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    Here is an interesting and useful explanation of how COVID effects
    change as we grow older. I've pasted in some highlights here, and
    the full article from Katelyn Jetelina is below.--Manny<br>
    <br>
    "We already see benefits with older people vaccinated with one
    booster dose having 4 times the risk of dying compared to people
    with two booster doses. (Unvaccinated people had 42 times the risk
    of dying from COVID-19 compared to those with 2 boosters.)...<span>But,
      the FDA needs to require pharmaceutical companies to test B cell
      and T cell functions—not just neutralizing antibodies—to assess
      the added benefit, instead of retrospectively determining good or
      bad policy...</span><span>Only </span><a
href="https://substack.com/redirect/4e41f6eb-ee10-4ce8-bf3a-bab5434b45da?r=a13t"
      rel="" style="color: #0068ef; text-decoration: none;">39.8%</a><span>
      of 65+ year olds are up-to-date on COVID-19 vaccines. The best
      thing that this group can do is to fill the holes in their
      immunity walls by staying up-to-date. This also highlights that we
      cannot rely on immune systems alone, especially people aged 50+. </span><em>Everyone
      else</em><span> also needs to </span><a
href="https://substack.com/redirect/8f318fd0-9660-4130-8df9-b4c2ac9ec5cf?r=a13t"
      rel="" style="color: #0068ef; text-decoration: none;">do their
      part</a><span> (still) to keep the more vulnerable safe. </span><span>"</span><br>
    <br>
    <br>
    <pre class="moz-signature" cols="72">"Fight for the things that you care about, but do it 
in a way that will lead others to join you."
― Ruth Bader Ginsburg </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>Why older people are at higher risk for severe COVID-19</td>
          </tr>
          <tr>
            <th valign="BASELINE" nowrap="nowrap" align="RIGHT">Date: </th>
            <td>Fri, 19 Aug 2022 13:04:43 +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+1529t4&a13t&&a1e149ef80e675108cd4a98de654465e3b7a6e1423edb4e40ea4b426c7bc632b@mg1.substack.com"><reply+1529t4&a13t&&a1e149ef80e675108cd4a98de654465e3b7a6e1423edb4e40ea4b426c7bc632b@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>Why older people are at higher risk for severe COVID-19</title>
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  .use-theme-bg table.thread-head h1 a,
  .use-theme-bg table.thread-head h2 a,
  .use-theme-bg table.thread-head h3 a,
  .use-theme-bg table.thread-head h4 a,
  .use-theme-bg table.thread-head h5 a,
  .use-theme-bg table.thread-head h6 a {
    color: #00f;
  }
}


@media print {
  .use-theme-bg table.thread-head a.ui-secondary a {
    color: #00f;
  }
}


@media screen and (max-width: 540px) {
  .subscribe-widget form.form .sideBySideWrap button.rightButton {
    padding: 10px 12px;
  }
}


@media screen and (min-width: 541px) {
  .pub-icon:hover .logo-hover,
  .feed-item-icon:hover .logo-hover {
    display: block;
  }
}


@media print {
  .mobile-footer-ufi {
    display: none;
  }
}


@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,
  .file-embed-error-button.wide {
    display: none;
  }
}


@media only screen and (min-width: 630px) {
  .file-embed-button.narrow,
  .file-embed-error-button.narrow {
    display: none;
  }
}


@media screen and (min-width: 541px) {
  .audio-player-wrapper .audio-player {
    min-width: 500px;
  }
}


@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 screen and (max-width: 540px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-progress {
    border-left-width: 16px;
    border-right-width: 16px;
  }
}


@media screen and (max-width: 540px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-progress .audio-player-progress-bar .audio-player-progress-bar-popup {
    top: -54px;
  }
}


@media (min-width: 250px) {
  .audio-player-wrapper-fancy .audio-player {
    padding: 32px;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group {
    display: flex;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:last-of-type {
    display: block;
  }
}


@media (min-width: 300px) {
  .audio-player-wrapper-fancy .audio-player .btn-group {
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:first-of-type {
    display: block;
  }
}


@media (min-width: 350px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-substack-logo {
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .audio-player-title {
    margin-top: 16px;
  }
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-container {
    padding-top: 15%;
    width: 15%;
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:first-of-type {
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .audio-player-substack-logo {
    display: block;
  }
}


@media (min-width: 350px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-container {
    padding-top: 25%;
    width: 25%;
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group {
    display: flex;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:first-of-type {
    display: block;
  }
}


@media (min-width: 400px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-container {
    padding-top: 40%;
    width: 40%;
  }
}


@media (max-width: 400px) {
  .audio-player-wrapper-fancy .audio-player .btn-group {
    margin-top: 12px;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button {
    font-size: 13px;
    padding: 6px 12px;
    height: auto;
    margin-top: 10px;
  }
}


@media (min-width: 600px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-container {
    padding-top: 55%;
    width: 55%;
  }
}


@media (max-width: 620px) {
  .poll-editor-modal {
    min-width: calc(100% - 20px);
  }
}


@media (max-width: 750px) {
  .poll-embed .poll-anchor-target .poll-anchor-copy-button {
    left: 8px;
    top: 45px;
  }
}


@media screen and (min-width: 541px) {
  .poll-embed .poll-wrapper.poll-web .poll-dialog .modal-table .modal-row .modal-content > .container {
    width: 552px;
    padding: 26px 24px;
  }
}


@media screen and (max-width: 630px) {
  .poll-embed .poll-wrapper.poll-web .poll-dialog .modal-table .modal-row .modal-content > .container {
    padding: 40px 0;
  }
}


@media screen and (max-width: 630px) {
  .poll-embed .poll-wrapper.poll-web .poll-dialog .modal-row .modal-cell .modal-exit-btn {
    margin-right: -20px;
  }
}


@media (min-width: 631px) {
  .sm\:tw-relative {
    position: relative !important;
  }
  .sm\:tw-left-1 {
    left: 0.25rem !important;
  }
  .sm\:tw-my-8 {
    margin-top: 2rem !important;
    margin-bottom: 2rem !important;
  }
  .sm\:tw-mx-0 {
    margin-left: 0px !important;
    margin-right: 0px !important;
  }
  .sm\:tw-mt-0 {
    margin-top: 0px !important;
  }
  .sm\:tw-ml-3 {
    margin-left: 0.75rem !important;
  }
  .sm\:tw-mb-0 {
    margin-bottom: 0px !important;
  }
  .sm\:tw-mb-1 {
    margin-bottom: 0.25rem !important;
  }
  .sm\:tw-block {
    display: block !important;
  }
  .sm\:tw-inline-block {
    display: inline-block !important;
  }
  .sm\:tw-flex {
    display: flex !important;
  }
  .sm\:tw-hidden {
    display: none !important;
  }
  .sm\:tw-h-7 {
    height: 1.75rem !important;
  }
  .sm\:tw-h-screen {
    height: 100vh !important;
  }
  .sm\:tw-h-56 {
    height: 14rem !important;
  }
  .sm\:tw-max-h-\[60vh\] {
    max-height: 60vh !important;
  }
  .sm\:tw-w-auto {
    width: auto !important;
  }
  .sm\:tw-w-7 {
    width: 1.75rem !important;
  }
  .sm\:tw-w-full {
    width: 100% !important;
  }
  .sm\:tw-w-56 {
    width: 14rem !important;
  }
  .sm\:tw-w-\[500px\] {
    width: 500px !important;
  }
  .sm\:tw-max-w-lg {
    max-width: 32rem !important;
  }
  .sm\:tw-max-w-none {
    max-width: none !important;
  }
  .sm\:tw-translate-y-0 {
    transform: translate(var(--tw-translate-x), var(--tw-translate-y)) rotate(var(--tw-rotate)) skewX(var(--tw-skew-x)) skewY(var(--tw-skew-y)) scaleX(var(--tw-scale-x)) scaleY(var(--tw-scale-y)) !important;
  }
  .sm\:tw-scale-95 {
    transform: translate(var(--tw-translate-x), var(--tw-translate-y)) rotate(var(--tw-rotate)) skewX(var(--tw-skew-x)) skewY(var(--tw-skew-y)) scaleX(var(--tw-scale-x)) scaleY(var(--tw-scale-y)) !important;
  }
  .sm\:tw-scale-100 {
    transform: translate(var(--tw-translate-x), var(--tw-translate-y)) rotate(var(--tw-rotate)) skewX(var(--tw-skew-x)) skewY(var(--tw-skew-y)) scaleX(var(--tw-scale-x)) scaleY(var(--tw-scale-y)) !important;
  }
  .sm\:tw-flex-row-reverse {
    flex-direction: row-reverse !important;
  }
  .sm\:tw-items-start {
    align-items: flex-start !important;
  }
  .sm\:tw-gap-4 {
    gap: 1rem !important;
  }
  .sm\:tw-gap-5 {
    gap: 1.25rem !important;
  }
  .sm\:tw-gap-1 {
    gap: 0.25rem !important;
  }
  .sm\:tw-gap-2 {
    gap: 0.5rem !important;
  }
  .sm\:tw-space-y-0 > :not([hidden]) ~ :not([hidden]) {
    margin-top: calc(0px * calc(1 - var(--tw-space-y-reverse))) !important;
    margin-bottom: calc(0px * var(--tw-space-y-reverse)) !important;
  }
  .sm\:tw-border {
    border-width: 1px !important;
  }
  .sm\:tw-p-0 {
    padding: 0px !important;
  }
  .sm\:tw-p-6 {
    padding: 1.5rem !important;
  }
  .sm\:tw-px-6 {
    padding-left: 1.5rem !important;
    padding-right: 1.5rem !important;
  }
  .sm\:tw-py-2 {
    padding-top: 0.5rem !important;
    padding-bottom: 0.5rem !important;
  }
  .sm\:tw-pb-4 {
    padding-bottom: 1rem !important;
  }
  .sm\:tw-pb-16 {
    padding-bottom: 4rem !important;
  }
  .sm\:tw-text-left {
    text-align: left !important;
  }
  .sm\:tw-align-middle {
    vertical-align: middle !important;
  }
  .sm\:tw-text-sm {
    font-size: 0.875rem !important;
    line-height: 1.25rem !important;
  }
  .sm\:tw-text-4xl {
    font-size: 2.25rem !important;
    line-height: 2.5rem !important;
  }
  .sm\:tw-font-medium {
    font-weight: 500 !important;
  }
  .sm\:tw-text-pub-secondary-text {
    color: #767676 !important;
  }
  .sm\:tw-opacity-70 {
    opacity: 0.7 !important;
  }
  .sm\:hover\:tw-opacity-100:hover {
    opacity: 1 !important;
  }
}


@media (min-width: 768px) {
  .md\:tw-left-auto {
    left: auto !important;
  }
  .md\:tw-bottom-4 {
    bottom: 1rem !important;
  }
  .md\:tw-right-4 {
    right: 1rem !important;
  }
  .md\:tw-w-3\/4 {
    width: 75% !important;
  }
  .md\:tw-pl-4 {
    padding-left: 1rem !important;
  }
}


@media (max-width: var(--nav-bp-2)) {
  .frontend-reader2-Page-module__linkRow--1QoCL.frontend-reader2-Page-module__isPadded--Gbh4N {
    padding: var(--size-12) 0;
  }
}


@media screen and (max-width: 540px) {
  .frontend-components-prompts-WriterShareModal-module__toast--wc1bo {
    margin-bottom: 20px;
  }
}


@media (max-width: 540px) {
  .frontend-lib-ProfileSetupToast-module__headerRow--17w27 {
    flex-wrap: wrap;
  }
}


@media screen and (max-width: 630px) {
  .frontend-substack-home_page-module__hero--24Zq7 {
    padding-top: 164px;
    padding-bottom: 80px;
    height: auto;
    flex-direction: column;
    align-items: flex-start;
    justify-content: flex-start;
  }
  .frontend-substack-home_page-module__heroInnerRow--2ULAC {
    height: auto;
    flex-direction: column;
    justify-content: flex-start;
    gap: 32px;
  }
  .frontend-substack-home_page-module__heroButtonWrap--3V7jR {
    flex-direction: column;
  }
  .frontend-substack-home_page-module__heroImg--1E7-g {
    max-width: 342px;
  }
  .frontend-substack-home_page-module__hero--24Zq7 h1 {
    font-size: 44px;
    line-height: 54.56px;
    margin: 0;
  }
  .frontend-substack-home_page-module__home--28JuV section h2 {
    margin-top: 80px;
    font-size: 44px;
    line-height: 54.56px;
  }
  .frontend-substack-home_page-module__writerList--1rikY {
    padding: 0 24px 80px 24px;
    gap: 80px;
  }
  .frontend-substack-home_page-module__writerList--1rikY h3 {
    font-size: 28px;
    line-height: 34.72px;
  }
  .frontend-substack-home_page-module__writerList--1rikY > div {
    flex-direction: column;
    margin-top: 0px;
    gap: 80px;
    justify-content: flex-start;
    align-items: center;
  }
  .frontend-substack-home_page-module__benefits--VLGOQ {
    gap: 80px;
    padding: 0 24px 80px 24px;
  }
  .frontend-substack-home_page-module__benefit--PpUoA {
    flex-direction: column;
    justify-content: flex-start;
    align-items: center;
    width: 100%;
    gap: 24px;
  }
  .frontend-substack-home_page-module__benefitItems--emU-2 {
    gap: 80px;
  }
  .frontend-substack-home_page-module__benefit--PpUoA img {
    max-width: 320px;
    min-width: 200px;
  }
  .frontend-substack-home_page-module__benefit--PpUoA h3 {
    font-family: Cahuenga, serif;
    font-weight: 500;
    font-size: 32px;
    line-height: 33.79px;
    margin: 0;
    color: var(--color-primary);
  }
  .frontend-substack-home_page-module__readingExperiences--1gQwI {
    padding: 0 24px 80px 24px;
  }
  .frontend-substack-home_page-module__readingExperiences--1gQwI > div {
    gap: 80px;
    align-items: center;
    flex-direction: column-reverse;
  }
  .frontend-substack-home_page-module__readingExperience--3sCWK h3 {
    font-family: Cahuenga, serif;
    font-weight: 500;
    font-size: 32px;
    line-height: 33.79px;
    margin: 0;
    color: var(--color-primary);
    margin-bottom: 10px;
  }
  .frontend-substack-home_page-module__expandCollapseButton--3UjfI {
    top: 34px;
  }
  .frontend-substack-home_page-module__centerAlignedSection--z-lIj h4 {
    font-size: 28px;
    line-height: 35px;
  }
  .frontend-substack-home_page-module__faqs--2JSzX {
    justify-content: flex-start;
    gap: 80px;
    padding: 0 24px 80px 24px;
  }
  .frontend-substack-home_page-module__faq--2A0bm {
    gap: 12px;
    justify-content: flex-start;
    flex-direction: column;
  }
  .frontend-substack-home_page-module__faq--2A0bm h3 {
    font-weight: 500;
    font-size: 28px;
    line-height: 35px;
  }
}


@media screen and (max-width: 540px) {
  .frontend-substack-PublicationThreadAppLinkPage-module__threadsLinkContainer--3JR5W {
    width: calc(100vw - 80px);
  }
}


@media screen and (max-width: 540px) {
  .frontend-account-groups-GroupManagement-module__groupSubWrapper--OIOo2 {
    width: 100%;
  }
}


@media screen and (max-width: 500px) {
  .frontend-reader2-ManageSubscriptionPage-module__highlightRow--1lIkl.frontend-reader2-ManageSubscriptionPage-module__withPlans--3KhSk {
    align-items: start;
    flex-direction: column;
  }
  .frontend-reader2-ManageSubscriptionPage-module__highlightButtons--1lIV5 {
    flex-direction: column;
    width: 100%;
  }
}


@media screen and (max-width: 631px) {
  .frontend-editor-post-AudioEducationModal-module__modalContainer--3-T0R {
    height: 524px;
  }
}


@media (max-width: 540px) {
  .frontend-publish-stats-pages-reader_referrals_stats-reader_referrals_stats-module__popoverWrapper--3Gh5i {
    display: none;
  }
}


@media not all and (min-resolution: 0.001dpcm) {
}


@media (min-width: 631px) {
  .sm\:tw-relative {
    position: relative !important;
  }
  .sm\:tw-left-1 {
    left: 0.25rem !important;
  }
  .sm\:tw-my-8 {
    margin-top: 2rem !important;
    margin-bottom: 2rem !important;
  }
  .sm\:tw-mx-0 {
    margin-left: 0px !important;
    margin-right: 0px !important;
  }
  .sm\:tw-mt-0 {
    margin-top: 0px !important;
  }
  .sm\:tw-ml-3 {
    margin-left: 0.75rem !important;
  }
  .sm\:tw-mb-0 {
    margin-bottom: 0px !important;
  }
  .sm\:tw-mb-1 {
    margin-bottom: 0.25rem !important;
  }
  .sm\:tw-block {
    display: block !important;
  }
  .sm\:tw-inline-block {
    display: inline-block !important;
  }
  .sm\:tw-flex {
    display: flex !important;
  }
  .sm\:tw-hidden {
    display: none !important;
  }
  .sm\:tw-h-7 {
    height: 1.75rem !important;
  }
  .sm\:tw-h-screen {
    height: 100vh !important;
  }
  .sm\:tw-h-56 {
    height: 14rem !important;
  }
  .sm\:tw-max-h-\[60vh\] {
    max-height: 60vh !important;
  }
  .sm\:tw-w-auto {
    width: auto !important;
  }
  .sm\:tw-w-7 {
    width: 1.75rem !important;
  }
  .sm\:tw-w-full {
    width: 100% !important;
  }
  .sm\:tw-w-56 {
    width: 14rem !important;
  }
  .sm\:tw-w-\[500px\] {
    width: 500px !important;
  }
  .sm\:tw-max-w-lg {
    max-width: 32rem !important;
  }
  .sm\:tw-max-w-none {
    max-width: none !important;
  }
  .sm\:tw-translate-y-0 {
    transform: translate(var(--tw-translate-x), var(--tw-translate-y)) rotate(var(--tw-rotate)) skewX(var(--tw-skew-x)) skewY(var(--tw-skew-y)) scaleX(var(--tw-scale-x)) scaleY(var(--tw-scale-y)) !important;
  }
  .sm\:tw-scale-95 {
    transform: translate(var(--tw-translate-x), var(--tw-translate-y)) rotate(var(--tw-rotate)) skewX(var(--tw-skew-x)) skewY(var(--tw-skew-y)) scaleX(var(--tw-scale-x)) scaleY(var(--tw-scale-y)) !important;
  }
  .sm\:tw-scale-100 {
    transform: translate(var(--tw-translate-x), var(--tw-translate-y)) rotate(var(--tw-rotate)) skewX(var(--tw-skew-x)) skewY(var(--tw-skew-y)) scaleX(var(--tw-scale-x)) scaleY(var(--tw-scale-y)) !important;
  }
  .sm\:tw-flex-row-reverse {
    flex-direction: row-reverse !important;
  }
  .sm\:tw-items-start {
    align-items: flex-start !important;
  }
  .sm\:tw-gap-4 {
    gap: 1rem !important;
  }
  .sm\:tw-gap-5 {
    gap: 1.25rem !important;
  }
  .sm\:tw-gap-1 {
    gap: 0.25rem !important;
  }
  .sm\:tw-gap-2 {
    gap: 0.5rem !important;
  }
  .sm\:tw-space-y-0 > :not([hidden]) ~ :not([hidden]) {
    margin-top: calc(0px * calc(1 - var(--tw-space-y-reverse))) !important;
    margin-bottom: calc(0px * var(--tw-space-y-reverse)) !important;
  }
  .sm\:tw-border {
    border-width: 1px !important;
  }
  .sm\:tw-p-0 {
    padding: 0px !important;
  }
  .sm\:tw-p-6 {
    padding: 1.5rem !important;
  }
  .sm\:tw-px-6 {
    padding-left: 1.5rem !important;
    padding-right: 1.5rem !important;
  }
  .sm\:tw-py-2 {
    padding-top: 0.5rem !important;
    padding-bottom: 0.5rem !important;
  }
  .sm\:tw-pb-4 {
    padding-bottom: 1rem !important;
  }
  .sm\:tw-pb-16 {
    padding-bottom: 4rem !important;
  }
  .sm\:tw-text-left {
    text-align: left !important;
  }
  .sm\:tw-align-middle {
    vertical-align: middle !important;
  }
  .sm\:tw-text-sm {
    font-size: 0.875rem !important;
    line-height: 1.25rem !important;
  }
  .sm\:tw-text-4xl {
    font-size: 2.25rem !important;
    line-height: 2.5rem !important;
  }
  .sm\:tw-font-medium {
    font-weight: 500 !important;
  }
  .sm\:tw-text-pub-secondary-text {
    color: #767676 !important;
  }
  .sm\:tw-opacity-70 {
    opacity: 0.7 !important;
  }
  .sm\:hover\:tw-opacity-100:hover {
    opacity: 1 !important;
  }
}


@media (min-width: 768px) {
  .md\:tw-left-auto {
    left: auto !important;
  }
  .md\:tw-bottom-4 {
    bottom: 1rem !important;
  }
  .md\:tw-right-4 {
    right: 1rem !important;
  }
  .md\:tw-w-3\/4 {
    width: 75% !important;
  }
  .md\:tw-pl-4 {
    padding-left: 1rem !important;
  }
}


@media (max-width: var(--nav-bp-2)) {
  .frontend-reader2-Page-module__linkRow--1QoCL.frontend-reader2-Page-module__isPadded--Gbh4N {
    padding: var(--size-12) 0;
  }
}


@media screen and (max-width: 540px) {
  .frontend-components-prompts-WriterShareModal-module__toast--wc1bo {
    margin-bottom: 20px;
  }
}


@media (max-width: 540px) {
  .frontend-lib-ProfileSetupToast-module__headerRow--17w27 {
    flex-wrap: wrap;
  }
}


@media screen and (max-width: 630px) {
  .frontend-substack-home_page-module__hero--24Zq7 {
    padding-top: 164px;
    padding-bottom: 80px;
    height: auto;
    flex-direction: column;
    align-items: flex-start;
    justify-content: flex-start;
  }
  .frontend-substack-home_page-module__heroInnerRow--2ULAC {
    height: auto;
    flex-direction: column;
    justify-content: flex-start;
    gap: 32px;
  }
  .frontend-substack-home_page-module__heroButtonWrap--3V7jR {
    flex-direction: column;
  }
  .frontend-substack-home_page-module__heroImg--1E7-g {
    max-width: 342px;
  }
  .frontend-substack-home_page-module__hero--24Zq7 h1 {
    font-size: 44px;
    line-height: 54.56px;
    margin: 0;
  }
  .frontend-substack-home_page-module__home--28JuV section h2 {
    margin-top: 80px;
    font-size: 44px;
    line-height: 54.56px;
  }
  .frontend-substack-home_page-module__writerList--1rikY {
    padding: 0 24px 80px 24px;
    gap: 80px;
  }
  .frontend-substack-home_page-module__writerList--1rikY h3 {
    font-size: 28px;
    line-height: 34.72px;
  }
  .frontend-substack-home_page-module__writerList--1rikY > div {
    flex-direction: column;
    margin-top: 0px;
    gap: 80px;
    justify-content: flex-start;
    align-items: center;
  }
  .frontend-substack-home_page-module__benefits--VLGOQ {
    gap: 80px;
    padding: 0 24px 80px 24px;
  }
  .frontend-substack-home_page-module__benefit--PpUoA {
    flex-direction: column;
    justify-content: flex-start;
    align-items: center;
    width: 100%;
    gap: 24px;
  }
  .frontend-substack-home_page-module__benefitItems--emU-2 {
    gap: 80px;
  }
  .frontend-substack-home_page-module__benefit--PpUoA img {
    max-width: 320px;
    min-width: 200px;
  }
  .frontend-substack-home_page-module__benefit--PpUoA h3 {
    font-family: Cahuenga, serif;
    font-weight: 500;
    font-size: 32px;
    line-height: 33.79px;
    margin: 0;
    color: var(--color-primary);
  }
  .frontend-substack-home_page-module__readingExperiences--1gQwI {
    padding: 0 24px 80px 24px;
  }
  .frontend-substack-home_page-module__readingExperiences--1gQwI > div {
    gap: 80px;
    align-items: center;
    flex-direction: column-reverse;
  }
  .frontend-substack-home_page-module__readingExperience--3sCWK h3 {
    font-family: Cahuenga, serif;
    font-weight: 500;
    font-size: 32px;
    line-height: 33.79px;
    margin: 0;
    color: var(--color-primary);
    margin-bottom: 10px;
  }
  .frontend-substack-home_page-module__expandCollapseButton--3UjfI {
    top: 34px;
  }
  .frontend-substack-home_page-module__centerAlignedSection--z-lIj h4 {
    font-size: 28px;
    line-height: 35px;
  }
  .frontend-substack-home_page-module__faqs--2JSzX {
    justify-content: flex-start;
    gap: 80px;
    padding: 0 24px 80px 24px;
  }
  .frontend-substack-home_page-module__faq--2A0bm {
    gap: 12px;
    justify-content: flex-start;
    flex-direction: column;
  }
  .frontend-substack-home_page-module__faq--2A0bm h3 {
    font-weight: 500;
    font-size: 28px;
    line-height: 35px;
  }
}


@media screen and (max-width: 540px) {
  .frontend-substack-PublicationThreadAppLinkPage-module__threadsLinkContainer--3JR5W {
    width: calc(100vw - 80px);
  }
}


@media screen and (max-width: 540px) {
  .frontend-account-groups-GroupManagement-module__groupSubWrapper--OIOo2 {
    width: 100%;
  }
}


@media screen and (max-width: 500px) {
  .frontend-reader2-ManageSubscriptionPage-module__highlightRow--1lIkl.frontend-reader2-ManageSubscriptionPage-module__withPlans--3KhSk {
    align-items: start;
    flex-direction: column;
  }
  .frontend-reader2-ManageSubscriptionPage-module__highlightButtons--1lIV5 {
    flex-direction: column;
    width: 100%;
  }
}


@media screen and (max-width: 631px) {
  .frontend-editor-post-AudioEducationModal-module__modalContainer--3-T0R {
    height: 524px;
  }
}


@media (max-width: 540px) {
  .frontend-publish-stats-pages-reader_referrals_stats-reader_referrals_stats-module__popoverWrapper--3Gh5i {
    display: none;
  }
}
</style><img
src="https://mailgun.substack.com/api/v1/email/open?token=eyJtIjoiPDIwMjIwODE5MTMwNDQzLjMuNGM4ZGI1YjZlNWNiOWRkMEBtZy1kMS5zdWJzdGFjay5jb20-IiwidSI6NDY3OTkzLCJyIjoibWFubnlAcmF0YWZpYXMuY29tIiwiZCI6Im1nLWQxLnN1YnN0YWNrLmNvbSIsInAiOjY4OTcwMjgwLCJ0IjoibmV3c2xldHRlciIsImEiOiJldmVyeW9uZSIsInMiOjI4MTIxOSwiYyI6InBvc3QiLCJmIjp0cnVlLCJwb3NpdGlvbiI6InRvcCIsImlhdCI6MTY2MDkxNDQ1MSwiaXNzIjoicHViLTAiLCJzdWIiOiJlbyJ9.3Zx-oGr3O0492A9aD45UAOMqFQnsvxqexW7ooRyRcNo"
        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">Age is the strongest predictor of COVID-19
        severe disease and death. Even though those aged 65+ are the
        leaders in vaccination rates, they continue to lead
        hospitalizations in the U.S. and across the globe. But… why? An
        onslaught of scientific information can tell us why this may be
        the case. I worked with
 ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌</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%;">
                <table role="presentation" width="100%" cellspacing="0"
                  cellpadding="0" border="0">
                  <tbody>
                    <tr>
                      <td style="height: 40px;" align="right">
                        <table role="presentation" width="auto"
                          cellspacing="0" cellpadding="0" border="0">
                          <tbody>
                            <tr>
                              <td><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=68970280&utm_source=email"
                                  class="tw-font-body tw-text-ssm
                                  tw-text-substack-secondary"
                                  style="color: rgb(128,128,128)
                                  !important; font-family: SF Pro Text,
                                  -apple-system, BlinkMacSystemFont,
                                  Inter, Segoe UI, Roboto, Helvetica,
                                  Arial, sans-serif, Apple Color Emoji,
                                  Segoe UI Emoji, Segoe UI Symbol
                                  !important; font-size: 13px
                                  !important;" moz-do-not-send="true">Open
                                  in browser</a></td>
                            </tr>
                          </tbody>
                        </table>
                      </td>
                    </tr>
                  </tbody>
                </table>
                <table role="presentation" class="header graphic-header"
                  style="border-spacing: 0; padding: 16px 0;"
                  width="auto">
                  <tbody>
                    <tr>
                      <td style="padding: 0; text-align: center;"
                        align="center"><a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vcC93aHktb2xkZXItcGVvcGxlLWFyZS1hdC1oaWdoZXItcmlzaz90b2tlbj1leUoxYzJWeVgybGtJam8wTmpjNU9UTXNJbWxoZENJNk1UWTJNRGt4TkRRMU1Dd2lhWE56SWpvaWNIVmlMVEk0TVRJeE9TSXNJbk4xWWlJNkluQnZjM1F0Y21WaFkzUnBiMjRpZlEuYWRFSi01VmRoMURDTUZ3VmVka0R4OUVMWDdMUjR1SzBsVm9fb1VyWFAxUSIsInAiOjY4OTcwMjgwLCJzIjoyODEyMTksImYiOnRydWUsInUiOjQ2Nzk5MywiaWF0IjoxNjYwOTE0NDUwLCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.QB4DfH3-Tvhz3ZAdeRDgKty3PYt5F4MshXa6GC4-1jc?"
                          moz-do-not-send="true"><img
                            role="presentation"
src="https://substackcdn.com/image/fetch/w_1100,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F523ac601-a63a-4d07-906e-bc4e7bfbb83a_2200x440.png"
                            class="header-image" style="border: none
                            !important; display: block; height: auto;
                            margin: 0 auto; max-width: 550px;
                            vertical-align: middle; width: 100%;"
                            moz-do-not-send="true" width="550"></a></td>
                    </tr>
                  </tbody>
                </table>
                <div class="typography" style="font-size: 16px;
                  line-height: 26px;">
                  <div class="preamble" style="font-size: 16px;
                    line-height: 26px;">
                    <div dir="auto" class="body markup"
                      style="font-size: 16px; line-height: 26px;
                      margin-bottom: 12px; text-align: initial; width:
                      100%; word-break: break-word;">
                      <p style="color: #1a1a1a; font-size: 16px;
                        line-height: 26px; margin: 0 0 1em 0;
                        margin-bottom: 0; margin-top: 0;"><em><span>Si
                            quiere leer la versión en español, pulse </span><a
href="https://substack.com/redirect/e60a2e82-3fdd-49b8-a317-567455afaf70?r=a13t"
                            rel="" style="color: #0068ef;
                            text-decoration: none;"
                            moz-do-not-send="true">aquí</a><span>.</span></em></p>
                    </div>
                    <hr style="background: #ebebeb; border: none;
                      height: 1px; margin: 48px 0; padding: 0;"></div>
                </div>
                <div dir="auto" class="post typography"
                  style="font-size: 16px; line-height: 26px; padding:
                  16px 0 0 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://substack.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.KIf8Px5JNnlvqSf6dTWr10icSSHjHoVtC32HtXXx1Es?"
                        style="color: #1a1a1a; text-decoration: none;"
                        moz-do-not-send="true">Why older people are at
                        higher risk for severe COVID-19</a></h1>
                    <table class="meta-author-wrap with-photo"
                      style="margin: 1em 0;">
                      <tbody>
                        <tr class="meta-author-wrap-row">
                          <td>
                            <div class="user-head " style="font-size:
                              16px; line-height: 26px;"><a
href="https://substack.com/redirect/a6d50178-36c8-4215-8103-1ba15711be5d?r=a13t"
                                moz-do-not-send="true">
                                <div class="profile-img-wrap"
                                  style="font-size: 16px; line-height:
                                  26px; position: relative;"><img
src="https://substackcdn.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%2Fb1cf8441-2181-452a-a5af-364eb49b32b5_828x1792.png"
                                    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 class="meta-author-contents">
                            <div class="meta-right-column"
                              style="font-size: 16px; line-height: 1em;
                              margin-left: 12px;">
                              <div class="meta-author" 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;
                                line-height: 17px;"><a
href="https://substack.com/redirect/a6d50178-36c8-4215-8103-1ba15711be5d?r=a13t"
                                  style="color: #1a1a1a;
                                  text-decoration: none;"
                                  moz-do-not-send="true">Katelyn
                                  Jetelina</a></div>
                              <table class="post-meta custom"
                                style="align-items: center; height:
                                20px; margin: 4px 0 0 0;"
                                cellspacing="0" cellpadding="0">
                                <tbody>
                                  <tr>
                                    <td title="2022-08-19T13:07:03.709Z"
                                      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: 14px;
                                      padding: 0px 12px 0px 0;
                                      padding-bottom: 2px; padding-top:
                                      2px; position: relative;
                                      text-decoration: none;
                                      white-space: nowrap;"><time
                                        datetime="2022-08-19T13:07:03.709Z">Aug
                                        19</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: 14px;
                                      padding: 0px 12px 0px 0;
                                      padding-bottom: 0; padding-top: 0;
                                      position: relative;
                                      text-decoration: none;
                                      text-indent: 3px; white-space:
                                      nowrap;"><span
                                        class="post-meta-icon
                                        like-reaction-button"><a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vYXBpL3YxL3Bvc3QvZW1haWwtcmVhY3Rpb24_dXRtX3NvdXJjZT1zdWJzdGFjayZ1dG1fbWVkaXVtPWVtYWlsJnRva2VuPWV5SjFjMlZ5WDJsa0lqbzBOamM1T1RNc0luQnZjM1JmYVdRaU9qWTRPVGN3TWpnd0xDSnlaV0ZqZEdsdmJpSTZJdUtkcENJc0ltbGhkQ0k2TVRZMk1Ea3hORFExTUN3aWFYTnpJam9pY0hWaUxUSTRNVEl4T1NJc0luTjFZaUk2SW5KbFlXTjBhVzl1SW4wLmktbHJwVTJiWW9OYmRoSldpNDIyX0VkRXh2cGEtTTJBUTJGdVlpbEJ2NlEiLCJwIjo2ODk3MDI4MCwicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY2MDkxNDQ1MCwiaXNzIjoicHViLTAiLCJzdWIiOiJsaW5rLXJlZGlyZWN0In0.0riKevhhg53-zVqVPOb-p4TcPcMjWgjWJr-oq93-3pc?"
                                          class="like-button"
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                                      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: 14px;
                                      padding: 0px 12px 0px 0;
                                      padding-bottom: 0; padding-top: 0;
                                      position: relative;
                                      text-decoration: none;
                                      text-indent: 3px; white-space:
                                      nowrap;"><a class=""
href="https://substack.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.3AZ_D1r_2S9f-VY7O3sjLVtgiT4ewcCif8uglsz36PA?&utm_source=substack&utm_medium=email"
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                                        block; text-decoration: none;"
                                        moz-do-not-send="true"><img
src="https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideComments%3Fv%3D4%26height%3D36%26fill%3Dtransparent%26stroke%3D%2523757575%26strokeWidth%3D2"
                                          style="border: none
                                          !important; display:
                                          inline-block; float: left;
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                                      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: 14px;
                                      margin-right: 0; padding: 0px 12px
                                      0px 0; padding-bottom: 0;
                                      padding-right: 0; padding-top: 0;
                                      position: relative;
                                      text-decoration: none;
                                      text-indent: 3px; white-space:
                                      nowrap;"><span><a
href="https://substack.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.T6Dh28JtgOeJfnDWx9-JFBj_hYoyhp9RTjGbKgb9yak?"
                                          style="color: #767676;
                                          display: block;
                                          text-decoration: none;"
                                          moz-do-not-send="true"><img
src="https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideShare%3Fv%3D4%26height%3D36%26fill%3Dtransparent%26stroke%3D%2523757575%26strokeWidth%3D2"
                                            style="border: none
                                            !important; display:
                                            inline-block; float: left;
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                                            width: auto;" alt="Share"
                                            class="recommend-icon
                                            post-meta-icon"
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                                            width="18" height="18"></a></span></td>
                                  </tr>
                                </tbody>
                              </table>
                            </div>
                          </td>
                        </tr>
                      </tbody>
                    </table>
                  </div>
                </div>
                <div dir="auto" class="post typography"
                  style="font-size: 16px; line-height: 26px; padding:
                  16px 0 0 0;">
                  <div dir="auto" class="body markup" style="font-size:
                    16px; line-height: 26px; margin-bottom: 12px;
                    text-align: initial; width: 100%; word-break:
                    break-word;">
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0; margin-top:
                      0;">Age is the strongest predictor of COVID-19
                      severe disease and death. Even though those aged
                      65+ are the leaders in vaccination rates, they
                      continue to lead hospitalizations in the U.S. and
                      across the globe. </p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>But…
                      </span><em>why</em><span>?</span></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="1456" align="left"><a
                                  class="image-link" target="_blank"
href="https://substack.com/redirect/d29c4a66-f9bd-4053-ac6b-2585f5620a84?r=a13t"
                                  rel="" style="align-items: center;
                                  border: none; display: block;
                                  flex-direction: column; height: auto;
                                  margin: 0; padding: 0; position:
                                  relative; 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/cb5de582-76a2-416b-8df7-c46d90ceb410_1600x647.png","fullscreen":null,"imageSize":null,"height":589,"width":1456,"resizeWidth":null,"bytes":null,"alt":null,"title":null,"type":null,"href":null,"belowTheFold":false}"
                                    alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2912,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fcb5de582-76a2-416b-8df7-c46d90ceb410_1600x647.png"
                                    style="-ms-interpolation-mode:
                                    bicubic; border: none !important;
                                    display: block; height: auto;
                                    margin: 0 auto; margin-bottom: 0;
                                    max-width: 100% !important;
                                    vertical-align: middle; width: auto
                                    !important;" moz-do-not-send="true"
                                    width="550"
                                    height="222.49313186813185"></a></td>
                              <td style="text-align: center;"><br>
                              </td>
                            </tr>
                          </tbody>
                        </table>
                        <figcaption class="image-caption" style="color:
                          #767676; font-family: sans-serif; font-size:
                          14px; font-weight: 300; line-height: 1.4em;
                          text-align: center;">Hospital admissions by
                          age group (CDC)</figcaption></figure>
                    </div>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>An
                        onslaught of scientific information can tell us
                        why this may be the case. I worked with </span><a
href="https://substack.com/redirect/c62d9705-e347-4f6c-973c-b3ea498cc14e?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">Edward Nirenberg</a><span>
                        to translate the science to show why boosters
                        among this population, especially, should be of
                        utmost priority.</span></p>
                    <h4 class="header-with-anchor-widget"
                      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: 1.125em; font-weight: bold;
                      line-height: 1.16em; margin: 1em 0 0.625em 0;
                      position: relative;"><strong>First wall of
                        defense: Degrading</strong>
                      <div id="§first-wall-of-defense-degrading"
                        class="header-anchor-widget" style="font-size:
                        16px; height: 100%; left: -56px; line-height:
                        26px; position: absolute; top: -72px; width:
                        56px;">
                        <div
                          class="header-anchor-widget-button-container"
                          style="align-items: center; display: flex;
                          font-size: 16px; height: 1.2em; left: 0;
                          line-height: 26px; position: absolute; top:
                          72px; width: 40px;"><a
                            class="header-anchor-widget-button"
href="https://substack.com/redirect/a1c08070-ff92-409a-9a76-ef469e60af55?r=a13t"
                            style="align-items: center; border-radius:
                            50%; color: #1a1a1a; display: none; height:
                            40px; justify-content: center;
                            text-decoration: underline; width: 40px;"
                            moz-do-not-send="true"><svg
                              xmlns="http://www.w3.org/2000/svg"
                              width="20" height="20" viewBox="0 0 24 24"
                              fill="none" stroke="currentColor"
                              stroke-width="2" stroke-linecap="round"
                              stroke-linejoin="round"
                              class="header-anchor-widget-icon"
                              style="height: 20px; stroke: #9a9a9a;
                              width: 20px;"><path d="M10 13a5 5 0
                                007.54.54l3-3a5 5 0 00-7.07-7.07l-1.72
                                1.71"></path><path d="M14 11a5 5 0
                                00-7.54-.54l-3 3a5 5 0 007.07
                                7.07l1.71-1.71"></path></svg></a></div>
                      </div>
                    </h4>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">We have a
                      complex immune system, but for simplicity, we can
                      reduce it to a few major walls of defense. </p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">The first
                      wall is neutralizing antibodies. These antibodies
                      are powerful because they act fast—you inhale the
                      virus and neutralizing antibodies stop the virus
                      before there’s a chance for it to get into your
                      cells (and start replicating). This prevents
                      infection from happening in the first place. The
                      issue is that it’s essentially impossible to
                      retain a high level of neutralizing antibodies
                      without regular, repeated exposures—and it gets
                      even harder as you get older. </p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>A
                        recent </span><a
href="https://substack.com/redirect/84d9d526-1d80-4a64-a91d-7dea5f75bcd9?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">preprint</a><span>
                        study found that the number of neutralizing
                        antibodies you make in response to infection
                        differs by age: the older you are, the fewer
                        neutralizing antibodies you have (see figure
                        below). In fact, when faced with Omicron, 43% of
                        people had </span><em>no </em><span>detectable
                        neutralizing activity and, among those, the mean
                        age was 63.5 years.</span></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="510" align="left"><a
                                  class="image-link" target="_blank"
href="https://substack.com/redirect/20438e07-06e6-41c4-aecf-801bf3595918?r=a13t"
                                  rel="" style="align-items: center;
                                  border: none; display: block;
                                  flex-direction: column; height: auto;
                                  margin: 0; padding: 0; position:
                                  relative; 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/924466d1-f73b-4919-9587-275a2372a640_1077x750.png","fullscreen":null,"imageSize":null,"height":750,"width":1077,"resizeWidth":510,"bytes":194073,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":false}"
                                    alt="" class=""
src="https://substackcdn.com/image/fetch/w_510,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F924466d1-f73b-4919-9587-275a2372a640_1077x750.png"
                                    style="-ms-interpolation-mode:
                                    bicubic; border: none !important;
                                    display: block; height: auto;
                                    margin: 0 auto; margin-bottom: 0;
                                    max-width: 100% !important;
                                    vertical-align: middle; width: auto
                                    !important;" moz-do-not-send="true"
                                    width="510"
                                    height="355.1532033426184"></a></td>
                              <td style="text-align: center;"><br>
                              </td>
                            </tr>
                          </tbody>
                        </table>
                        <figcaption class="image-caption" style="color:
                          #767676; font-family: sans-serif; font-size:
                          14px; font-weight: 300; line-height: 1.4em;
                          text-align: center;"><span>Bates et al.,
                            preprint; Source </span><a
href="https://substack.com/redirect/84d9d526-1d80-4a64-a91d-7dea5f75bcd9?r=a13t"
                            rel="" moz-do-not-send="true">here</a></figcaption></figure>
                    </div>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">Another
                      important aspect of antibodies is not just the
                      sheer number we have, but also the ability for the
                      same antibody to recognize different variants of
                      the same part of spike. Scientists found that
                      antibodies among people 65+ years old were less
                      likely to recognize multiple variants’ spikes
                      compared to antibodies among those less than 65
                      years old. </p>
                    <h4 class="header-with-anchor-widget"
                      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: 1.125em; font-weight: bold;
                      line-height: 1.16em; margin: 1em 0 0.625em 0;
                      position: relative;">Second wall of defense: Solid
                      <div id="§second-wall-of-defense-solid"
                        class="header-anchor-widget" style="font-size:
                        16px; height: 100%; left: -56px; line-height:
                        26px; position: absolute; top: -72px; width:
                        56px;">
                        <div
                          class="header-anchor-widget-button-container"
                          style="align-items: center; display: flex;
                          font-size: 16px; height: 1.2em; left: 0;
                          line-height: 26px; position: absolute; top:
                          72px; width: 40px;"><a
                            class="header-anchor-widget-button"
href="https://substack.com/redirect/cb03791c-823f-47bd-a56d-9d62f038ff13?r=a13t"
                            style="align-items: center; border-radius:
                            50%; color: #1a1a1a; display: none; height:
                            40px; justify-content: center;
                            text-decoration: underline; width: 40px;"
                            moz-do-not-send="true"><svg
                              xmlns="http://www.w3.org/2000/svg"
                              width="20" height="20" viewBox="0 0 24 24"
                              fill="none" stroke="currentColor"
                              stroke-width="2" stroke-linecap="round"
                              stroke-linejoin="round"
                              class="header-anchor-widget-icon"
                              style="height: 20px; stroke: #9a9a9a;
                              width: 20px;"><path d="M10 13a5 5 0
                                007.54.54l3-3a5 5 0 00-7.07-7.07l-1.72
                                1.71"></path><path d="M14 11a5 5 0
                                00-7.54-.54l-3 3a5 5 0 007.07
                                7.07l1.71-1.71"></path></svg></a></div>
                      </div>
                    </h4>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">Another
                      line of defense are memory B cells. When we come
                      in contact with a virus after having been
                      vaccinated or previously infected, B cells
                      remember what they need to create and start
                      pumping out antibodies to help fight the virus. B
                      cells can be quickly called in the event that more
                      antibodies are needed. </p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>An </span><a
href="https://substack.com/redirect/30f090ca-9528-4b30-8664-aeb0833cf141?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">article</a><span>
                        published this week showed that B cell levels
                        largely did </span><em>not </em><span>differ
                        by age, which is great news. This wall of
                        defense is solid. The challenge, however, is
                        that for B cells to live up to their potential,
                        they need the help of another wall: T cells.</span></p>
                    <h4 class="header-with-anchor-widget"
                      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: 1.125em; font-weight: bold;
                      line-height: 1.16em; margin: 1em 0 0.625em 0;
                      position: relative;">Third wall of defense:
                      Degraded
                      <div id="§third-wall-of-defense-degraded"
                        class="header-anchor-widget" style="font-size:
                        16px; height: 100%; left: -56px; line-height:
                        26px; position: absolute; top: -72px; width:
                        56px;">
                        <div
                          class="header-anchor-widget-button-container"
                          style="align-items: center; display: flex;
                          font-size: 16px; height: 1.2em; left: 0;
                          line-height: 26px; position: absolute; top:
                          72px; width: 40px;"><a
                            class="header-anchor-widget-button"
href="https://substack.com/redirect/2a5359e8-b0d7-4b5d-a443-f1f3fe9d8290?r=a13t"
                            style="align-items: center; border-radius:
                            50%; color: #1a1a1a; display: none; height:
                            40px; justify-content: center;
                            text-decoration: underline; width: 40px;"
                            moz-do-not-send="true"><svg
                              xmlns="http://www.w3.org/2000/svg"
                              width="20" height="20" viewBox="0 0 24 24"
                              fill="none" stroke="currentColor"
                              stroke-width="2" stroke-linecap="round"
                              stroke-linejoin="round"
                              class="header-anchor-widget-icon"
                              style="height: 20px; stroke: #9a9a9a;
                              width: 20px;"><path d="M10 13a5 5 0
                                007.54.54l3-3a5 5 0 00-7.07-7.07l-1.72
                                1.71"></path><path d="M14 11a5 5 0
                                00-7.54-.54l-3 3a5 5 0 007.07
                                7.07l1.71-1.71"></path></svg></a></div>
                      </div>
                    </h4>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>The
                        third wall of defense is T cells. T cells are a
                      </span><a
href="https://substack.com/redirect/8d13e042-a930-4c95-8859-40fae0e4058e?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">key factor</a><span>
                        in determining the outcome of infections (severe
                        or mild disease). There are two major groups of
                        T cells. </span></p>
                    <ul style="margin-top: 0;">
                      <li style="margin-bottom: 4px; margin-left: 8px;
                        margin-right: 0; margin-top: 4px;
                        mso-special-format: bullet;">
                        <p style="color: #1a1a1a; font-size: 16px;
                          line-height: 26px; margin: 0; margin-bottom:
                          0;"><em><strong>Killer T cells </strong></em><span>recognize
                            and kill infected cells</span></p>
                      </li>
                      <li style="margin-bottom: 4px; margin-left: 8px;
                        margin-right: 0; margin-top: 4px;
                        mso-special-format: bullet;">
                        <p style="color: #1a1a1a; font-size: 16px;
                          line-height: 26px; margin: 0; margin-bottom:
                          0;"><em><strong>Helper T cells</strong></em><span>
                            help B cells make antibodies and instruct B
                            cells to make better antibodies</span></p>
                      </li>
                    </ul>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">This means
                      that while T cells can’t stop infections from
                      happening altogether, they can rapidly control
                      them once they start, potentially even to the
                      point that people don’t have symptoms. </p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>But
                        there’s a challenge with T cells. Once we reach
                        puberty, the thymus (the organ that gives rise
                        to T cells) gradually degrades into a useless
                        blob of fat and we stop making new T cells.
                        There’s an especially </span><a
href="https://substack.com/redirect/f09ca59c-af75-476b-be75-70dbf59378d0?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">big decline</a><span>
                        once we hit about age 40. This is usually okay
                        because we typically accumulate all of the T
                        cells we need throughout our lifespan. Unless a
                        totally new microbe comes along that we have no
                        exposure to (and fortunately, though SARS-CoV-2
                        is new, it’s still a coronavirus, so there is T
                        cell memory from old coronavirus infections to
                        work with). But as we get older, just like the
                        rest of the body, our T cells age too. </span></p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>Unfortunately,
                        we see T cell dysfunction in COVID-19. An</span><a
href="https://substack.com/redirect/30f090ca-9528-4b30-8664-aeb0833cf141?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true"> article</a><span>
                        published this week showed that the diversity of
                        T cells for those aged 50+ years is much more
                        limited than those under 50 at infection. Once
                        symptoms resolved, there was restoration but
                        people over 50 can’t really make full use of
                        this unless they are infected again. </span></p>
                    <h4 class="header-with-anchor-widget"
                      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: 1.125em; font-weight: bold;
                      line-height: 1.16em; margin: 1em 0 0.625em 0;
                      position: relative;">Implications
                      <div id="§implications"
                        class="header-anchor-widget" style="font-size:
                        16px; height: 100%; left: -56px; line-height:
                        26px; position: absolute; top: -72px; width:
                        56px;">
                        <div
                          class="header-anchor-widget-button-container"
                          style="align-items: center; display: flex;
                          font-size: 16px; height: 1.2em; left: 0;
                          line-height: 26px; position: absolute; top:
                          72px; width: 40px;"><a
                            class="header-anchor-widget-button"
href="https://substack.com/redirect/48e8498d-aafc-431f-9ed8-af16977d117f?r=a13t"
                            style="align-items: center; border-radius:
                            50%; color: #1a1a1a; display: none; height:
                            40px; justify-content: center;
                            text-decoration: underline; width: 40px;"
                            moz-do-not-send="true"><svg
                              xmlns="http://www.w3.org/2000/svg"
                              width="20" height="20" viewBox="0 0 24 24"
                              fill="none" stroke="currentColor"
                              stroke-width="2" stroke-linecap="round"
                              stroke-linejoin="round"
                              class="header-anchor-widget-icon"
                              style="height: 20px; stroke: #9a9a9a;
                              width: 20px;"><path d="M10 13a5 5 0
                                007.54.54l3-3a5 5 0 00-7.07-7.07l-1.72
                                1.71"></path><path d="M14 11a5 5 0
                                00-7.54-.54l-3 3a5 5 0 007.07
                                7.07l1.71-1.71"></path></svg></a></div>
                      </div>
                    </h4>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>Two
                        of the three defense walls among people over 50
                        years old have more holes than those of younger
                        people. Comorbidities also increase with age,
                        which means the immune response in general is a
                        lot more taxed. This means the rate of
                        breakthrough cases, and specifically </span><em>severe
                      </em><span>breakthrough cases, is substantially
                        higher for older people. </span></p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>The
                        good news is that the immune system is still
                        working for a majority of people. We clearly see
                        that the risk of severe disease even in the very
                        elderly </span><a
href="https://substack.com/redirect/94861a88-0e4b-478b-b798-223cc4cd76ed?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">dramatically
                        declines</a><span> with even just the primary
                        vaccine series. </span></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="630" align="left"><a
                                  class="image-link" target="_blank"
href="https://substack.com/redirect/074ea170-42c7-4bb9-9339-4e2b362434bd?r=a13t"
                                  rel="" style="align-items: center;
                                  border: none; display: block;
                                  flex-direction: column; height: auto;
                                  margin: 0; padding: 0; position:
                                  relative; 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/dfad30d9-626f-4b23-a677-3d075080c826_1600x841.png","fullscreen":null,"imageSize":null,"height":765,"width":1456,"resizeWidth":630,"bytes":null,"alt":null,"title":null,"type":null,"href":null,"belowTheFold":true}"
                                    alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_1260,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fdfad30d9-626f-4b23-a677-3d075080c826_1600x841.png"
                                    style="-ms-interpolation-mode:
                                    bicubic; border: none !important;
                                    display: block; height: auto;
                                    margin: 0 auto; margin-bottom: 0;
                                    max-width: 100% !important;
                                    vertical-align: middle; width: auto
                                    !important;" moz-do-not-send="true"
                                    width="550"
                                    height="288.97664835164835"></a></td>
                              <td style="text-align: center;"><br>
                              </td>
                            </tr>
                          </tbody>
                        </table>
                        <figcaption class="image-caption" style="color:
                          #767676; font-family: sans-serif; font-size:
                          14px; font-weight: 300; line-height: 1.4em;
                          text-align: center;">(CDC)</figcaption></figure>
                    </div>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">However, it
                      may take more doses to coax immune systems into
                      doing the things we want. This may mean more
                      frequent boosting in older age groups. We already
                      see benefits with older people vaccinated with one
                      booster dose having 4 times the risk of dying
                      compared to people with two booster doses.
                      (Unvaccinated people had 42 times the risk of
                      dying from COVID-19 compared to those with 2
                      boosters.)</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="1456" align="left"><a
                                  class="image-link" target="_blank"
href="https://substack.com/redirect/ca53bfca-a87c-4acb-8bc5-57c4e49ea272?r=a13t"
                                  rel="" style="align-items: center;
                                  border: none; display: block;
                                  flex-direction: column; height: auto;
                                  margin: 0; padding: 0; position:
                                  relative; 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/841110ac-21a5-430c-8bdd-f2657bb32feb_1456x1025.png","fullscreen":null,"imageSize":null,"height":1025,"width":1456,"resizeWidth":null,"bytes":null,"alt":null,"title":null,"type":null,"href":null,"belowTheFold":true}"
                                    alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2912,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F841110ac-21a5-430c-8bdd-f2657bb32feb_1456x1025.png"
                                    style="-ms-interpolation-mode:
                                    bicubic; border: none !important;
                                    display: block; height: auto;
                                    margin: 0 auto; margin-bottom: 0;
                                    max-width: 100% !important;
                                    vertical-align: middle; width: auto
                                    !important;" moz-do-not-send="true"
                                    width="550"
                                    height="387.1909340659341"></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;"><span>How
                        much each incremental booster helps (or does not
                        help) is something that we really don’t have a
                        good grip on </span><em>prospectively</em><span>.
                        For example, we didn’t really know a second
                        booster was needed among 50+ year olds. We kind
                        of guessed and relied on data from Israel (and
                        the recent articles suggests why 50 might be a
                        key age). Retrospectively, we can see that this
                        was certainly the right policy call. But, the
                        FDA needs to require pharmaceutical companies to
                        test B cell and T cell functions—not just
                        neutralizing antibodies—to assess the added
                        benefit, instead of retrospectively determining
                        good or bad policy.</span></p>
                    <h4 class="header-with-anchor-widget"
                      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: 1.125em; font-weight: bold;
                      line-height: 1.16em; margin: 1em 0 0.625em 0;
                      position: relative;"><strong>Bottom line</strong>
                      <div id="§bottom-line"
                        class="header-anchor-widget" style="font-size:
                        16px; height: 100%; left: -56px; line-height:
                        26px; position: absolute; top: -72px; width:
                        56px;">
                        <div
                          class="header-anchor-widget-button-container"
                          style="align-items: center; display: flex;
                          font-size: 16px; height: 1.2em; left: 0;
                          line-height: 26px; position: absolute; top:
                          72px; width: 40px;"><a
                            class="header-anchor-widget-button"
href="https://substack.com/redirect/d07cba12-4cf5-4c88-bd0e-7c724c2931f8?r=a13t"
                            style="align-items: center; border-radius:
                            50%; color: #1a1a1a; display: none; height:
                            40px; justify-content: center;
                            text-decoration: underline; width: 40px;"
                            moz-do-not-send="true"><svg
                              xmlns="http://www.w3.org/2000/svg"
                              width="20" height="20" viewBox="0 0 24 24"
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                              stroke-width="2" stroke-linecap="round"
                              stroke-linejoin="round"
                              class="header-anchor-widget-icon"
                              style="height: 20px; stroke: #9a9a9a;
                              width: 20px;"><path d="M10 13a5 5 0
                                007.54.54l3-3a5 5 0 00-7.07-7.07l-1.72
                                1.71"></path><path d="M14 11a5 5 0
                                00-7.54-.54l-3 3a5 5 0 007.07
                                7.07l1.71-1.71"></path></svg></a></div>
                      </div>
                    </h4>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><span>Only
                      </span><a
href="https://substack.com/redirect/4e41f6eb-ee10-4ce8-bf3a-bab5434b45da?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">39.8%</a><span> of
                        65+ year olds are up-to-date on COVID-19
                        vaccines. The best thing that this group can do
                        is to fill the holes in their immunity walls by
                        staying up-to-date. This also highlights that we
                        cannot rely on immune systems alone, especially
                        people aged 50+. </span><em>Everyone else</em><span>
                        also needs to </span><a
href="https://substack.com/redirect/8f318fd0-9660-4130-8df9-b4c2ac9ec5cf?r=a13t"
                        rel="" style="color: #0068ef; text-decoration:
                        none;" moz-do-not-send="true">do their part</a><span>
                        (still) to keep the more vulnerable safe. </span></p>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;">Love, YLE
                      and Edward Nirenberg</p>
                    <div style="font-size: 16px; line-height: 26px;">
                      <hr style="background: #ebebeb; border: none;
                        height: 1px; margin: 48px 0; padding: 0;"></div>
                    <p style="color: #1a1a1a; font-size: 16px;
                      line-height: 26px; margin: 0 0 1em 0;"><em>“Your
                        Local Epidemiologist (YLE)” is written by Dr.
                        Katelyn Jetelina, MPH PhD—an epidemiologist,
                        biostatistician, wife, and mom of two little
                        girls. During the day she works at a nonpartisan
                        health policy think tank, and at night she
                        writes this newsletter. Her main goal is to
                        “translate” the ever-evolving public health
                        science so that people will be well equipped to
                        make evidence-based decisions. This newsletter
                        is free thanks to the generous support of fellow
                        YLE community members.</em></p>
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                        Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
                        font-size: 14px; height: 100%; line-height:
                        18px; padding: 0px 12px 0px 0; padding-right:
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                        text-indent: 3px; white-space: nowrap;"><span
                          class="post-meta-icon like-reaction-button"><a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vYXBpL3YxL3Bvc3QvZW1haWwtcmVhY3Rpb24_dXRtX3NvdXJjZT1zdWJzdGFjayZ1dG1fbWVkaXVtPWVtYWlsJnRva2VuPWV5SjFjMlZ5WDJsa0lqbzBOamM1T1RNc0luQnZjM1JmYVdRaU9qWTRPVGN3TWpnd0xDSnlaV0ZqZEdsdmJpSTZJdUtkcENJc0ltbGhkQ0k2TVRZMk1Ea3hORFExTUN3aWFYTnpJam9pY0hWaUxUSTRNVEl4T1NJc0luTjFZaUk2SW5KbFlXTjBhVzl1SW4wLmktbHJwVTJiWW9OYmRoSldpNDIyX0VkRXh2cGEtTTJBUTJGdVlpbEJ2NlEiLCJwIjo2ODk3MDI4MCwicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY2MDkxNDQ1MCwiaXNzIjoicHViLTAiLCJzdWIiOiJsaW5rLXJlZGlyZWN0In0.0riKevhhg53-zVqVPOb-p4TcPcMjWgjWJr-oq93-3pc?"
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                              inline-block; float: left; height: 14px;
                              margin-right: 4px; max-width: 18px;
                              vertical-align: top; width: auto;" alt=""
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                              height="18"><span class="like-count"
                              style="color: #1a1a1a; margin-left: 7px;">Like</span></a></span></td>
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                        #767676; font-family: -apple-system,
                        BlinkMacSystemFont, 'Segoe UI', Roboto,
                        Helvetica, Arial, sans-serif, 'Apple Color
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                        font-size: 14px; height: 100%; line-height:
                        18px; padding: 0px 12px 0px 0; padding-right:
                        16px; position: relative; text-decoration: none;
                        text-indent: 3px; white-space: nowrap;"><a
href="https://substack.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.3AZ_D1r_2S9f-VY7O3sjLVtgiT4ewcCif8uglsz36PA?&utm_source=substack&utm_medium=email"
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                          color: #1a1a1a; cursor: pointer; display:
                          flex; font-family: -apple-system,
                          BlinkMacSystemFont, 'Segoe UI', Roboto,
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                          font-size: 16px; font-weight: normal; height:
                          auto; line-height: 15px; margin: 0; opacity:
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                          white-space: nowrap;" moz-do-not-send="true"><img
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                        Helvetica, Arial, sans-serif, 'Apple Color
                        Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
                        font-size: 14px; height: 100%; line-height:
                        18px; margin-right: 0; padding: 0px 12px 0px 0;
                        padding-right: 0; position: relative;
                        text-decoration: none; text-indent: 3px;
                        white-space: nowrap;"><span><a
href="https://substack.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.T6Dh28JtgOeJfnDWx9-JFBj_hYoyhp9RTjGbKgb9yak?"
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                  <p style="font-size: 16px; font-style: italic;
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                        moz-do-not-send="true">Your Local Epidemiologist</a>.
                      For the full experience, <a
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                    Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI
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                    line-height: 22px; margin: 0; margin-top: 0;
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href="https://substack.com/redirect/ecb67664-d5e3-49e9-b13d-34911dadfa2a?r=a13t"
                      style="color: #0068ef; display: inline-block;
                      margin: 8px 4px 0; text-decoration: none;"
                      moz-do-not-send="true"><img
src="https://substackcdn.com/image/fetch/w_260,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fapp-button%402x.png"
srcset="https://substackcdn.com/image/fetch/w_130,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fapp-button.png,
https://substackcdn.com/image/fetch/w_260,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fapp-button%402x.png
                        2x,
https://substackcdn.com/image/fetch/w_390,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fapp-button%403x.png
                        3x" alt="Get the app" style="border: none
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href="https://substack.com/redirect/c97c5647-b6ba-4a95-a087-4ec13318ff50?r=a13t"
                      style="color: #0068ef; display: inline-block;
                      margin: 8px 4px 0; text-decoration: none;"
                      moz-do-not-send="true"><img
src="https://substackcdn.com/image/fetch/w_270,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fpublish-button%402x.png"
srcset="https://substackcdn.com/image/fetch/w_135,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fpublish-button.png,
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                        2x,
https://substackcdn.com/image/fetch/w_405,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Femail%2Fpublish-button%403x.png
                        3x" alt="Start writing" style="border: none
                        !important; max-width: 550px; vertical-align:
                        middle;" moz-do-not-send="true" width="135"
                        height="40"></a></p>
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            </td>
            <td><br>
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          </tr>
        </tbody>
      </table>
      <img
src="https://mailgun.substack.com/api/v1/email/open?token=eyJtIjoiPDIwMjIwODE5MTMwNDQzLjMuNGM4ZGI1YjZlNWNiOWRkMEBtZy1kMS5zdWJzdGFjay5jb20-IiwidSI6NDY3OTkzLCJyIjoibWFubnlAcmF0YWZpYXMuY29tIiwiZCI6Im1nLWQxLnN1YnN0YWNrLmNvbSIsInAiOjY4OTcwMjgwLCJ0IjoibmV3c2xldHRlciIsImEiOiJldmVyeW9uZSIsInMiOjI4MTIxOSwiYyI6InBvc3QiLCJmIjp0cnVlLCJwb3NpdGlvbiI6ImJvdHRvbSIsImlhdCI6MTY2MDkxNDQ1MSwiaXNzIjoicHViLTAiLCJzdWIiOiJlbyJ9.nJrNy-wF4vUvGSvNMivopQPZW8dKMfqRUgB6j2qVOdM"
        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"><img alt=""
src="https://email.mg-d1.substack.com/o/eJw9UEluxSAMPU3ZNWIKHxacJQLspKgEIiCtcvuSH6k769l-U3Adt1Ive5TWCe4upmXDjHXgsLhumVLUMClnRhUjYIXxVAdFYlvWiu8H2-uJ5Dh9isH1WPISwXLNODPky-o1zApAyVWoIF8gYAYHBrkxWjujyK28uBMi5oAWf7BeJSMJZd8x95vrORmD0uZFuaYkWk45p5oZJqiUYhKTDBr87BXOwRsA-iHpvn0Cm9rpW3fhexqMpNrd5XyN5Ujo1ujaGx7ml1vwzLFfC2bnE8KTqz_VnA3rbUGqlzHicdSvA23G35awd6xkKEEZjWR7lbOmElzCIwLusaSyxbvg_z4V_wO16ICK"
        moz-do-not-send="true" width="1px" height="1px">
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          <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://s-install.avcdn.net/ipm/preview/icons/icon-envelope-tick-green-avg-v1.png"
                    alt=" width=" 46"="" style="width: 46px; height:
                    29px;" moz-do-not-send="true" 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>
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