;opacity:0;overflow:hidden;"
class="preview">Up until now, we had two big unanswered
questions regarding COVID19 vaccines in the United States: Can
we safely mix vaccines? For example, if you had an original
Johnson and Johnson (J&J) vaccine can you safely get a
Moderna booster? We know that mixing AstraZeneca with Pfizer is
safe from clinical trials in the UK. Because J&J is the same
biotechnology as AstraZeneca, we hypothesized that mixing would
be okay too. But needed to see the
data. </div>
<table role="presentation" class="email-body-container"
width="100%" cellspacing="0" cellpadding="0" border="0">
<tbody>
<tr>
<td><br>
</td>
<td class="content" width="550"><br>
</td>
<td><br>
</td>
</tr>
<tr>
<td><br>
</td>
<td class="content" width="550" align="left">
<div style="font-size: 16px; line-height: 26px; margin: 0
auto; max-width: 550px; overflow-wrap: break-word;
width: 100%;">
<div class="post typography" style="font-size: 16px;
line-height: 26px; padding: 9px 0;">
<div class="post-header" style="font-size: 16px;
line-height: 26px;">
<h1 class="post-title long published"
style="-moz-osx-font-smoothing: antialiased;
-webkit-font-smoothing: antialiased; color:
#1a1a1a; font-family: 'SF Compact Display',
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple Color
Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
font-size: 1.625em; font-weight: bold;
line-height: 130%; margin: 0.378em 0 0 0;"><a
href="https://email.mg2.substack.com/c/eJx1kk2TojAQhn-N3KTyAQwcOMyO45bWiOvOh3qiQmgwGhKWBDX--o3jaQ9blaRTnfdNV_XTnFlo9eDyXhsb3I_Suh5yBRcjwVoYgtHAUIo6j5KnLKOBv9Q4jdNAmLIZADomZG6HEYJ-rKTgzAqt7nqSYoKz4JBTXDdRBThLkxhBk1QpyeqEpQgwNA2KHmXZWAtQHHI4w-C0gkDmB2t7M6HPEzL3y-lxkJozCb2ooRNa6lYYG5qxMpbxU8h152W93524CtVOz4xzocBM7QGmxo61m17891Mm5YTOrT6BmtAZuCXm5MvtiDwtjhoVRx6vP1ZmoX6cOf3dsO1GrI8bV3x84uK4d28vy36_u-deyeq2uRbH9h7NopM37haJ9-G9QG49e3Wrj5Pw-lu9XYi1WF4qWqC33VLutwVi22xcKBTG83n25_S54nX_9b4aXujssrP2TZ2uXz_n06xAn3h2jH4d-PM-EDlBBGOEKaERxTQkYUyiKsli39W0iWjWhOP5qbKDbicR6lryT3uCIe-YUs4_DcyyRjDznfboSh-7UQnrSlCsklA_qNrHaHxzLltQ4I1Ql8zmOKERTtKExiiOHxDvY0LiOE4SEvi6tfYulf8H3F-1e9ng"
style="color: #1a1a1a; text-decoration: none;"
moz-do-not-send="true">Mixing vaccines: The
study we've all been waiting for</a></h1>
<table class="meta-author-wrap with-photo"
style="margin: 1em 0;">
<tbody>
<tr>
<td>
<div class="user-head " style="font-size:
16px; line-height: 26px;"><a
href="https://email.mg2.substack.com/c/eJxNUEluxCAQfM1wi2Uas_jAIZd8w2Jpe0gwWIAn8u_DzFwitbqrN5WqnGm45XLpI9dGnmlp14E64W-N2BoWclYsS_B6EnKeGenAU8UVCXVZC-JuQtStnEiO08bgTAs5Pe9BUaAzuWthqbKz8opKUE5K65R0cuIcRy_c7N605vQBk0ONDyxXTkiivrd21Bv7vMFXj3ra2oz7GVzee3uUvIaIHYEEkOMIHz9dTbzSxzf2GpIhQcMIlI6UAZsYZQMMHCYrZm4VqHVi8zqcD2lbydttGvcNhv8spOjdpHT1VTHNrMHU17grXXrdzxTatWAyNqJ_m9DeTr5sWTZM2B_RL6ZpKthEhRKMj5y_NT9dBc65EEA6r8_9K-krnyVmZyIeweMecsxbqO0PGj2QYw"
moz-do-not-send="true">
<div class="profile-img-wrap"
style="font-size: 16px; line-height:
26px; position: relative;"><img
src="https://cdn.substack.com/image/fetch/w_90,h_90,c_fill,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F0d83e8ba-8e88-44b6-b3cf-8b1dfbcba4e5_2162x2260.jpeg"
alt="" style="border: none
!important; border-radius: 50%;
cursor: pointer; display: block;
height: 45px; max-width: 550px;
vertical-align: middle; width:
45px;" moz-do-not-send="true"
width="45" height="45"></div>
</a></div>
</td>
<td>
<div class="meta-right-column"
style="font-size: 16px; line-height: 1em;
margin-left: 12px;">
<div class="meta-author" style="color:
#767676; font-family: Helvetica, Arial,
sans-serif; font-size: 14px;
line-height: 17px;"><a
href="https://email.mg2.substack.com/c/eJxNUEluxCAQfM1wi2Uas_jAIZd8w2Jpe0gwWIAn8u_DzFwitbqrN5WqnGm45XLpI9dGnmlp14E64W-N2BoWclYsS_B6EnKeGenAU8UVCXVZC-JuQtStnEiO08bgTAs5Pe9BUaAzuWthqbKz8opKUE5K65R0cuIcRy_c7N605vQBk0ONDyxXTkiivrd21Bv7vMFXj3ra2oz7GVzee3uUvIaIHYEEkOMIHz9dTbzSxzf2GpIhQcMIlI6UAZsYZQMMHCYrZm4VqHVi8zqcD2lbydttGvcNhv8spOjdpHT1VTHNrMHU17grXXrdzxTatWAyNqJ_m9DeTr5sWTZM2B_RL6ZpKthEhRKMj5y_NT9dBc65EEA6r8_9K-krnyVmZyIeweMecsxbqO0PGj2QYw"
style="color: #1a1a1a;
text-decoration: none;"
moz-do-not-send="true">Katelyn
Jetelina</a></div>
<table class="post-meta custom"
style="margin: 4px 0 0 0;"
cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td title="2021-10-13T23:43:21.384Z"
class="post-meta-item post-date"
style="color: #767676;
font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial,
sans-serif, 'Apple Color Emoji',
'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 14px;
font-weight: 400; height: 20px;
line-height: 18px; padding: 7px
12px 7px 0; padding-bottom: 0;
padding-top: 0; position:
relative; text-decoration: none;
vertical-align: middle;
white-space: nowrap;"><time
datetime="2021-10-13T23:43:21.384Z">Oct
13</time></td>
<td class="post-meta-item icon"
style="color: #767676;
font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial,
sans-serif, 'Apple Color Emoji',
'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 14px;
font-weight: 400; height: 20px;
line-height: 18px; padding: 7px
12px 7px 0; padding-bottom: 0;
padding-top: 0; position:
relative; text-decoration: none;
text-indent: 3px; vertical-align:
middle; white-space: nowrap;"><span><a
href="https://email.mg2.substack.com/c/eJx1Uk1z2jAQ_TX4VsaSLGMffGhJoIZgpgkNoRePLC0gIkuuJZMqv75yaA89dEazb2e13285c3AyvS86Y100itr5DgoNb1aBc9BHg4W-lqJI0lmekygoAmU0i6Stjz1Ay6QqXD9A1A2Nkpw5afTojzOEUR6dCwyUEj4DHidxzqEhIhMon82oaDKMEbmVZYOQoDkUcIXeGw2RKs7OdXZCPk_wIjxvhl4ZzhR0UkArjTInad3UDo11jL9OuWmDG-tkkFcUxJg4wEePn3pgfOxtQhbOvELAO_ArxPGzf8HqtbyYuLpwut1tbKm_XDl5PLL9N7m9fPPV7juqLgf_MF_5H_vFRSzVtZFlWg5r0c1LW7bqLOZlutkd3qu7e7y9Czh_k-yleg95Jf_6LB92ZbLZlb-2T8FfV-gwxuuVOuyrmO3zodTxtMlO51VC5stErc5oT9VTf1gs135n2WKt2IMvfz42y_Vhs7mf4HRwbW3DTjiEUf4u4Y-9BSGHdhxxnD2SBY4xQjEimCQEkSmeUpw0aU4DBdkxIflxOlxnjevNaZLE7Qn_s9WoL1qmtQ9fPXPsKJn9MAfG64DtoKXzNWjWKBC3Y3C3i_ooX59AQwgEUTNXoJQkKM1SQmNKb9yP14UppWmKo1BXmBCli__w_RuHMuvo"
class="like-button"
style="color: #767676;
display: block; position:
relative; text-decoration:
none;" moz-do-not-send="true"><img
src="https://cdn.substack.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FHeartIcon%3Fv%3D2%26height%3D36%26fill%3D%2523757575%26stroke%3D%2523757575%26strokeWidth%3D2"
style="border: none
!important; float: left;
height: 20px; max-width:
18px; vertical-align:
middle; width: auto;" alt=""
moz-do-not-send="true"
width="18" height="18"></a></span></td>
<td class="post-meta-item icon"
style="color: #767676;
font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial,
sans-serif, 'Apple Color Emoji',
'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 14px;
font-weight: 400; height: 20px;
line-height: 18px; padding: 7px
12px 7px 0; padding-bottom: 0;
padding-top: 0; position:
relative; text-decoration: none;
text-indent: 3px; vertical-align:
middle; white-space: nowrap;"><a
href="https://email.mg2.substack.com/c/eJx1UsFy2yAQ_RrrZo8AIUsHHdK47tgTy02bxPZJg2AtYyNQBbJDvr4obg89dAZYZnnLg_eWMweN6X3RGeuicamc76DQcLMKnIM-Giz0lRRFks7znERhI1BGs0ja6tgDtEyqwvUDRN1QK8mZk0aPeJwhjPLoVCR0zhASQtRJTLP5MWO4zmqYozRmeY35nZYNQoLmUMAVem80RKo4OdfZCXmY4GUY3gy9Mpwp6KSAVhplGmndzA61dYxfZty0AdaF2cp3qZvplXEuNdipO8HUukH46S1cP2VKBVCAt6BdIFg6cwE9IQvwa8Txm99jdVmdTVyeOd2-bOxKf7ly8uPIds9ye3725csrKs8H__S47g77MfcVbz6e38tzM0a7atUH96s01KGDjP128dVvXi4y4D_EbiW3cn2rSRk_7dfqsCtjtsuHlY5ndLnMf11eN1x0bz83_SNZ3PbOPenL-9u35TQv41e0OCffT_zhMMHp4NrKBlE4hKf_VeFPvgUhh3b80mhQJAscY4RiRDBJCCIzPKM4qdOc1hnOjgnJj7PhOq9db5pJErcN_kfWqC9aprUPRz1z7CiZ_UwHy6tRxkFL5yvQrFYg7t3g7i31SV81oCEUgqiYK1BKEpRmKaExpXfzx_bClNI0xVHgFSZU6eI_hv8Gz6vuCQ"
style="color: #767676; display:
block; text-decoration: none;"
moz-do-not-send="true"><img
src="https://cdn.substack.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FCommentIcon%3Fv%3D2%26height%3D36%26fill%3D%2523757575%26stroke%3D%2523757575%26strokeWidth%3D2"
style="border: none
!important; float: left;
height: 20px; max-width: 18px;
vertical-align: middle; width:
auto;" alt="Comment"
class="comment-icon"
moz-do-not-send="true"
width="18" height="18"></a></td>
<td class="post-meta-item icon"
style="color: #767676;
font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial,
sans-serif, 'Apple Color Emoji',
'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 14px;
font-weight: 400; height: 20px;
line-height: 18px; margin-right:
0; padding: 7px 12px 7px 0;
padding-bottom: 0; padding-right:
0; padding-top: 0; position:
relative; text-decoration: none;
text-indent: 3px; vertical-align:
middle; white-space: nowrap;"><span><a
href="https://email.mg2.substack.com/c/eJx1kk1z2jAQhn8NvsFYkuXYBx_SEDowwTRtEuDkkaXFCGTJtWSI8usrh3amPXRGn4_e3R3tvJw5aEzvi85YF41L5XwHhYarVeAc9NFgoa-kKJL0Ls9JFA4CZTSLpK0OPUDLpCpcP0DUDbWSnDlp9KjHGcIoj45FzoFkVOQZEgdMUixoWhOWsiSuKcEc38qyQUjQHAq4QO-NhkgVR-c6OyH3E7wIw5uhV4YzBZ0U0EqjTCOtm9mhto7x84ybNsi6MFv5LnUzvTDOpQY7dUeYWjcIP72G9FOm1IQsBtdWNuTkMCHzP0kmOB15C0IObeCf__sNudEOtBvVR9ZDoIyPv_0LOHOG8Q5-hTh-8zuszsuTicsTp5uXtV3qLxdOvh_Y9lluTs--fHlF5Wnvnx5W3X43ske8_nh-L0_NuNtlqz64X6YhDu1l7DfzR79-Ocug_xDbpdzI1bUmZfy0W6n9tozZNh-WOp7RxSL_eX5dc9G9_Vj3D2R-3Tn3pM_vb18X07yMX9H8lHw78vt9JAscY4RiRDBJCCIzPKM4qdOc1hnODgnJD7Phcle73jSTJG4b_E_Lo75omdY-PPXMsYNk9hMHO4SOte2gpfMVaFYrEDenuJvdPntbNaAhBIKomCtQShKUZimhMaU3Y4zWw5TSNMVRqCtMiNLFf8zwC8aE91E"
style="color: #767676;
display: block;
text-decoration: none;"
moz-do-not-send="true"><img
src="https://cdn.substack.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FRecommendIcon%3Fv%3D2%26height%3D36%26fill%3D%2523757575%26stroke%3Dnone%26strokeWidth%3D2"
style="border: none
!important; float: left;
height: 18px; max-width:
550px; vertical-align:
middle; width: 18px;"
alt="Share"
class="recommend-icon"
moz-do-not-send="true"
width="18" height="18"></a></span></td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div class="post typography" style="font-size: 16px;
line-height: 26px; padding: 9px 0;">
<div class="body markup" style="font-size: 16px;
line-height: 26px; margin-bottom: 12px; word-break:
break-word;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0; margin-top:
0;">Up until now, we had two big unanswered
questions regarding COVID19 vaccines in the United
States:</p>
<ol style="margin-bottom: 1em; margin-top: 1em;">
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;"><em><strong>Can
we safely mix vaccines?</strong></em> For
example, if you had an original Johnson and
Johnson (J&J) vaccine can you safely get a
Moderna booster? We <a
href="https://email.mg2.substack.com/c/eJwlkM1u5SAMhZ8m7BrxE0iyYDGbSt2N1AeIHOLkMiUQgdPbvP1wGwnB4diW7c8B4ZbyZY9UiL2uia4DbcRnCUiEmZ0F8-QX25l-HBWrYhGDHpgv05oRd_DBUj6RHeccvAPyKb7y5SCkGNnDCt7DonnvuOi7wcEAKDoFq3Zrv5plvNvCuXiMDi1-Y75SRBbsg-gojfrTyPd6ns9nSw8MULOodWmv3r905gihVHn7VUAm7wJW9ffj45OLjr-ZXplGDlI0cuRCCP1Wv-_rGQLhDzFvJZdCcKGk6pRQrWy17GYz6nmQw9qpcW3P736mnLam4_sm23LOhcB9veZg2e4Q41VDGQhWD-XXrkCm-u5n9HRNGGEOuNys6Ab-S2_aMGItxGUCssKoTpjBKM21vtG84EuttTGS1b5LqlXRXnX1kBwEPPyCu08hbb7Qf3flm10"
rel="" style="color: #0068ef;
text-decoration: none;"
moz-do-not-send="true">know </a>that mixing
AstraZeneca with Pfizer is safe from clinical
trials in the UK. Because J&J is the same
biotechnology as AstraZeneca, we hypothesized
that mixing would be okay too. But needed to
see the data.</p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;"><em><strong>Can
(and how do) we effectively mix vaccines?</strong></em>
For example, if you had two doses of Moderna,
should you get a third booster of J&J? Is
this any better (or worse) than a Moderna
booster?</p>
</li>
</ol>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">These
questions were answered in a landslide <a
href="https://email.mg2.substack.com/c/eJwtkEtuxCAQRE8zLJGbn-0Fi2xyDQtD20HBYPGZiW8fnImEmuqmSi2eNRX3lC99plLJXZZ6nagjvkrAWjGTVjAv3mmhxnnmpAsHk5yIL8uWEQ_jg665ITnbGrw11ad4-9kEDGbypWfHEQUa7lYYRgCw1go3OqZwtDDL91rTnMdoUeMT85UikqC_aj3Lg3882Gc_r9eLHujyj3_SlPc-sSlWjLUrGCjAAF2xgQG924EyYEpMbHwC3VoI9HQb8fo2dCtnXHDglFHJxKpmuU5s2gSfN9qe41pz2h9iOHZGS1tLNfab2nSQrA8T49Wfsqlm86b8jfvfl34fLfp6LRjNGtC9sdQ32z9Qy44RexDdYqoGxQWoSXE5yH8KN2cmpVSKkb7XpZ6K-koth2RNwNM7PHwKafel_gIIhpNx"
rel="" style="color: #0068ef; text-decoration:
none;" moz-do-not-send="true">study</a> that was
just released today. The timing of the preprint is
not a coincidence. VRBPAC (external scientific
advisory committee to the FDA) is reviewing the
evidence for mixing vaccines on Friday. Any data
they review and discuss has to be released 48
hours prior to the meeting.</p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;"><strong><code>The
study</code></strong></p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">In total,
458 volunteers were divided into nine groups with
roughly 50 volunteers in each group. I threw
together a figure to show how those people were
divided. </p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">Briefly,
people that got a primary J&J, Moderna series,
or Pfizer series were randomly given a booster
four to six months after. For example, those who
initially got the two dose Moderna series got
either another Moderna shot, a Pfizer shot or a
J&J shot.</p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin-bottom: 16px; text-align: center;">
<figure style="display: inline-block; margin: 0
auto; width: 100%;">
<table class="image-wrapper" style="margin: 8px
auto; mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="550" align="left"><a
class="image-link" target="_blank"
href="https://email.mg2.substack.com/c/eJxVUtuOrSAM_Zrtm0bKRXjwYXKS8xuGS3WTUXAA94zz9Qe3Tych7aKlXaWt1QWXmM5xj7k0l5jKueMY8DuvWAqm5siYJu9GJgalaFOBI5LLxudpToib9utY0oHNfpjVW118DNd7kASIap6jIWruuTKgNRCYDTNIUCAIovpBMnbT6sN5DBZHfGE6Y8BmHZ-l7PlBPx7wtx7rQpcPk4u2n52NWzX5TS9Y9YzFPi9d05T4gD9fN6AfS4yu3ud12lNcEubsX1jtuSDuNeKmAH6R8IumCnPYT6z-1GLPjbGStUZr2jI6YKs4ka12hoLBYVCSdZl2etO_MejvfNdVc9zNeMN3kfkNUTEplKEtUO7a2kjeSsKHdpCSC4ust5xNBAT8UK66PSyNH6EHQnpCgTJKaAcdB2aE4kaCnBlVc3e8BlPq7x6s3xb4r0dNGjcdwlldSRc9e_0u8ZrVVPV2BF_OCYM2K7p7jOXehfdgpwUD1kB0ky4jEZQRIQXlPef31K69AM65ENBUXhdrVBjPeKQ1Wr3i7h1uPq5x8bn8A-MkykI"
rel="" style="border: none; display:
block; height: auto; margin: 0;
padding: 0; text-decoration: none;
width: auto;" moz-do-not-send="true"><img
data-attrs="{"src":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/e94869b3-235d-4d15-8157-78856ce40c54_1262x359.png","height":359,"width":1262,"resizeWidth":null,"bytes":32595,"alt":null,"title":null,"type":"image/png","href":null}"
alt="" class="wide-image"
src="https://cdn.substack.com/image/fetch/w_2524,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fe94869b3-235d-4d15-8157-78856ce40c54_1262x359.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 550px; vertical-align:
middle; width: 100%;"
moz-do-not-send="true" width="550"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
</figure>
</div>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">Then
participants were asked to report side effects in
the 29 days following. Scientists also drew blood
from participants to quantify protection: number
of neutralizing antibodies and IgG antibodies.
What did they find?</p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;"><strong><code>Can
we safety mix vaccines?</code></strong></p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">Yes, the
safety profile was nothing more than what we
expected. Mixing is safe, but you will probably
experience a side effect (like chills, fever,
headache, or fatigue). In all groups, there were
only 2 severe events: renal failure due to a fall
injury and gallbladder swelling. After
investigation, these events were not linked to the
booster. One person reported vomiting 1 day after
the J&J booster (Group 5). </p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin-bottom: 16px; text-align: center;">
<figure style="display: inline-block; margin: 0
auto; width: 100%;">
<table class="image-wrapper" style="margin: 8px
auto; mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="538" align="left"><a
class="image-link" target="_blank"
href="https://email.mg2.substack.com/c/eJxVUkuO5CAMPU1ll4g_ZMGiNdJcI-LjpFAnkAZS3enTD6msRkL2w8Z-xrYzFZaUT72nUrtLTPXcQUf4LivUCrk7CuQpeM2EHEfaNeCx4qoLZZozwGbCqms-oNsPuwZnakjxek8UJnjsnlqMSiFPvTVGci-cN8AZwtQiicio0E1rDh8gOtDwgnymCN2qn7Xu5UE_HuRvO87HoRy2VOM-B5e2ZgqbWaDpGap7XrqlqelB_nzdgH4sKfl2n9dpz2nJUEp4QbOXCrC3iJuC8IuEXzRN2MN9QvPnHhC31inWt9ppz6iEfuRY9cZbSixIOSo2FDqYzfymaL7LXVfLcTfjDd9FljcENwvBEOmx59A3QHrL-dwjCZjNHEtC1CSk-JGMD3tcuqAJIhi3bhHKKKYDGThhVozcKqJmRsd5OF7S1va5B0PbQv5rUZf1ZmI8myubauZg3hVeo5qa3o4Y6jlBNHYFf0-x3qvwnuu0QIQWCH4yVWNBGRZKUI44v4d2rQXhnAtBusbrU4uK-kxHXpMzK-zBwxbSmpZQ6j-D78pb"
rel="" style="border: none; display:
block; height: auto; margin: 0;
padding: 0; text-decoration: none;
width: auto;" moz-do-not-send="true"><img
data-attrs="{"src":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/ecf66402-1d5e-4022-b55f-07e14f517228_676x745.png","height":745,"width":676,"resizeWidth":538,"bytes":295324,"alt":null,"title":null,"type":"image/png","href":null}"
alt="" class=""
src="https://cdn.substack.com/image/fetch/w_538,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fecf66402-1d5e-4022-b55f-07e14f517228_676x745.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100%; vertical-align:
middle; width: auto;"
moz-do-not-send="true" width="538"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
</figure>
</div>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;"><strong><code>Which
combination works best? </code></strong>To
me, this was the most interesting…</p>
<ul style="margin-bottom: 1em; margin-top: 1em;">
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;
mso-special-format: bullet;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">The most
benefit, by far, was for those with a primary
J&J shot. A Moderna booster gave the
greatest benefit to J&J folks (56.1 fold
increase in IgG; 76.1 fold increase in
neutralizing antibodies). Pfizer also worked
very well (32.8 fold increase in IgG; 35 fold
increase in neutralizing antibodies). There
was minimal increase with a J&J booster
(4-fold increase).</p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;
mso-special-format: bullet;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">After the
primary Moderna series, there was benefit from
either a Moderna or Pfizer booster. There was
really no difference between the two. </p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;
mso-special-format: bullet;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">After the
primary Pfizer series, the greatest benefit
was from a Moderna booster. But a Pfizer
booster helped a lot too. </p>
</li>
</ul>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin-bottom: 16px; text-align: center;">
<figure style="display: inline-block; margin: 0
auto; width: 100%;">
<table class="image-wrapper" style="margin: 8px
auto; mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="550" align="left"><a
class="image-link" target="_blank"
href="https://email.mg2.substack.com/c/eJxVUt2OpSAMfprjnUb-FC64mGyyr2EKVA8ZBQfwzDhPv3i82oS0Hy3tV9paKLjEdOo95tJcYirnjjrgd16xFEzNkTFN3mk-jEqxpgJHpJCNz9OcEDfwqy7pwGY_zOotFB_D9Z5KQolqnnqUZDDSKcPcYJ2joyNOomVWKsKR0ZsWDucxWNT4wnTGgM2qn6Xs-cE-HvRvPdaFLh8mF7CfnY1bNfkNFqx6xmKfl65pSnzQP183YB9LjK7e53XaU1wS5uxfWO25IO414qag4iIRF00V5rCfWP2pxV4YYyVvDQBrORuxVYLIFpxh1OA4Ksm7zDrY4DcG-M53XTXH3Yw3fBeZ35CMveFGze1IzNhyAqaVBFUrgfVSABc160TowH54TbyHpfGa9pSQnjDKOCOso52g3AxKGEnlzJmau-M1mlJ_9-D9ttD_etQkvUEIZ3UlKDB7eJd4zWqqejuCL-eEAcyK7h5juXfhPdhpwYA1EN0ERZOBcTLIgYleiHtq115QIcQw0Kbyulijgj7jkdZoYcXdO9x8XOPic_kHMZnLKQ"
rel="" style="border: none; display:
block; height: auto; margin: 0;
padding: 0; text-decoration: none;
width: auto;" moz-do-not-send="true"><img
data-attrs="{"src":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/170b4b9f-71b7-41ab-81e9-8a3085a4532b_1263x484.png","height":484,"width":1263,"resizeWidth":null,"bytes":41697,"alt":null,"title":null,"type":"image/png","href":null}"
alt="" class="wide-image"
src="https://cdn.substack.com/image/fetch/w_2526,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F170b4b9f-71b7-41ab-81e9-8a3085a4532b_1263x484.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 550px; vertical-align:
middle; width: 100%;"
moz-do-not-send="true" width="550"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
</figure>
</div>
<ul style="margin-bottom: 1em; margin-top: 1em;">
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;
mso-special-format: bullet;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">A J&J
booster following an mRNA series did help, but
not as much as another mRNA booster. I thought
this was interesting. Scientists originally
hypothesized that different vaccine
biotechnologies could help more. In theory,
your body got more tools to recognize the
virus. But that doesn’t seem to be the case.
Only higher efficacy matters. This is,
importantly, assuming that J&J doesn’t get
better with time. In original J&J clinical
trials, the most benefit occurred 4 weeks
after the original shot. The follow up period
for the current study was 29 days, so optimal
benefit may have been missed. </p>
</li>
</ul>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;"><strong><code>Results
will be discussed Friday in great detail </code></strong></p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">This data
will be discussed on Friday at the VRBPAC meeting.
And, although we finally have some answers it’ll
be interesting to see what happens next from a
regulatory perspective:</p>
<ol style="margin-bottom: 1em; margin-top: 1em;">
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">The FDA cannot
recommend mixing vaccines because none of the
vaccine companies have asked for approval. For
example, J&J has not asked to approve
mixing with a Moderna booster. So, this will
likely be punted to ACIP and the CDC to make a
“preferential” recommendation next week. A
preferential recommendation doesn’t direct
anyone to do anything, but it rather says: “if
you do this, this is what the experts
recommend and it’s okay”. </p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">Then, the
natural next question is can agencies make a
preferential recommendation if Moderna is
still under an EUA? Or would this have to
wait?</p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;">Finally, this
study included Moderna as a 100 μg booster.
The problem is Moderna applied for a 50 μg
booster EUA. Would a 50 μg booster change this
study’s results? Probably. So… then what?</p>
</li>
</ol>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;"><strong><code>Other
important meetings are coming up too…</code></strong></p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">And, to
make matters more complicated, there are other
meetings coming up at the FDA (then the CDC):</p>
<ol style="margin-bottom: 1em; margin-top: 1em;">
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;"><strong>Tomorrow</strong>:
What is the safety, effectiveness, and, most
importantly, need of a Moderna (50 μg)
booster? There’s not much evidence that
Moderna people <em>need</em> a booster so
this should be an interesting discussion to
follow. </p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;"><strong>Friday
morning</strong>: What is the safety,
effectiveness, and need of a J&J booster?
This should be more straightforward; I expect
a booster to be recommended. </p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;"><strong>Friday
afternoon</strong>: What is the safety and
effectiveness of mixing vaccines? </p>
</li>
<li style="margin-bottom: 3.75px; margin-left:
7.5px; margin-right: 0; margin-top: 3.75px;">
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0;"><strong>Oct 26</strong>:
What is the safety, effectiveness, and need of
a vaccine for 5-11 year olds? </p>
</li>
</ol>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">Then the
FDA will make a decision and then data and
decisions go to ACIP and CDC. And THEN there will
finally be a formal recommendation. Phew. </p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">We’re
starting see a data dump in preparation for all of
the scheduled meetings. And, more than ever, we’ll
be drinking from a firehose of information. I will
(try to) distill the data, meeting information,
and cliff notes as we go. </p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">Gear up;
this will be a lot. </p>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;">Love, YLE </p>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #dfe9f6; border: none;
height: 1px; margin: 24px 0; padding: 0;"></div>
<p style="color: #1a1a1a; font-size: 16px;
line-height: 26px; margin: 0 0 1em 0;
margin-bottom: 0;">And a very big thank you to the
66,066 people that have already filled out my “Who
are you” survey! If you haven’t already, please
complete it <a
href="https://email.mg2.substack.com/c/eJwlUMtuxCAM_JrlGAUICTlwaKW2UtVT1XtkgpNFSyDisW3-vuzGsmzL9siemSHjGuKh9pAyeYQpHzsqj7_JYc4YSUkYJ2tU1w_jyEktDJVCEpumJSJuYJ3KsSDZi3Z2hmyDf-wzSRkdyVUBp7PkEo2EAWi1ceha7E1r5hE1wHkWirHoZ1R4x3gEj8Spa857uvCXC3uvvoS4pWZ1WOu3j89D4339_nnVty__V99RrGWUtpQz3nHKG9YI1ul-FFoyuXR8XJpyH3SOYb107bayJhWdMsy3Zg4biWoD7486ipBhsZCe7Upqqnkr3uZjQg_aoTn55lO0pwLTih4rEM0EWdGed7SXPRetECe9h4BMCNH3jNS7JlSUV0co0YUZHO7W4GaDC6tN-R8Zi4nb"
rel="" style="color: #0068ef; text-decoration:
none;" moz-do-not-send="true">here</a>. </p>
</div>
</div>
<table class="post-meta big custom" style="margin: 0;"
cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td class="post-meta-item icon" style="color:
#767676; font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI', Roboto,
Helvetica, Arial, sans-serif, 'Apple Color
Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
font-size: 16px; height: 30px; line-height:
24px; padding: 7px 12px 7px 0; padding-right:
16px; position: relative; text-decoration: none;
text-indent: 3px; vertical-align: middle;
white-space: nowrap;"><span><a
href="https://email.mg2.substack.com/c/eJx1Uk1z2jAQ_TX4VsaSLGMffGhJoIZgpgkNoRePLC0gIkuuJZMqv75yaA89dEazb2e13285c3AyvS86Y100itr5DgoNb1aBc9BHg4W-lqJI0lmekygoAmU0i6Stjz1Ay6QqXD9A1A2Nkpw5afTojzOEUR6dCwyUEj4DHidxzqEhIhMon82oaDKMEbmVZYOQoDkUcIXeGw2RKs7OdXZCPk_wIjxvhl4ZzhR0UkArjTInad3UDo11jL9OuWmDG-tkkFcUxJg4wEePn3pgfOxtQhbOvELAO_ArxPGzf8HqtbyYuLpwut1tbKm_XDl5PLL9N7m9fPPV7juqLgf_MF_5H_vFRSzVtZFlWg5r0c1LW7bqLOZlutkd3qu7e7y9Czh_k-yleg95Jf_6LB92ZbLZlb-2T8FfV-gwxuuVOuyrmO3zodTxtMlO51VC5stErc5oT9VTf1gs135n2WKt2IMvfz42y_Vhs7mf4HRwbW3DTjiEUf4u4Y-9BSGHdhxxnD2SBY4xQjEimCQEkSmeUpw0aU4DBdkxIflxOlxnjevNaZLE7Qn_s9WoL1qmtQ9fPXPsKJn9MAfG64DtoKXzNWjWKBC3Y3C3i_ooX59AQwgEUTNXoJQkKM1SQmNKb9yP14UppWmKo1BXmBCli__w_RuHMuvo"
class="like-button" style="color: #767676;
display: block; position: relative;
text-decoration: none;"
moz-do-not-send="true"><img
src="https://cdn.substack.com/image/fetch/w_48,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FHeartIcon%3Fv%3D2%26height%3D48%26fill%3D%2523757575%26stroke%3D%2523757575%26strokeWidth%3D2"
style="border: none !important; float:
left; height: 30px; max-width: 24px;
vertical-align: middle; width: auto;"
alt="" moz-do-not-send="true" width="24"
height="24"></a></span></td>
<td class="post-meta-item icon" style="color:
#767676; font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI', Roboto,
Helvetica, Arial, sans-serif, 'Apple Color
Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
font-size: 16px; height: 30px; line-height:
24px; padding: 7px 12px 7px 0; padding-right:
16px; position: relative; text-decoration: none;
text-indent: 3px; vertical-align: middle;
white-space: nowrap;"><a
href="https://email.mg2.substack.com/c/eJx1UsFy2yAQ_RrrZo8AIUsHHdK47tgTy02bxPZJg2AtYyNQBbJDvr4obg89dAZYZnnLg_eWMweN6X3RGeuicamc76DQcLMKnIM-Giz0lRRFks7znERhI1BGs0ja6tgDtEyqwvUDRN1QK8mZk0aPeJwhjPLoVCR0zhASQtRJTLP5MWO4zmqYozRmeY35nZYNQoLmUMAVem80RKo4OdfZCXmY4GUY3gy9Mpwp6KSAVhplGmndzA61dYxfZty0AdaF2cp3qZvplXEuNdipO8HUukH46S1cP2VKBVCAt6BdIFg6cwE9IQvwa8Txm99jdVmdTVyeOd2-bOxKf7ly8uPIds9ye3725csrKs8H__S47g77MfcVbz6e38tzM0a7atUH96s01KGDjP128dVvXi4y4D_EbiW3cn2rSRk_7dfqsCtjtsuHlY5ndLnMf11eN1x0bz83_SNZ3PbOPenL-9u35TQv41e0OCffT_zhMMHp4NrKBlE4hKf_VeFPvgUhh3b80mhQJAscY4RiRDBJCCIzPKM4qdOc1hnOjgnJj7PhOq9db5pJErcN_kfWqC9aprUPRz1z7CiZ_UwHy6tRxkFL5yvQrFYg7t3g7i31SV81oCEUgqiYK1BKEpRmKaExpXfzx_bClNI0xVHgFSZU6eI_hv8Gz6vuCQ"
style="color: #767676; display: block;
text-decoration: none;" moz-do-not-send="true"><img
src="https://cdn.substack.com/image/fetch/w_48,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FCommentIcon%3Fv%3D2%26height%3D48%26fill%3D%2523757575%26stroke%3D%2523757575%26strokeWidth%3D2"
style="border: none !important; float: left;
height: 30px; max-width: 24px;
vertical-align: middle; width: auto;"
alt="Comment" class="comment-icon"
moz-do-not-send="true" width="24"
height="24"></a></td>
<td class="post-meta-item icon" style="color:
#767676; font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI', Roboto,
Helvetica, Arial, sans-serif, 'Apple Color
Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
font-size: 16px; height: 30px; line-height:
24px; margin-right: 0; padding: 7px 12px 7px 0;
padding-right: 16px; position: relative;
text-decoration: none; text-indent: 3px;
vertical-align: middle; white-space: nowrap;"><span><a
href="https://email.mg2.substack.com/c/eJx1kk1z2jAQhn8NvsFYkuXYBx_SEDowwTRtEuDkkaXFCGTJtWSI8usrh3amPXRGn4_e3R3tvJw5aEzvi85YF41L5XwHhYarVeAc9NFgoa-kKJL0Ls9JFA4CZTSLpK0OPUDLpCpcP0DUDbWSnDlp9KjHGcIoj45FzoFkVOQZEgdMUixoWhOWsiSuKcEc38qyQUjQHAq4QO-NhkgVR-c6OyH3E7wIw5uhV4YzBZ0U0EqjTCOtm9mhto7x84ybNsi6MFv5LnUzvTDOpQY7dUeYWjcIP72G9FOm1IQsBtdWNuTkMCHzP0kmOB15C0IObeCf__sNudEOtBvVR9ZDoIyPv_0LOHOG8Q5-hTh-8zuszsuTicsTp5uXtV3qLxdOvh_Y9lluTs--fHlF5Wnvnx5W3X43ske8_nh-L0_NuNtlqz64X6YhDu1l7DfzR79-Ocug_xDbpdzI1bUmZfy0W6n9tozZNh-WOp7RxSL_eX5dc9G9_Vj3D2R-3Tn3pM_vb18X07yMX9H8lHw78vt9JAscY4RiRDBJCCIzPKM4qdOc1hnODgnJD7Phcle73jSTJG4b_E_Lo75omdY-PPXMsYNk9hMHO4SOte2gpfMVaFYrEDenuJvdPntbNaAhBIKomCtQShKUZimhMaU3Y4zWw5TSNMVRqCtMiNLFf8zwC8aE91E"
style="color: #767676; display: block;
text-decoration: none;"
moz-do-not-send="true"><img
src="https://cdn.substack.com/image/fetch/w_48,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FRecommendIcon%3Fv%3D2%26height%3D48%26fill%3D%2523757575%26stroke%3Dnone%26strokeWidth%3D2"
style="border: none !important; float:
left; height: 24px; max-width: 550px;
vertical-align: middle; width: 24px;"
alt="Share" class="recommend-icon"
moz-do-not-send="true" width="24"
height="24"></a></span></td>
</tr>
</tbody>
</table>
<div class="post-cta" style="font-size: 16px;
line-height: 26px; margin: 24px 0 40px;">
<p style="color: #1a1a1a; font-size: 16px; font-style:
italic; line-height: 26px; margin: 24px 0 0;
margin-top: 0;"><span>You’re on the free list for <a
href="https://email.mg2.substack.com/c/eJx1UMtuxCAM_JrlGIVnyIFDL_0NRIKTohKIwGyVvy-7OfVQybIte-zRzOoQ9lwuc-aK5JUsXieYBD81AiIU0ioUG7wRappnTnrjqZaahGq3AnC4EA2WBuRsSwyrw5DTC880ZXQmX2bzMI6KT6PWwk8LAzaDWD30b5OcnbhpXfMB0goGnlCunIBE84V41gf_eLDPHlduJebVRTiDhyPkmPdQcahtqejW72HNR4eRYNjIKB0pZ1xwygc2SCYWNctFM70JPm9De04Llrw_xHjs7M8LUszhUrr6qjh0W3D1Pe7ybK9HSwEvC8ktEfytHG_73l7YHRL0Q_DWoaGKC6q04nKU8hb6spJJKZVipPP63K-S-UfcL6OmjoA"
style="color: #0068ef; text-decoration: none;"
moz-do-not-send="true">Your Local Epidemiologist</a>.
For the full experience, <a
href="https://email.mg2.substack.com/c/eJx1UsGOmzAQ_ZpwKwIbEzhwSJNsFVQSbbXaJr0gYw_gxNgUDCz5-ppNeuihkuWxn99o5s0zowYq3c1Jq3vjLFtu5hYSBVMvwRjonKGHLhc8CcJ1HGPHHrgfkcgRfV52AA0VMjHdAE47FFIwaoRWCx9FPvJjp04gApsZeZhTzsErgoISj0acknIdhiV5lKUDF6AYJDBCN2sFjkxqY9p-hTcr9GLXrIdOakYltIJDI7TUleiN2w9Fbyi7uUw3lrZcWScKWOEXo2-gVngHc-oz9D6fkbwdrto7Xhk5vWX9oZE13x7C7O1yP-726LSzcTuJX-d6sryP4zVDx_tlstH7vk1bhjNxEunEfx5Mdq0-suueHMQkGH4Xli8uqJYXZEZ-fhXlq_uja1HtpZuvm295sY_f6t_eLDfj5Tbc0_2dfylLPWaFrMfUSgwH0-S91chs57u_op54A1wMzaJkmfcTZFoZUMaiywSZoY5IkId83_MxwgH2sYtcgoIijEkRoagMcFy6w7guTKerVeA1Ffpnek6XNFSp2T511NBS0P4Tts7aYk0zKGHmHBQtJPCH6ebxcz7byitQYBOB59QkfogDP4xCTDzy9Hj5RYgQEobIsXW5tlkq-Y-vfwA56uey"
style="color: #0068ef; text-decoration: none;"
moz-do-not-send="true">become a paying
subscriber.</a></span></p>
<p class="cta-box" style="color: #1a1a1a; font-size:
16px; font-style: italic; line-height: 26px; margin:
24px 0 0; text-align: center;"><a role="button"
href="https://email.mg2.substack.com/c/eJx1UsGOmzAQ_ZpwKwIbEzhwSJNsFVQSbbXaJr0gYw_gxNgUDCz5-ppNeuihkuWxn99o5s0zowYq3c1Jq3vjLFtu5hYSBVMvwRjonKGHLhc8CcJ1HGPHHrgfkcgRfV52AA0VMjHdAE47FFIwaoRWCx9FPvJjp04gApsZeZhTzsErgoISj0acknIdhiV5lKUDF6AYJDBCN2sFjkxqY9p-hTcr9GLXrIdOakYltIJDI7TUleiN2w9Fbyi7uUw3lrZcWScKWOEXo2-gVngHc-oz9D6fkbwdrto7Xhk5vWX9oZE13x7C7O1yP-726LSzcTuJX-d6sryP4zVDx_tlstH7vk1bhjNxEunEfx5Mdq0-suueHMQkGH4Xli8uqJYXZEZ-fhXlq_uja1HtpZuvm295sY_f6t_eLDfj5Tbc0_2dfylLPWaFrMfUSgwH0-S91chs57u_op54A1wMzaJkmfcTZFoZUMaiywSZoY5IkId83_MxwgH2sYtcgoIijEkRoagMcFy6w7guTKerVeA1Ffpnek6XNFSp2T511NBS0P4Tts7aYk0zKGHmHBQtJPCH6ebxcz7byitQYBOB59QkfogDP4xCTDzy9Hj5RYgQEobIsXW5tlkq-Y-vfwA56uey"
class="button primary subscribe-btn"
style="background-color: #0068EF; border: 0px
solid #0068EF; border-radius: 4px; border-width:
13px 20px 13px 18px; box-sizing: content-box;
color: #ffffff !important; cursor: pointer;
display: inline-block; font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI', Roboto, Helvetica,
Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI
Emoji', 'Segoe UI Symbol'; font-size: 17px;
font-style: normal; font-weight: 300; height:
24px; line-height: 24px; margin: 0; opacity: 1;
outline: none; padding: 0; text-align: center;
text-decoration: none !important; vertical-align:
middle;" moz-do-not-send="true">Subscribe</a></p>
</div>
<div class="footer" style="background: #f8f8f8
!important; color: #bcbcbc; font-size: 16px;
line-height: 26px; padding: 32px; text-align: center;">
<p class="small" style="color: #bcbcbc; font-family:
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple Color
Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
font-size: 13px; line-height: 26px; margin: 0 0 1em
0; margin-bottom: 0; padding-bottom: 30px;">© 2021 <span>Your
Local Epidemiologist</span> <a
href="https://email.mg2.substack.com/c/eJx1Uk2P2yAQ_TXxbSMDxh8HH9LuRnKUj6abbpK9WBiwQ4zBNThd8uuLk1MPlRAzGubxRu8NJZY3enB5r40Npqu0rue54n-M5NbyIRgNH0rB8ihOsgwFPmEgxWkgTFkPnHdEyNwOIw_6sZKCEiu0mvphCiDIgktOKc1YEkICEsYAripYxzSucR0lYZ34Lx-0ZGSCK8pzfuOD04oHMr9Y25sZWszg0h-nx0FqSiTvBeOd0FI3wti5GStjCW3nVHe-jdBpAp8wYUglefkYcYaWVrdczdArdytA4Yc7QdkWVx1urxTvDhtTqG83in7W5LgXu-vebQ-_wPZ6duvvq_58mmpvcHPff22vzRRN0ck7dUXsceAsQrd7fXObQyt8_50dC7ETq5actpdz9yVP8MOej9JzhPP1e7xUkn7qlq0X7-j3xoaj2R1f7u3thMPyzGBWvxT3H5-LfSByGEIAQoAgihBAczjHMKriDFcpTOsIZfV8vCWVHXQzi8Kugf_IEQx5R5Ry_mkgltSCmEfZW1X62I1KWFdyNenEni7a5yo8RCsbrrgHclYSm4MYRSBOY4RDjJ-mTWsBMcZxDAPPy7RHqfw_Rv0FH-rVaQ"
style="color: #0068ef; text-decoration: none;"
moz-do-not-send="true"><span style="color:
#bcbcbc; text-decoration: underline;">Unsubscribe</span></a><br>
111 Sutter Street, 7th Floor, San Francisco, CA
94104</p>
<p class="small powered-by-substack" style="color:
#bcbcbc; font-family: -apple-system,
BlinkMacSystemFont, 'Segoe UI', Roboto, Helvetica,
Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI
Emoji', 'Segoe UI Symbol'; font-size: 13px;
line-height: 26px; margin: 0 0 1em 0; margin-bottom:
0; padding-bottom: 0;"><a
href="https://email.mg2.substack.com/c/eJxNkNFq7SAQRb8mPoao0aMPPhQu_Y1gdJJKowYde8nf15zTQmGQYY3D3rOdRdhzucyZK5L7WfA6wST4Xw9AhEJahbIEb2b50JqT3niqhCKhLlsBiDYcBksDcrb1CM5iyOn-zxRlVJMP8_AAdmNMUy22zW1cWyeV0txLyScFL1nbfIDkwMAXlCsnIIf5QDzrwN8G9t6rtrWidZ-jy_Em_L1hXGpuxcHA__2OByZvHsGHFjt_OvyBLieEhJ1uOd_HBcMmRulEOeMzp3xko2DzKrVYFVPbzPU2tq_HiiXvwzzFnY1_bZBiok3p6qNi0W7B1ifuUXStGFsKeC2Q7HqAf6WEr6ifrpYdEvRF8ItFQyWfqVSSi0mIVyh37EwIISUjXdfnvpXM1U8-srMHnMFDDPnIe6j4DbfmnbI"
style="color: #0068ef; text-decoration: none;"
moz-do-not-send="true"><img alt="Publish on
Substack"
src="https://cdn.substack.com/image/fetch/w_340,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Fpublish-on-substack.png"
style="border: none !important; margin-top: 3px;
max-width: 550px; vertical-align: middle;"
moz-do-not-send="true" width="170"></a></p>
</div>
</div>
</td>
<td><br>
</td>
</tr>
</tbody>
</table>
<img alt=""
src="https://email.mg2.substack.com/o/eJwlUEmOhSAQPU2zNFIMwoKzGITSJo1gGH7H2zetq0pevbzJ2YZHLre5cm0ETxviemDCMnC_2maoZJxKJZmYhSDecE-VUCTUdS_48E0rHcnVtxicbSGnNXgDigLV5NuIBaQEWJZZgHbWMtzBc-ROqEUDVeTfeLXdB0wODX6w3DnhCw8hDkKIoUCCgRkonSkDxhllE0wC-Ca12BSonTO9T_2zbK3k44vP5wFT7Vtt1v1MLp-kmNOmdI_X6Gb3YOsDj9zruGdPod0rJrtF9G-l9o7SK5YniVy0Zm-wdl9oEv7WiK1hIcPJ5zFGMnfuJWZnI17B4xlyzEeo7Q-KInnC"
moz-do-not-send="true" width="1px" height="1px">
<div id="DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2"><br>
<table style="border-top: 1px solid #D3D4DE;">
<tbody>
<tr>
<td style="width: 55px; padding-top: 13px;"><a
href="http://www.avg.com/email-signature?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient"
target="_blank" moz-do-not-send="true"><img
src="https://ipmcdn.avast.com/images/icons/icon-envelope-tick-green-avg-v1.png"
alt="" style="width: 46px; height: 29px;"
moz-do-not-send="true" width="46" height="29"></a></td>
<td style="width: 470px; padding-top: 12px; color:
#41424e; font-size: 13px; font-family: Arial, Helvetica,
sans-serif; line-height: 18px;">Virus-free. <a
href="http://www.avg.com/email-signature?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient"
target="_blank" style="color: #4453ea;"
moz-do-not-send="true">www.avg.com</a> </td>
</tr>
</tbody>
</table>
<a href="#DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2" width="1"
height="1" moz-do-not-send="true"> </a></div>
</div>
</body>
</html>