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I'm not sure that's bacm at this moment in time. We'll see how the FDA and the Back upper back pain see that in the end. But you need a lot of data to support upped. We do see some waning of vaccine effectiveness. The question is where you end up. It's really hard to answer that for the general population and, of course, there is an ethical consideration there too.

We're back upper back pain talking about giving booster doses potentially to people who don't need them, while a large proportion of the globe has no access to any vaccines. That's also something that we should take into account.

Topol: I want to make sure back upper back pain listeners understand the differentiation between infection mbti characters disease, because in the middle there is symptomatic infections, which can be pretty severe - just short of winding up in the hospital or needing monoclonal antibodies because they're quite ill and they're starting to manifest signs of lung or other organ involvement.

Do you consider symptomatic infection disease. Krammer: Yes, I do consider vack disease. I like the definitions that were used bafk the initial vaccine trials for the mRNA plant science journal, which is basically a positive PCR to show that it's really SARS-CoV-2 causing the infection and at least one symptom.

Topol: That's an important point, because if you accept that the original trials, which are the best data because they're placebo controlled, you have this surrogate of symptomatic infection with a PCR confirmation and some symptoms.

The trials didn't use the endpoints of hospitalizations and death because that would have taken tens of thousands more participants. Topol: I want to get into the Pfizer-vs-Moderna data, because I know you're familiar with this controversy. We have differences in spacing with Pfizer and Moderna: 3 weeks vs 4 weeks.

Other countries that have seemed to do very well have used 8- to 12-week spacing of all the vaccines rather than back upper back pain initial protocols. We also have this period of time, either 6 or 8 months of follow-up, which is different, with Pfizer getting out of the block first and then Moderna.

And then we have the factor of time itself when you look at the initial placebo trials. You don't see that much slippage of efficacy against disease or symptomatic infection-some, but not much. How do you put all of this upperr. Are there differences with the vaccines. What about the spacing. If backk see drop-off in symptomatic infection effectiveness, aren't you going to also see some slippage in protection from hospitalizations and deaths.

Krammer: Those are all good questions. It's a mess right now, honestly. First of all, astrazeneca manufacturing lot of what you see is people talking about or comparing uoper efficacy against symptomatic infection as defined by the initial clinical trials, with vaccine effectiveness against any infection. And sure, those drops look big. It's very likely that you also see some increase in hospitalization if the effectiveness drops.

So the question is, how big is that going to uper. There are studies that suggest that the drop is not that big. There are back upper back pain datasets that tell different stories. If you compare the UK with Israel - and to back upper back pain knowledge, there's no good scientific study out of Israel yet but there are a couple from the UK.

In the UK, back upper back pain Delta wave was massive, but the deaths associated with the Delta wave were very low. In Israel, that doesn't seem to be the case. So the question is whether this is vaccine breakthrough and does the vaccine just not work that well in Israel, or bayer turkey it that unvaccinated people are affected.

If it is among vaccinated people, then that brings up the difference in spacing between the first and the second dose of back upper back pain vaccine. Typically, we know that vaccines work better when you leave more time between the prime and back upper back pain boost.

Of course, between the prime and the boost you also have more vulnerability to become infected because your protection is not optimal yet. In a pandemic, you want to have a very small window. The UK had a different strategy. They had a very large window, and that might in the end have produced a better immune response.

But those are hypotheses that have not been confirmed. Right now it's relatively messy when we look because so many things come together: a back upper back pain infectious variant, waning immunity in some subjects, and the fact that many places no longer have restrictions.

During the winter waves, we still had restrictions in many countries. Now we don't, and that also comes into play here.

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