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[PubMed: 37209197] 20

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To counter this constant evolution, seasonal vaccines are redesigned annually on predictions of what will be the dominant circulating variants in the upcoming flu season. Predictions must be made significantly ahead of time owing to the time needed to manufacture sufficient doses of vaccine, which can lead to mismatches between vaccine and circulating strains that almost universally lead to limited efficacy

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A vitamin B12 deficiency might cause various neurologic and also psychiatric disruptions