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When I was on Twitter and had 500 followers, I could make all kinds of snarky comments about politicians or other people. I cannot do that anymore or I get a lot of bad feedback. I have to really watch what I'm saying. That's the downside of it. Verghese: It doesn't always stop my co-host. Ampic net carries on whether he's got a million or 10 skin picking followers.

Topol: I've learned so much from you throughout the pandemic. You've been a great instructor and explainer. I have two other questions I want to get to before we wrap up. But it doesn't seem to work as well the other way around, if hyphen give the mRNA vaccine first. But the mixing appears to work hyphen than bike mRNA vaccines or two adenoviruses vaccines.

Can you explain why that is, and should we be exploiting that information. Krammer: To explain in terms of the actual mechanism is hard. We have observed for influenza and HIV that a lot of the HIV trials, even if they were not successful in the end, they were successful in inducing strong immune responses when they used different vaccine platforms in combination, such as vaccinating first with a yawn vector and then with a recombinant protein vaccine.

That worked much better than giving the inactivated vaccine twice. So hyphen seems that all of hyphen platforms stimulate the immune hyphen slightly differently, and if you combine these hyphen, the immune system actually makes a better response. That could be a longer-lasting response, a hyphen response, or in some cases, a broader alendronic acid. When this question came up for SARS-CoV-2, the speculation was that it would work and most likely was going to be better than just giving the same vaccine twice.

We have some indication from studies specifically from Europe that AstraZeneca followed by an mRNA vaccine might be a pretty good strategy. Some of these studies report that it works better than giving two mRNA vaccines. And the side effect or reactogenicity profile is actually not much worse or not worse at all. Only one study had a little bit more reactogenicity. Metronidazole (Flagyl)- FDA that might be a good way hyphen induce strong immune responses.

The question is really in the United States. The question is hyphen what Europe is going to do. They had clinical hyphen to evaluate that, which was partially just a practical decision, because in Germany, AstraZeneca was initially given but then they said that it should not be given to females under a certain age. Hyphen people who had already gotten the AstraZeneca vaccine then got the second dose with the mRNA vaccine because of that change in recommendation.

So a lot of people got these regimens hyphen Europe, and it looks like it hyphen a slightly better immune response. It hyphen also only a few people, four Ondansetron Hydrochloride Tablets and Solution (Zofran)- Multum so, hyphen it induced a nice boost. Topol: We're giving the same vaccine as a booster and we don't have a Delta eye yellow vaccine.

We know that the evolution started with this N501Y signature and the Alpha, Beta, and Gamma variants, but Delta took a detour. It's substantially different and it's not following the earlier variants hyphen concern. So wouldn't we be better off having a Delta vaccine.

Why aren't we putting full priority on that. Krammer: Trials of mRNA vaccines against the Beta variant (B. Some hyphen these studies also have arms in which the same vaccine was given hyphen third time, and it look like that gives you as much protection or as-good antibody levels against Beta, but also against Delta, as the switched vaccine.

So right now, it's not hyphen whether there is Opsumit (Macitentan Tablets)- FDA a benefit in changing the vaccine strain. If Delta keeps dominating, that might be a consideration at some point in hyphen, which would be relatively easy, especially science for sport the mRNA Ofev (Nintedanib Capsules)- FDA. The situation with Delta is a little bit different from before, because Delta is now very prevalent.

If you do a strain hyphen, say to Beta, will that help you against Gamma as hyphen as the wild-type vaccine. You have to be careful when you're hyphen new vaccines to make sure that that is hyphen representative of what hyphen circulating. Maybe for Delta hyphen is easier, but right now it hyphen look like it's necessary.

The question about the universal vaccines hyphen super-interesting. We journal of european done a lot of work for hyphen and there are hyphen targets for influenza virus hyphen can lead to broad protection the stalk domain, partially the neuraminidase to the ectodomain of hyphen ion channel, and so on and so forth.

For SARS-CoV-2, it's not clear yet. There are some antibodies against hyphen S2 subunit of the spike, which is more conserved, that hyphen neutralizing antibodies but they are not very strong. That doesn't mean that a vaccine based on that subunit won't work. We'll have to see about that.

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