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      This just came in and I thought I'd share it. Epidemiologist
      Katelyn Jetelina does a good job helping you decide on whether to 
      get a second COVID-19 updated (bivalent) booster vaccine now. The
      key factors are your age, any health conditions you may have, how
      long it has been since you got your first updated booster, and any
      upcoming social events you may have.<br>
      <br>
      Manny<br>
      <br>
      <pre class="moz-signature" cols="72">"Failure is unimportant. It takes courage to make a fool of yourself."
— Charlie Chaplin</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>Do I need a spring booster?</td>
            </tr>
            <tr>
              <th valign="BASELINE" nowrap="nowrap" align="RIGHT">Date:
              </th>
              <td>Tue, 25 Apr 2023 12:51:37 +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"
                  moz-do-not-send="true"><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+1xnsiz&a13t&&749b32fdbbd697875c9311388b602b280560249650b1c0a60dae20f1ed64bf69@mg1.substack.com"
                  moz-do-not-send="true"><reply+1xnsiz&a13t&&749b32fdbbd697875c9311388b602b280560249650b1c0a60dae20f1ed64bf69@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"
                  moz-do-not-send="true">manny@ratafias.com</a></td>
            </tr>
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        <title>Do I need a spring booster?</title>
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  .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 screen and (max-width: 650px) {
  .post-ufi.single-full-width-button .post-ufi-button-wrapper {
    width: 100%;
    padding: 16px;
  }
  .post-ufi.single-full-width-button .post-ufi-button-wrapper:empty {
    display: none;
  }
  .post-ufi.single-full-width-button .post-ufi-button {
    width: 100%;
    justify-content: center;
  }
}


@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: 650px) {
  .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: 650px) {
  .audio-player-wrapper .audio-player .audio-player-progress {
    border-left-width: 16px;
    border-right-width: 16px;
  }
}


@media screen and (max-width: 650px) {
  .audio-player-wrapper .audio-player .audio-player-progress .audio-player-progress-bar .audio-player-progress-bar-popup {
    top: -54px;
  }
}


@media screen and (max-width: 650px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-progress {
    border-left-width: 16px;
    border-right-width: 16px;
  }
}


@media screen and (max-width: 650px) {
  .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: 650px) {
  .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: 650px) {
  .poll-embed .poll-wrapper.poll-web .poll-dialog .modal-table .modal-row .modal-content > .container {
    padding: 40px 0;
  }
}


@media screen and (max-width: 650px) {
  .poll-embed .poll-wrapper.poll-web .poll-dialog .modal-row .modal-cell .modal-exit-btn {
    margin-right: -20px;
  }
}


@media not all and (min-resolution: 0.001dpcm) {
}
</style><img
src="https://mailgun.substack.com/api/v1/email/open?token=eyJtIjoiPDIwMjMwNDI1MTI1MTM3LjMuYjljYmU0NGUzZTJlNjc2ZkBtZy1kMS5zdWJzdGFjay5jb20-IiwidSI6NDY3OTkzLCJyIjoibWFubnlAcmF0YWZpYXMuY29tIiwiZCI6Im1nLWQxLnN1YnN0YWNrLmNvbSIsInAiOjExNzAwMzU2MywidCI6Im5ld3NsZXR0ZXIiLCJhIjoiZXZlcnlvbmUiLCJzIjoyODEyMTksImMiOiJwb3N0IiwiZiI6dHJ1ZSwicG9zaXRpb24iOiJ0b3AiLCJpYXQiOjE2ODI0MjcxMTYsImV4cCI6MTY4NTAxOTExNiwiaXNzIjoicHViLTAiLCJzdWIiOiJlbyJ9.MgT5Er3JbVssBDzPHcT7kXGFChtOdSXOtr-pz1qmUXE"
          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">The booster confusion in emails I have
          received over the past week is palpable. Should I get a spring
          booster? This is how I’m thinking about it. Hopefully it
          helps. Level of urgency The level of urgency for a spring
          booster should be dependent on two things:
 ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌</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: 20px;" align="right">
                          <table role="presentation" width="auto"
                            cellspacing="0" cellpadding="0" border="0">
                            <tbody>
                              <tr>
                                <td style="vertical-align: middle;"><span
                                    class="tw-font-body tw-text-ssm
                                    tw-text-substack-secondary"
                                    style="color: #808080 !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;"><a
href="https://open.substack.com/pub/yourlocalepidemiologist/p/do-i-need-a-spring-booster?utm_source=email&redirect=app-store"
                                      class="tw-text-substack-secondary
                                      tw-underline"
                                      style="-webkit-text-decoration-line:
                                      underline !important; color:
                                      #808080 !important;
                                      text-decoration-line: underline
                                      !important;"
                                      moz-do-not-send="true">Open in app</a>
                                    or <a
href="https://substack.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.wciNS7XxplA0iUvG4dmQgJD9y1ocezfdZRgEH4d4MDA?"
                                      class="tw-text-substack-secondary
                                      tw-underline"
                                      style="-webkit-text-decoration-line:
                                      underline !important; color:
                                      #808080 !important;
                                      text-decoration-line: underline
                                      !important;"
                                      moz-do-not-send="true">online</a></span></td>
                              </tr>
                            </tbody>
                          </table>
                        </td>
                      </tr>
                    </tbody>
                  </table>
                  <table role="presentation" class="header
                    graphic-header" style="border-spacing: 0; padding:
                    16px 0 32px;" width="auto">
                    <tbody>
                      <tr>
                        <td style="padding: 0; text-align: center;"
                          align="center"><a
href="https://substack.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.wciNS7XxplA0iUvG4dmQgJD9y1ocezfdZRgEH4d4MDA?"
                            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"
                              height="110"></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; margin-top: 16px;">
                      <div dir="auto" class="body markup"
                        style="font-size: 16px; line-height: 26px;
                        margin-bottom: 16px; text-align: initial; width:
                        100%; word-break: break-word;">
                        <p style="color: #404040; font-size: 16px;
                          line-height: 26px; margin: 0 0 20px 0;
                          margin-bottom: 0; margin-top: 0;"><em><span>Si
                              quiere leer la versión en español, pulse </span><a
href="https://substack.com/redirect/cdfa40b3-fafa-4adf-9324-d0a1c28e3aa4?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                              rel="" style="color: #538cfa;
                              text-decoration: none;"
                              moz-do-not-send="true">aquí</a><span>.</span></em></p>
                      </div>
                      <hr style="background: #e0e0e0; border: none;
                        height: 1px; margin: 16px 0 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 published"
                        style="-moz-osx-font-smoothing:
                        subpixel-antialiased; -webkit-font-smoothing:
                        subpixel-antialiased; color: #404040;
                        font-family: 'SF Pro Display', -apple-system,
                        BlinkMacSystemFont, 'Inter', 'Segoe UI', Roboto,
                        Helvetica, Arial, sans-serif, 'Apple Color
                        Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol';
                        font-size: 32px; font-weight: 900; line-height:
                        36px; margin: 0;"><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=117003563&utm_source=post-email-title&isFreemail=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjExNzAwMzU2MywiaWF0IjoxNjgyNDI3MTE2LCJleHAiOjE2ODUwMTkxMTYsImlzcyI6InB1Yi0yODEyMTkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.5yhpE7yUk1DDFep6uMkFGHI0o-3RO1ioNcbudUhU-iQ"
                          style="color: #404040; text-decoration: none;"
                          moz-do-not-send="true">Do I need a spring
                          booster?</a></h1>
                      <table role="presentation" class="post-meta"
                        style="align-items: center; height: 20px;
                        margin: 1em 0;" width="100%" cellspacing="0"
                        cellpadding="0" border="0">
                        <tbody>
                          <tr>
                            <td>
                              <table role="presentation" width="auto"
                                cellspacing="0" cellpadding="0"
                                border="0">
                                <tbody>
                                  <tr>
                                    <td>
                                      <table role="presentation"
                                        width="auto" cellspacing="0"
                                        cellpadding="0" border="0">
                                        <tbody>
                                          <tr>
                                            <td style="vertical-align:
                                              middle;">
                                              <div
                                                class="frontend-pencraft-Text-module__reset--20JLV
frontend-pencraft-Text-module__size-11--1-ofT
                                                frontend-pencraft-Text-module__line-height-20--1soeQ
frontend-pencraft-Text-module__weight-medium--aTbx5
                                                frontend-pencraft-Text-module__font-meta--2i-cR
frontend-pencraft-Text-module__color-primary--2I-sF
                                                frontend-pencraft-Text-module__transform-uppercase--38jbr
frontend-pencraft-Text-module__meta--3RRSj custom-css-email-post-author"
                                                style="color: #404040;
                                                font-family: 'SF
                                                Compact', -apple-system,
                                                -apple-system,
                                                -system-ui,
                                                BlinkMacSystemFont,
                                                'Segoe UI', Roboto,
                                                Helvetica, Arial,
                                                sans-serif, 'Apple Color
                                                Emoji', 'Segoe UI
                                                Emoji', 'Segoe UI
                                                Symbol'; font-size:
                                                11px; font-weight: 500;
                                                letter-spacing: .2px;
                                                line-height: 20px;
                                                margin: 0;
                                                text-decoration: unset;
                                                text-transform:
                                                uppercase;"><a
href="https://substack.com/redirect/87734c6d-0af0-42aa-8960-24582c61df24?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                                                  style="color: #404040;
                                                  font-family: 'SF
                                                  Compact',
                                                  -apple-system,
                                                  -apple-system,
                                                  -system-ui,
                                                  BlinkMacSystemFont,
                                                  'Segoe UI', Roboto,
                                                  Helvetica, Arial,
                                                  sans-serif, 'Apple
                                                  Color Emoji', 'Segoe
                                                  UI Emoji', 'Segoe UI
                                                  Symbol'; font-size:
                                                  11px; font-weight:
                                                  500; letter-spacing:
                                                  .2px; line-height:
                                                  20px; margin: 0;
                                                  text-decoration: none;
                                                  text-transform:
                                                  uppercase;"
                                                  class="frontend-pencraft-Text-module__reset--20JLV
frontend-pencraft-Text-module__size-11--1-ofT
                                                  frontend-pencraft-Text-module__line-height-20--1soeQ
frontend-pencraft-Text-module__weight-medium--aTbx5
                                                  frontend-pencraft-Text-module__font-meta--2i-cR
frontend-pencraft-Text-module__color-primary--2I-sF
                                                  frontend-pencraft-Text-module__transform-uppercase--38jbr
frontend-pencraft-Text-module__meta--3RRSj" moz-do-not-send="true">Katelyn
                                                  Jetelina</a></div>
                                            </td>
                                          </tr>
                                        </tbody>
                                      </table>
                                    </td>
                                  </tr>
                                  <tr>
                                    <td>
                                      <table role="presentation"
                                        width="auto" cellspacing="0"
                                        cellpadding="0" border="0">
                                        <tbody>
                                          <tr>
                                            <td style="vertical-align:
                                              middle;">
                                              <div
                                                class="frontend-pencraft-Text-module__reset--20JLV
frontend-pencraft-Text-module__size-11--1-ofT
                                                frontend-pencraft-Text-module__line-height-20--1soeQ
frontend-pencraft-Text-module__weight-medium--aTbx5
                                                frontend-pencraft-Text-module__font-meta--2i-cR
frontend-pencraft-Text-module__color-secondary--XjVGl
                                                frontend-pencraft-Text-module__transform-uppercase--38jbr
frontend-pencraft-Text-module__meta--3RRSj" style="color: #808080;
                                                font-family: 'SF
                                                Compact', -apple-system,
                                                -apple-system,
                                                -system-ui,
                                                BlinkMacSystemFont,
                                                'Segoe UI', Roboto,
                                                Helvetica, Arial,
                                                sans-serif, 'Apple Color
                                                Emoji', 'Segoe UI
                                                Emoji', 'Segoe UI
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                                                11px; font-weight: 500;
                                                letter-spacing: .2px;
                                                line-height: 20px;
                                                margin: 0;
                                                text-decoration: unset;
                                                text-transform:
                                                uppercase;"><time
                                                  datetime="2023-04-25T12:51:41.115Z">Apr
                                                  25</time></div>
                                            </td>
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                                </tbody>
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                                cellspacing="0" cellpadding="0"
                                border="0">
                                <tbody>
                                  <tr>
                                    <td style="vertical-align: middle;"><a
href="https://substack.com/redirect/87734c6d-0af0-42aa-8960-24582c61df24?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                                        moz-do-not-send="true"><img
src="https://substackcdn.com/image/fetch/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"
                                          style="border: none
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                                          min-height: 40px; min-width:
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                                          vertical-align: middle; width:
                                          40px;"
                                          class="custom-css-email-avatar
frontend-email-system-basics-module__avatar--1sRIo"
                                          moz-do-not-send="true"
                                          width="40" height="40"></a></td>
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                      <table role="presentation" class="email-ufi-2-top"
                        style="border-bottom: 1px solid #e0e0e0;
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                            <td style="font-size: 0px; line-height: 0;"
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                                cellspacing="0" cellpadding="0"
                                border="0">
                                <tbody>
                                  <tr>
                                    <td>
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                                        width="auto" cellspacing="0"
                                        cellpadding="0" border="0">
                                        <tbody>
                                          <tr>
                                            <td style="vertical-align:
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                                              <table role="presentation"
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                                                    <td align="center"><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=117003563&utm_source=substack&isFreemail=true&submitLike=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjExNzAwMzU2MywicmVhY3Rpb24iOiLinaQiLCJpYXQiOjE2ODI0MjcxMTYsImV4cCI6MTY4NTAxOTExNiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InJlYWN0aW9uIn0.FfomAWpj14vfGuTAS_O7ZzTLUkmCEINcvtwDRjCV-dk&utm_medium=email"
                                                        style="border:
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                                                        #e0e0e0;
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                                                        color: #808080;
                                                        display:
                                                        inline-block;
                                                        font-family: 'SF
                                                        Pro Text',
                                                        -apple-system,
                                                        ui-sans-serif,
                                                        BlinkMacSystemFont,
                                                        'Segoe UI',
                                                        Roboto,
                                                        Helvetica,
                                                        Arial,
                                                        sans-serif,
                                                        'Apple Color
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                                                        'Segoe UI
                                                        Symbol';
                                                        font-size: 12px;
                                                        font-weight:
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                                                        line-height: 1;
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                                                        padding: 9px 0;
                                                        text-decoration:
                                                        none;
                                                        text-transform:
                                                        uppercase;
                                                        width: 38px;"
                                                        class="email-icon-button"
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%2FLucideHeart%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2"
                                                          style="border:
                                                          none
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                                                          max-width:
                                                          18px;
                                                          vertical-align:
                                                          middle;"
                                                          alt=""
                                                          class="icon"
                                                          moz-do-not-send="true"
                                                          width="18"
                                                          height="18"></a></td>
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                                            </td>
                                            <td style="min-width: 8px"
                                              width="8"><br>
                                            </td>
                                            <td style="vertical-align:
                                              middle;">
                                              <table role="presentation"
                                                width="38"
                                                cellspacing="0"
                                                cellpadding="0"
                                                border="0">
                                                <tbody>
                                                  <tr>
                                                    <td align="center"><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=117003563&utm_source=substack&utm_medium=email&isFreemail=true&comments=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjExNzAwMzU2MywiaWF0IjoxNjgyNDI3MTE2LCJleHAiOjE2ODUwMTkxMTYsImlzcyI6InB1Yi0yODEyMTkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.5yhpE7yUk1DDFep6uMkFGHI0o-3RO1ioNcbudUhU-iQ&utm_source=substack&utm_medium=email"
                                                        style="border:
                                                        1px solid
                                                        #e0e0e0;
                                                        border-radius:
                                                        100000px;
                                                        box-sizing:
                                                        border-box;
                                                        color: #808080;
                                                        display:
                                                        inline-block;
                                                        font-family: 'SF
                                                        Pro Text',
                                                        -apple-system,
                                                        ui-sans-serif,
                                                        BlinkMacSystemFont,
                                                        'Segoe UI',
                                                        Roboto,
                                                        Helvetica,
                                                        Arial,
                                                        sans-serif,
                                                        'Apple Color
                                                        Emoji', 'Segoe
                                                        UI Emoji',
                                                        'Segoe UI
                                                        Symbol';
                                                        font-size: 12px;
                                                        font-weight:
                                                        500;
                                                        line-height: 1;
                                                        min-width: 38px;
                                                        padding: 9px 0;
                                                        text-decoration:
                                                        none;
                                                        text-transform:
                                                        uppercase;
                                                        width: 38px;"
                                                        class="email-icon-button"
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%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2"
                                                          style="border:
                                                          none
                                                          !important;
                                                          max-width:
                                                          18px;
                                                          vertical-align:
                                                          middle;"
                                                          alt=""
                                                          class="icon"
                                                          moz-do-not-send="true"
                                                          width="18"
                                                          height="18"></a></td>
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                                                </tbody>
                                              </table>
                                            </td>
                                            <td style="min-width: 8px"
                                              width="8"><br>
                                            </td>
                                            <td style="vertical-align:
                                              middle;">
                                              <table role="presentation"
                                                width="38"
                                                cellspacing="0"
                                                cellpadding="0"
                                                border="0">
                                                <tbody>
                                                  <tr>
                                                    <td align="center"><a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vcC9kby1pLW5lZWQtYS1zcHJpbmctYm9vc3Rlcj91dG1fc291cmNlPXN1YnN0YWNrJnV0bV9tZWRpdW09ZW1haWwmYWN0aW9uPXJlc3RhY2stY29tbWVudCIsInAiOjExNzAwMzU2MywicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY4MjQyNzExNiwiZXhwIjoxNjg1MDE5MTE2LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.cfSj1GkA2rHBECbsYjBD0Dfhh22ygbe-S8EO1z-3GXo?&utm_source=substack&utm_medium=email"
                                                        style="border:
                                                        1px solid
                                                        #e0e0e0;
                                                        border-radius:
                                                        100000px;
                                                        box-sizing:
                                                        border-box;
                                                        color: #808080;
                                                        display:
                                                        inline-block;
                                                        font-family: 'SF
                                                        Pro Text',
                                                        -apple-system,
                                                        ui-sans-serif,
                                                        BlinkMacSystemFont,
                                                        'Segoe UI',
                                                        Roboto,
                                                        Helvetica,
                                                        Arial,
                                                        sans-serif,
                                                        'Apple Color
                                                        Emoji', 'Segoe
                                                        UI Emoji',
                                                        'Segoe UI
                                                        Symbol';
                                                        font-size: 12px;
                                                        font-weight:
                                                        500;
                                                        line-height: 1;
                                                        min-width: 38px;
                                                        padding: 9px 0;
                                                        text-decoration:
                                                        none;
                                                        text-transform:
                                                        uppercase;
                                                        width: 38px;"
                                                        class="email-icon-button"
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%2FNoteForwardIcon%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2"
                                                          style="border:
                                                          none
                                                          !important;
                                                          max-width:
                                                          18px;
                                                          vertical-align:
                                                          middle;"
                                                          alt=""
                                                          class="icon"
                                                          moz-do-not-send="true"
                                                          width="18"
                                                          height="18"></a></td>
                                                  </tr>
                                                </tbody>
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                                    </td>
                                    <td align="right">
                                      <table role="presentation"
                                        width="auto" cellspacing="0"
                                        cellpadding="0" border="0">
                                        <tbody>
                                          <tr>
                                            <td style="vertical-align:
                                              middle;">
                                              <table role="presentation"
                                                width="auto"
                                                cellspacing="0"
                                                cellpadding="0"
                                                border="0">
                                                <tbody>
                                                  <tr>
                                                    <td align="center"><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=117003563&utm_source=substack&utm_medium=email&utm_content=share&action=share&triggerShare=true&isFreemail=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjExNzAwMzU2MywiaWF0IjoxNjgyNDI3MTE2LCJleHAiOjE2ODUwMTkxMTYsImlzcyI6InB1Yi0yODEyMTkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.5yhpE7yUk1DDFep6uMkFGHI0o-3RO1ioNcbudUhU-iQ"
class="email-button-outline" style="border: 1px solid #e0e0e0;
                                                        border-radius:
                                                        100000px; color:
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                                                        display:
                                                        inline-block;
                                                        font-family: 'SF
                                                        Pro Text',
                                                        -apple-system,
                                                        ui-sans-serif,
                                                        BlinkMacSystemFont,
                                                        'Segoe UI',
                                                        Roboto,
                                                        Helvetica,
                                                        Arial,
                                                        sans-serif,
                                                        'Apple Color
                                                        Emoji', 'Segoe
                                                        UI Emoji',
                                                        'Segoe UI
                                                        Symbol';
                                                        font-size: 12px;
                                                        font-weight:
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                                                        line-height:
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                                                        moz-do-not-send="true"><span
class="email-button-text" style="vertical-align: middle;">Share</span></a></td>
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                          </tr>
                          <tr height="16">
                            <td style="font-size: 0px; line-height: 0;"
                              height="16"> </td>
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                        </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: 16px; text-align: initial; width:
                      100%; word-break: break-word;">
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;
                        margin-top: 0;"><span>The booster confusion in
                          emails I have received over the past week is
                          palpable. </span><em>Should I get a spring
                          booster</em><span>? </span></p>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;">This is
                        how I’m thinking about it. Hopefully it helps. </p>
                      <h4 class="header-with-anchor-widget"
                        style="-moz-osx-font-smoothing:
                        subpixel-antialiased; -webkit-font-smoothing:
                        subpixel-antialiased; color: #404040;
                        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;">Level of urgency</h4>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;">The
                        level of urgency for a spring booster should be
                        dependent on two things: </p>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;"><em><strong>1.
                            Risk factors. </strong></em><span>Ninety
                          percent of people in the hospital “for” or
                          “with” COVID-19 do </span><em>not</em><span>
                          have a bivalent vaccine (i.e. fall booster).
                          This group has the highest level of urgency. </span></p>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;"><span>If
                          you had the fall booster, you’re in pretty
                          good shape against acute severe disease. </span><em>Will
                          this change with time?</em><span> We don’t
                          know. The U.S. (and a handful of other
                          countries) don’t want to risk finding out, so
                          a spring booster is “permissible”. </span></p>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;"><span>People
                          in the hospital today for COVID-19 are older
                          adults and/or those with a comorbidity. (If
                          you want to know why, read more </span><a
href="https://substack.com/redirect/ca64fbd0-2719-4829-9953-a15cff69fe95?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                          rel="" style="color: #538cfa; text-decoration:
                          none;" moz-do-not-send="true">here</a><span>.)
                          This means groups with the second highest
                          level of urgency for a spring booster are
                          those with a fall booster and: </span></p>
                      <ul style="margin-top: 0; padding: 0;">
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;">Adults over 75 years; </p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;">Adults over the age of 65 years with a
                            comorbidity; and,</p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;">Moderate or severely
                            immunocompromised. </p>
                        </li>
                      </ul>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;"><span>If
                          you’re not in one of these groups, your level
                          of urgency is </span><em>significantly </em><span>reduced.
                          You could time a booster for maximum
                          protection. If I were over 65 </span><em>without</em><span>
                          a comorbidity, I would, especially since
                          wastewater concentration is </span><a
href="https://substack.com/redirect/f5416f32-825a-41c6-a475-f183eb532681?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                          rel="" style="color: #538cfa; text-decoration:
                          none;" moz-do-not-send="true">nosediving</a><span>.
                          For example, four weeks before a really big
                          event you don’t want to miss, like a wedding,
                          get a booster. Or wait to get a booster on the
                          chance that another variant of concern comes
                          (and get it right before a wave). </span></p>
                      <div class="captioned-image-container-static"
                        style="font-size: 16px; line-height: 26px;
                        margin: 32px auto;">
                        <figure style="margin: 0 auto; width: 100%;">
                          <table class="image-wrapper"
                            style="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/efafda3a-b7b5-4e28-8215-20f76ed119a7?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                                    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://substack-post-media.s3.amazonaws.com/public/images/5dbbcb4b-f0fb-4c8b-b8a1-82b23a5fc9ba_2765x1220.jpeg","fullscreen":null,"imageSize":null,"height":642,"width":1456,"resizeWidth":null,"bytes":221734,"alt":null,"title":null,"type":"image/jpeg","href":null,"belowTheFold":true,"internalRedirect":null}"
                                      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%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5dbbcb4b-f0fb-4c8b-b8a1-82b23a5fc9ba_2765x1220.jpeg"
                                      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="242.51373626373626"></a></td>
                                <td style="text-align: center;"><br>
                                </td>
                              </tr>
                            </tbody>
                          </table>
                        </figure>
                      </div>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;"><em><strong>2.
                            Timing. </strong></em><span>If you’re in
                          one of the urgent groups, the next question
                          is: </span><em>When was your last infection
                          or vaccine? </em></p>
                      <ul style="margin-top: 0; padding: 0;">
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;">6+ months ago: Go get a spring booster
                            today. </p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;">4-6 months: Schedule one, but you
                            don’t need to rush to the pharmacy. </p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;"><4 months: Wait. But do not wait
                            until past May/June, so that you enough
                            runway time before the (anticipated) fall
                            vaccine. </p>
                        </li>
                      </ul>
                      <h4 class="header-with-anchor-widget"
                        style="-moz-osx-font-smoothing:
                        subpixel-antialiased; -webkit-font-smoothing:
                        subpixel-antialiased; color: #404040;
                        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;">Potential individual-level
                        risks</h4>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;"><span>People
                          are wondering about risks of spring boosters.
                          The risks are small, especially when we
                          compare them to risks resulting from
                          infection. Perhaps the following risks should
                          really only be considered for those who are </span><em>not
                        </em><span>in the high-urgency groups above. </span></p>
                      <ul style="margin-top: 0; padding: 0;">
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;"><em><strong>Myocarditis</strong></em><span>.
                              This is the biggest risk of COVID-19
                              vaccines but is really only a problem for
                              adolescents. (Benefits still outweigh
                              risks. There is also a risk of myocarditis
                              from COVID-19 infection.) </span></p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;"><em><strong>Flu vaccine.</strong></em><span>
                              There may be an </span><a
href="https://substack.com/redirect/0403416c-2a92-4463-9e23-c9ca42539adf?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                              rel="" style="color: #538cfa;
                              text-decoration: none;"
                              moz-do-not-send="true">increased risk of
                              stroke </a><span>if you get flu and
                              COVID-19 vaccines at the same time. This
                              shouldn’t be a problem for your spring
                              decision. </span></p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;"><em><strong>Side effects</strong></em><span>.
                              Some people get their butt kicked from
                              side effects immediately after the
                              vaccine. Some just don’t have the ability
                              to be out of commission for a few days. </span></p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;"><em><strong>Imprinting</strong></em><span>.
                              We know imprinting is a thing with
                              COVID-19. And, we </span><em>should </em><span>expect
                              imprinting. (Read a deep dive </span><a
href="https://substack.com/redirect/8b0eb562-eba0-4016-b502-a8258265fd02?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                              rel="" style="color: #538cfa;
                              text-decoration: none;"
                              moz-do-not-send="true">here</a><span>.)
                              The biggest influence of imprinting occurs
                              after first exposure to the virus (through
                              vaccine or infection). We still don’t have
                              good evidence that imprinting is </span><em>harming
                            </em><span>protection, though. </span></p>
                        </li>
                        <li style="margin: 8px 0 0 32px;
                          mso-special-format: bullet;">
                          <p style="box-sizing: border-box; color:
                            #404040; font-size: 16px; line-height: 26px;
                            margin: 0; margin-bottom: 0; padding-left:
                            4px;"><em><strong>Unknown unknowns</strong></em><span>.
                              We simply don’t know the risks of
                              stimulating the immune system with 6 shots
                              in 2 years, too. There are always unknown
                              risks, albeit small.</span></p>
                        </li>
                      </ul>
                      <h4 class="header-with-anchor-widget"
                        style="-moz-osx-font-smoothing:
                        subpixel-antialiased; -webkit-font-smoothing:
                        subpixel-antialiased; color: #404040;
                        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;">Bottom line</h4>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;">Anyone
                        who hasn’t had a bivalent vaccine (i.e. fall
                        Omicron booster) needs to get one. If you have
                        your bivalent already, there is a spectrum of
                        urgency. Try not to overthink it too much. </p>
                      <p style="color: #404040; font-size: 16px;
                        line-height: 26px; margin: 0 0 20px 0;">Love,
                        YLE </p>
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                          “translate” the ever-evolving public health
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                          to make evidence-based decisions. This
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                                                    uppercase;"
                                                    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%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2"
                                                      style="border:
                                                      none !important;
                                                      margin-right: 8px;
                                                      max-width: 18px;
                                                      min-height: 18px;
                                                      min-width: 18px;
                                                      vertical-align:
                                                      middle;" alt=""
                                                      class="icon"
                                                      moz-do-not-send="true"
                                                      width="18"
                                                      height="18"><span
class="email-button-text" style="vertical-align: middle;">Comment</span></a></td>
                                              </tr>
                                            </tbody>
                                          </table>
                                        </td>
                                        <td style="min-width: 8px"
                                          width="8"><br>
                                        </td>
                                        <td style="vertical-align:
                                          middle;">
                                          <table role="presentation"
                                            width="auto" cellspacing="0"
                                            cellpadding="0" border="0">
                                            <tbody>
                                              <tr>
                                                <td align="center"><a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vcC9kby1pLW5lZWQtYS1zcHJpbmctYm9vc3Rlcj91dG1fc291cmNlPXN1YnN0YWNrJnV0bV9tZWRpdW09ZW1haWwmYWN0aW9uPXJlc3RhY2stY29tbWVudCIsInAiOjExNzAwMzU2MywicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY4MjQyNzExNiwiZXhwIjoxNjg1MDE5MTE2LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.cfSj1GkA2rHBECbsYjBD0Dfhh22ygbe-S8EO1z-3GXo?&utm_source=substack&utm_medium=email"
class="email-button-outline" style="border: 1px solid #e0e0e0;
                                                    border-radius:
                                                    100000px; color:
                                                    #808080; display:
                                                    inline-block;
                                                    font-family: 'SF Pro
                                                    Text',
                                                    -apple-system,
                                                    ui-sans-serif,
                                                    BlinkMacSystemFont,
                                                    'Segoe UI', Roboto,
                                                    Helvetica, Arial,
                                                    sans-serif, 'Apple
                                                    Color Emoji', 'Segoe
                                                    UI Emoji', 'Segoe UI
                                                    Symbol'; font-size:
                                                    12px; font-weight:
                                                    500; line-height:
                                                    12px; padding: 9px
                                                    14px;
                                                    text-decoration:
                                                    none;
                                                    text-transform:
                                                    uppercase;"
                                                    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%2FNoteForwardIcon%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2"
                                                      style="border:
                                                      none !important;
                                                      margin-right: 8px;
                                                      max-width: 18px;
                                                      min-height: 18px;
                                                      min-width: 18px;
                                                      vertical-align:
                                                      middle;" alt=""
                                                      class="icon"
                                                      moz-do-not-send="true"
                                                      width="18"
                                                      height="18"><span
class="email-button-text" style="vertical-align: middle;">Restack</span></a></td>
                                              </tr>
                                            </tbody>
                                          </table>
                                        </td>
                                      </tr>
                                    </tbody>
                                  </table>
                                </td>
                                <td align="right">
                                  <table role="presentation"
                                    width="auto" cellspacing="0"
                                    cellpadding="0" border="0">
                                    <tbody>
                                      <tr>
                                      </tr>
                                    </tbody>
                                  </table>
                                </td>
                              </tr>
                            </tbody>
                          </table>
                        </td>
                      </tr>
                      <tr height="16">
                        <td style="font-size: 0px; line-height: 0;"
                          height="16"> </td>
                      </tr>
                    </tbody>
                  </table>
                  <div class="footer
                    frontend-email-shared-typed-module__footer--WmMp1"
                    style="color: #808080; font-size: 16px; line-height:
                    26px; padding: 24px 0; text-align: center;">
                    <div
                      class="frontend-email-shared-typed-module__footerSection--9vwqp"
                      style="font-size: 16px; line-height: 26px;
                      padding: 0 24px;">
                      <div style="color: #404040; font-family:
                        -apple-system, -system-ui, BlinkMacSystemFont,
                        'Segoe UI', Roboto, Helvetica, Arial,
                        sans-serif, 'Apple Color Emoji', 'Segoe UI
                        Emoji', 'Segoe UI Symbol'; font-size: 16px;
                        font-weight: 700; letter-spacing: -.32px;
                        line-height: 20px; margin: 0; margin-bottom:
                        4px; text-decoration: unset;"
                        class="frontend-pencraft-Text-module__reset--20JLV
                        frontend-pencraft-Text-module__size-16--yeezN
                        frontend-pencraft-Text-module__line-height-20--1soeQ
frontend-pencraft-Text-module__weight-bold--VnIZR
                        frontend-pencraft-Text-module__font-text--hJYwu
frontend-pencraft-Text-module__color-primary--2I-sF
                        frontend-pencraft-Text-module__header4--29ICx">Read
                        Your Local Epidemiologist in the app</div>
                      <div style="color: #808080; font-family:
                        -apple-system, -system-ui, BlinkMacSystemFont,
                        'Segoe UI', Roboto, Helvetica, Arial,
                        sans-serif, 'Apple Color Emoji', 'Segoe UI
                        Emoji', 'Segoe UI Symbol'; font-size: 14px;
                        font-weight: 400; letter-spacing: -.15px;
                        line-height: 20px; margin: 0; margin-bottom:
                        16px; text-decoration: unset;"
                        class="frontend-pencraft-Text-module__reset--20JLV
                        frontend-pencraft-Text-module__size-14--1PYz8
                        frontend-pencraft-Text-module__line-height-20--1soeQ
frontend-pencraft-Text-module__weight-normal--mEmBf
                        frontend-pencraft-Text-module__font-text--hJYwu
frontend-pencraft-Text-module__color-secondary--XjVGl
                        frontend-pencraft-Text-module__body4--flxpT">Listen
                        to posts, join subscriber chats, and never miss
                        an update from Katelyn Jetelina.</div>
                      <div style="font-size: 16px; line-height: 26px;"><a
href="https://substack.com/redirect/b0681cdc-3c49-4c8d-be17-c3d15278e8d0?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                          class="email-footer-button"
                          style="border-radius: 8px; display:
                          inline-block; margin: 0 4px; overflow: hidden;
                          text-decoration: none;" moz-do-not-send="true"><img
                            alt="Get the iOS app"
src="https://substackcdn.com/image/fetch/w_246,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Fapp_page%2Fapp-store.png"
                            style="border: none !important; max-width:
                            550px; vertical-align: middle;"
                            moz-do-not-send="true" width="123"
                            height="40"></a><a
href="https://substack.com/redirect/651832ed-8d1b-4b05-a2ea-ad6637f664ad?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
                          class="email-footer-button"
                          style="border-radius: 8px; display:
                          inline-block; margin: 0 4px; overflow: hidden;
                          text-decoration: none;" moz-do-not-send="true"><img
                            alt="Get the Android app"
src="https://substackcdn.com/image/fetch/w_270,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Fimg%2Fapp_page%2Fgoogle-play.png%3Fv%3D1"
                            style="border: none !important; max-width:
                            550px; vertical-align: middle;"
                            moz-do-not-send="true" width="135"
                            height="40"></a></div>
                    </div>
                    <div style="font-size: 16px; line-height: 26px;
                      padding-bottom: 24px;">
                      <p
                        class="frontend-pencraft-Text-module__reset--20JLV
                        frontend-pencraft-Text-module__size-12--2onFT
                        frontend-pencraft-Text-module__color-secondary--XjVGl
                        small
                        frontend-email-shared-typed-module__meta--AAyPr"
                        style="color: #808080; font-family:
                        -apple-system, BlinkMacSystemFont, 'Segoe UI',
                        Roboto, Helvetica, Arial, sans-serif, 'Apple
                        Color Emoji', 'Segoe UI Emoji', 'Segoe UI
                        Symbol'; font-size: 12px; letter-spacing: 0;
                        line-height: 16px; margin: 0; padding-bottom: 0;
                        text-decoration: unset;">© 2023 <span>Your
                          Local Epidemiologist</span><br>
                        548 Market Street PMB 72296, San Francisco, CA
                        94104 <br>
                        <a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vYWN0aW9uL2Rpc2FibGVfZW1haWw_dG9rZW49ZXlKMWMyVnlYMmxrSWpvME5qYzVPVE1zSW5CdmMzUmZhV1FpT2pFeE56QXdNelUyTXl3aWFXRjBJam94TmpneU5ESTNNVEUyTENKbGVIQWlPakUyT0RVd01Ua3hNVFlzSW1semN5STZJbkIxWWkweU9ERXlNVGtpTENKemRXSWlPaUprYVhOaFlteGxYMlZ0WVdsc0luMC5BT2NRVHpRRnZ2ZUMyNm80S1h5aXBhMlFtY3pRQkVYb0xMeG1vZUpVNTVZIiwicCI6MTE3MDAzNTYzLCJzIjoyODEyMTksImYiOnRydWUsInUiOjQ2Nzk5MywiaWF0IjoxNjgyNDI3MTE2LCJleHAiOjE2ODUwMTkxMTYsImlzcyI6InB1Yi0wIiwic3ViIjoibGluay1yZWRpcmVjdCJ9.PVmqdppgWGfJQ3QeysdixJyjvyVMuYymCrOTTkuzFJQ?"
                          style="color: #538cfa; text-decoration: none;"
                          moz-do-not-send="true"><span style="color:
                            #808080; text-decoration: underline;">Unsubscribe</span></a></p>
                    </div>
                    <p
                      class="frontend-email-shared-typed-module__footerSection--9vwqp
                      small powered-by-substack" style="color: #808080;
                      font-family: -apple-system, BlinkMacSystemFont,
                      'Segoe UI', Roboto, Helvetica, Arial, sans-serif,
                      'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI
                      Symbol'; font-size: 12px; line-height: 20px;
                      margin: 0; margin-top: 0; padding: 0 24px;
                      padding-bottom: 0;"><a
href="https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9zdWJzdGFjay5jb20vc2lnbnVwP3V0bV9zb3VyY2U9c3Vic3RhY2smdXRtX21lZGl1bT1lbWFpbCZ1dG1fY29udGVudD1mb290ZXImdXRtX2NhbXBhaWduPWF1dG9maWxsZWQtZm9vdGVyJmZyZWVTaWdudXBFbWFpbD1tYW5ueUByYXRhZmlhcy5jb20iLCJwIjoxMTcwMDM1NjMsInMiOjI4MTIxOSwiZiI6dHJ1ZSwidSI6NDY3OTkzLCJpYXQiOjE2ODI0MjcxMTYsImV4cCI6MTY4NTAxOTExNiwiaXNzIjoicHViLTAiLCJzdWIiOiJsaW5rLXJlZGlyZWN0In0.hEIkgGWV7ZIKoBzimmO97iQP0f3nyxBpo-A-ttDYIi8?"
                        style="color: #538cfa; display: inline-block;
                        margin: 0 4px; 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,
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
                          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>
                  </div>
                </div>
              </td>
              <td><br>
              </td>
            </tr>
          </tbody>
        </table>
        <img
src="https://mailgun.substack.com/api/v1/email/open?token=eyJtIjoiPDIwMjMwNDI1MTI1MTM3LjMuYjljYmU0NGUzZTJlNjc2ZkBtZy1kMS5zdWJzdGFjay5jb20-IiwidSI6NDY3OTkzLCJyIjoibWFubnlAcmF0YWZpYXMuY29tIiwiZCI6Im1nLWQxLnN1YnN0YWNrLmNvbSIsInAiOjExNzAwMzU2MywidCI6Im5ld3NsZXR0ZXIiLCJhIjoiZXZlcnlvbmUiLCJzIjoyODEyMTksImMiOiJwb3N0IiwiZiI6dHJ1ZSwicG9zaXRpb24iOiJib3R0b20iLCJpYXQiOjE2ODI0MjcxMTYsImV4cCI6MTY4NTAxOTExNiwiaXNzIjoicHViLTAiLCJzdWIiOiJlbyJ9.j2AkMa5A757G-L-y6VsDHLHiGfqo5VcgsfrFxTdDZ38"
          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/eJw8kEvO3CAQBk8z7GLxsMFecBargbaDwsOCJpFvH3lm9G_rk0qlzwPhWdttr9qJBas2x1evGVqhVzlLIxbFMENM-4kFGxCGHehnFXpdJPttpTJay_XYwBhhAhcGlHarXITyuElg0UouFZ_lIh5oJjW5zTucZ1QoURt9vGaez19BTH24TuD_TL5mFvt-NHwnWGoD2VO6wwgRi0eLf7HdtXxxDFYIw7latPoQui-0Bf_1hETY2DXc7mvOo0S6dyzgEoaveLgUPVCs5RHJVUixsWYzlHK_Zt6A4IjQ31l9uFAzxGLvOlqqHhJeMWCONdUzdmL0-XR0bI9u1mbb1P8AAAD__4myevo"
          moz-do-not-send="true" width="1px" height="1px">
        <div id="DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2"><br>
          <table style="border-top: 1px solid #D3D4DE;">
            <tbody>
              <tr>
                <td style="width: 55px; padding-top: 13px;"><a
href="http://www.avg.com/email-signature?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient"
                    target="_blank" moz-do-not-send="true"><img
src="https://s-install.avcdn.net/ipm/preview/icons/icon-envelope-tick-green-avg-v1.png"
                      alt="" style="width: 46px; height: 29px;"
                      moz-do-not-send="true" width="46" height="29"></a></td>
                <td style="width: 470px; padding-top: 12px; color:
                  #41424e; font-size: 13px; font-family: Arial,
                  Helvetica, sans-serif; line-height: 18px;">Virus-free.<a
href="http://www.avg.com/email-signature?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient"
                    target="_blank" style="color: #4453ea;"
                    moz-do-not-send="true">www.avg.com</a></td>
              </tr>
            </tbody>
          </table>
          <a href="#DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2" width="1"
            height="1" moz-do-not-send="true"> </a></div>
      </div>
    </div>
  </body>
</html>