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Medicine Science

The First Covid Vaccines May Not Prevent Covid Infection (bloomberg.com) 103

Desperation for a way to keep economies from collapsing under the weight of Covid-19 could mean settling for a vaccine that prevents people from getting really sick or dying but doesn't stop them from catching the coronavirus. From a report: Although a knock-out blow against the virus is the ultimate goal, early vaccines may come with limitations on what they can deliver, according to Robin Shattock, an Imperial College London professor leading development of an experimental shot. "Is that protection against infection?" Shattock said. "Is it protection against illness? Is it protection against severe disease? It's quite possible a vaccine that only protects against severe disease would be very useful."

As countries emerge warily from lockdowns, leaders are looking to a preventive shot as the route to return to pre-pandemic life. Fueled by billions of dollars in government investment, vaccines from little-known companies like China's CanSino Biologics and giants like Pfizer Inc. and AstraZeneca Plc are in development. At least one of the fastest-moving experimental shots has already advanced into human trials after showing an impact on severe disease -- but less so on infection -- in animals. Experts say such a product would probably be widely used if approved, even if that's as much as it contributes, until a more effective version comes to market. "Vaccines need to protect against disease, not necessarily infection," said Dennis Burton, an immunologist and vaccine researcher at Scripps Research in La Jolla, California.

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The First Covid Vaccines May Not Prevent Covid Infection

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  • by GlobalEcho ( 26240 ) on Monday June 15, 2020 @10:23AM (#60184976)

    Maybe I have too simplistic a view of the human immune system, but I have to say I am kind of surprised that such gradations exist. My picture is that

    ( (previous infection) OR (vaccine) ) -> ( (exposure) + (antibodies) ) -> (infection prevented)

    but this is more like

    ( (vaccine) ) -> ( (exposure) + (antibodies) ) -> ( infection ) -> ( sickness prevented )

    So how does that happen?

    • Re:I wonder how (Score:5, Interesting)

      by monkeyxpress ( 4016725 ) on Monday June 15, 2020 @10:36AM (#60185016)

      I looked into this a few months back when the serological surveys started coming in. It became quite apparent after a small amount of research that my high school level understand of the human immune system was infantile, and that even for experts who dedicate their lives to the field, it is a world full of many mysteries we are still trying to unravel.

      I think that in the world where we appear to have such mastery over DNA we (especially those of us with a computation background) figure that it will be this really neat and tidy world where little angry virus particle wonders along and the antibody with the smiley face on it rocks on up latches on and defeats it. The reality is far more messy. Indeed a lot of biology seems to be 'we poked it with some stuff a hundred times, and this happened ten times, so maybe there is some kind of process that connects those two things'.

      • Re:I wonder how (Score:5, Informative)

        by UnknowingFool ( 672806 ) on Monday June 15, 2020 @10:49AM (#60185072)
        To clarify your statement, we don’t have "mastery" over DNA. DNA sequencing is easily done. Determining what particular gene segments do is ongoing research. Manipulating genes in living people (aka gene therapy) is not to the point where it is an option for many diseases.
        • Knowing the rules of go takes minutes, becoming good takes a lifetime, and complete knowledge of the game exceeds human capacity.
      • This is what I think of when people complain about medical science being indecisive. Biology is just really complicated.

    • Re:I wonder how (Score:5, Informative)

      by ceoyoyo ( 59147 ) on Monday June 15, 2020 @11:35AM (#60185240)

      Your immune system has a bunch of different parts, and one of the things that does is allow a graded response to an infection. That's important, because most infection fighting involves collateral damage.

      Vaccines are tyically aimed at triggering a cascade of responses by your immune system which eventually ends up with memory B cells specialized to produce antibodies to the antigens in the vaccine. These cells are long-lived and basically hang out until that antigen is spotted again, at which point they start dividing and pumping out antibodies. If that response is fast and effective enough you probably won't get sick, but if it's slower or weaker you might get some more mild symptoms.

      Vaccine making is a bit of an art, which includes pissing off your immune system just enough so that it takes the actually harmless vaccine antigen seriously and creates a robust, long-lasting response. Oh, and it has to do that without making anybody sick, because people don't like it when vaccines give them even very mild symptoms, or when they kill 0.001% of the people who get them.

      • When dealing with a pandemic the calculation changes a lot. If it works 2/3 of the time you already have herd immunity.
        If the vaccine reduces transmission(makes you less contagious, or for shorter time) it reduces the reproduction and the pandemic becomes easier to control.
        If it makes you ill but not very ill then it is an interesting alternative to dying , but only useful the high risk people.
        That is why I think getting a useful vaccine is feasible. It doesn't have to be perfect. But of course the result w

        • by ceoyoyo ( 59147 )

          You also have to convince people to take it. We are very, very bad at evaluating risk. Specifically, our brains blow the risk from rare but catastrophic events that we feel we have no control over out of all proportion. Vaccines are one of these, and there's no shortage of examples: problems with the live polio vaccine; distrust of vaccine supplies in Africa; autism and vaccines; even seasonal influenza, which is a yearly recurring pandemic. There are a bunch of people commenting right on this story that th

          • It's true, i noticed domestic distrust is running pretty high. I don't see it so much as risk assessment problem than a trust problem and that is more a symptom of general distrust than something specific to vaccines.
            Pumping up the China/Russia paranoia won't fix that.

      • by Tablizer ( 95088 )

        because people don't like it when vaccines give them even very mild symptoms, or when they kill 0.001% of the people who get them.

        This time more will probably accept risk to get back to normal life, as long as they are accurately told the risk up front.

        As far as vaccines killing some, if they are part of a high-risk category, does splitting the shot over multiple periods reduce the risk? For example, if they have an allergic reaction, giving them 1/3 the dose for a 3 period injection, will probably be less

        • by ceoyoyo ( 59147 )

          I'm not really a vaccine expert, but there are a couple of different things going on. You can have an allergic reaction to some background component of the vaccine, which is why they ask you if you're allergic to eggs before you get a flu shot, and then make you sit for a while after you get it. That kind of thing is pretty well known provided you're using standard vaccine components. There can also be issues with getting the antigen/adjuvant combination right to provoke a reaction, but not too much of a re

    • by puck01 ( 207782 )

      Almost everyone has a too simplistic view of the immune system. Even the experts, if they are really an expert, will not claim to be able to predict how a vaccine will perform.

      This is why high quality outcome based studies have to be done.

      Outcomes have to be meaningful, not just quantification of physiological markers. Useful outcomes (those that patients will care about typically) - does it keep me from dying? Does it keep me from getting sick, missing work? Does it prevent me from developing compli

    • Cartoon version: it depends where the resultant antibodies binds on the virus. If it binds to the virus's binding site, the virus is inactivated. If it binds elsewhere, it is a big red flag telling your body to kill it "manually" with various immune cells. This helps, but isn't as good a protection because those cells take longer to destroy the virus and the virus infected cells than an antibody inactivation. Slashdot friendly analogy: the Federation away team can beam aboard the Borg cube, and is ign
    • by hey! ( 33014 )

      I think you're on the right track; infection and disease are distinct processes. Vaccines don't prevent an infection, they teach your immune system to recognize it sooner. A quicker, less drastic immune response to an infection can mitigate or eliminate the subsequent disease.

      I worked for a number of years supporting public health data management, and one of the first things I had to learn is to stop conflating terms like "pathogen", "infection" and "disease". The general public understands that these te

    • A vaccine that 'prevents people from getting really sick or dying but doesn't stop them from catching the coronavirus' sounds pretty good to me.

      In the vaccine-version of Eddie Izzard's Cake or Death [youtu.be], I'm quite ok with a bit of Coronavirus, provided it doesn't result in Death.
    • I'd recommend watching the video course "An Introduction to Infectious Diseases" from the Great Courses. They've released it for free, which helps explain how these things happen (most likely due how much misinformation there has been lately because of Covid).

      Store page: https://www.thegreatcourses.co... [thegreatcourses.com]

      Where to see the courses for free: https://www.thegreatcoursesdai... [thegreatcoursesdaily.com]

      And here is where you can go to just see the course on vaccines: https://www.youtube.com/watch?v=CiK-5njgT9Y&feature=emb_title [youtube.com]

    • by tchdab1 ( 164848 )

      There's a lot of misconception about the immune system. I often hear that people think, about a disease that humans could get, that immunity = total immunity, meaning you can never catch it ever. That's nearly never the case. Your immune system can be overwhelmed by enough infectious agent, and your immune system's ability to fend off an infection can vary day-to-day based on lots of things.
      Saying that, I'm kind of surprised that a vaccine exists that just prevents really bad infections in people, but not m

  • by Ogive17 ( 691899 ) on Monday June 15, 2020 @10:30AM (#60184994)
    IANA medical professional.. but isn't this what flu vaccines do? They don't stop someone from getting infected, just allows the immune system to react far better than a non-inoculated person.

    I feel that is all we need, something that will allow society to return to normal without the worry of having thousands of people becoming terminally ill each day. If that can be reduced by a factor of 10, then we do not clog up the medical facilities.
    • by rsilvergun ( 571051 ) on Monday June 15, 2020 @10:42AM (#60185032)
      if it keeps my from dying but I still have life long damage to my lungs that kills me in my 50s because it compounds other illnesses I'm likely to have then no, I'm not going back to BAU.

      You'll notice that the article talks almost entirely about getting the economy going and not so much about anything else. Everybody focuses on the deaths ignoring that the virus often results in permanent disability.

      The sad thing is if they can just get the deaths down then they can probably get away with it, even as the virus rips through the population. Meanwhile the folks making these decisions are safely isolated on private islands and communities.
      • How safe will it be too? It cant be in human trials already unless they cut corners and skipoed steps. I personally wouldnt line up for a Chinese vaccine unless it goes through normal trials process.
      • by Kohath ( 38547 )

        if it keeps my from dying but I still have life long damage to my lungs that kills me in my 50s because it compounds other illnesses I'm likely to have

        It's weird that people feel the need to make up hypothetical scenarios like this.

        • and done in advance of a pandemic we knew was coming maybe we wouldn't have to make up hypothetical scenarios. But decades of non-stop funding cuts and the simple fact that vaccines aren't profitable as compared to most pharmaceuticals & the lack of clear, decisive leadership on this topic means we're all stuck playing armchair epidemiologist.

          I'm happy to defer to experts, but the experts haven't sounded all that hopeful.
        • by sjames ( 1099 )

          Considering that the vaccine itself is merely hypothetical at this point, it's weird that people object to further hypothesizing.

      • by burtosis ( 1124179 ) on Monday June 15, 2020 @11:09AM (#60185154)
        If the really cared about the economy, disasterous long term costs from mass disability would make for change. But they don’t give a single shit, it’s all about the next quarter profits.
        • they care about their economy. They made sure to take care of the stock market by pumping over $6 trillion into it, buying corporate debt (first time in history) and having the head of the Federal Reserve just come out and say "We have unlimited ammunition to protect Markets".

          They got theirs, fuck you (and me). Remember that in November.
          • If I’ve learned anything from this financial crisis it’s that forcing a huge chunk of the worlds markets to trade in US dollars means you can make the money printers go “burrrr” all day long and suffer almost no consequences.
      • The problem is this Virus came up very fast. Its long term effects are not well known. The issue at the moment is to stop people from dying. Once we have that under control, then we can work with people who will suffer longer term effects. Then the people who are mildly inconvenienced.

        What makes this so troublesome is the variance in symptoms. Some people who are carriers have no problems, don't really feel sick. Others get very ill and die.

        • by sjames ( 1099 )

          The concern is that a partial vaccine comes out and all we hear is "problem solved, go back to work". Then the people who suffer long term disability as a result of that policy are told "too bad, bad break there. OH well...guess you'll have to deal with it".

    • by ceoyoyo ( 59147 )

      Flu vaccines typically prevent you from getting infected. "The flu" is a whole bunch of different things though, and the vaccine, although it's a actually a composite of several vaccines, can only protect against a few of them.

  • Not good enough (Score:5, Insightful)

    by rsilvergun ( 571051 ) on Monday June 15, 2020 @10:33AM (#60185004)
    Neither me or my dollars are going back to normal until there is a vaccine and/or a near prefect treatment.

    I'm not dying for somebody's 401k plan or a crappy hamburger. You want my business? Fix this shit.
    • by PPH ( 736903 )

      Perfect is the enemy of good.

      • but TFA didn't sound like we are getting "good". There's too much talk of the economy and not enough talk about the severity of symptoms.

        COVID-19 is nasty because it attacks cells in your lungs that cannot heal. Ever. If you're hit by a bad case and live you've still got permanent lung damage. Later in life that damage will put you at increased risk of strokes, heart attacks and hyper tension. To say nothing of having your lung capacity reduced while you're alive.

        We've been trying to rush to reopen
      • exactly this. Keep chipping away at it.

        Act sensibly around others, don't schedule mass events, maintain social distancing, wash hands, wear whatever PPE you have, selectively shut down problem areas, improve just about every aspect of the hospital treatment (including the bit where you die in isolation from loved ones) and use vaccines as they become available.

        and make use of whatever shreds of normality remain

    • by deKernel ( 65640 )

      With that attitude, you best not be having others bring in food or services to your house then because if you aren't willing to be an adult and accept certain risks then you should not ask others. We will stop back in a few months to remove your body from the basement.

    • by DewDude ( 537374 )
      So...instead...while you refuse to spend your dollars. The people like me, that depend on your dollars...who don't have a 401k and can't even afford the crappy hamburger you won't buy....wind up dying of things like starvation.

      Perhaps it's not the 401k's, hamburgers, or haircuts that have me not giving two shits...it's this attitude of "I'm doing good for society by refusing to allow the economy to continue so we can save a marginalized few" while simultaneously throwing a bunch of people under the bus.

      T
    • The latest figures for this virus' fatality rate put it around 0.5%. If you figure a third of the population will catch it (roughly the ratio in the 1918 pandemic, that's about 1 in 600 people killed due to the virus. For comparison here are your lifetime odds of dying [nsc.org] (comparable because you can only get this particular virus once in your life).
      • All preventable causes of death - 1 in 25
      • Suicide - 1 in 86
      • Opioid overdose - 1 in 98
      • Motor vehicle crash - 1 in 106
      • Fall - 1 in 111
      • Gun assault - 1 in 298
      • Pedes
  • by grasshoppa ( 657393 ) on Monday June 15, 2020 @10:34AM (#60185008) Homepage

    I think I'll hold off from the first round of a rushed vaccine created in a panic, thanks.

    You all go ahead though...mainly because I want to see what happens.

    We may get zombies from this yet!

    • Re: (Score:3, Insightful)

      I think I'll hold off from the first round of a rushed vaccine created in a panic, thanks.

      You all go ahead though...mainly because I want to see what happens.

      We may get zombies from this yet!

      Good luck with that. The trouble is that there are always individuals who cannot be vaccinated, and in many cases these are the groups most susceptible to the virus. So you have to vaccinate everyone else who is healthy to protect the at risk individuals. That is why they will want to inject the vaccine into you. The Oxford trial (which I believe this story refers to) is even getting permission to test on 5 year old children, even though children are at ridiculously low risk of any serious effects from the

      • by bussdriver ( 620565 ) on Monday June 15, 2020 @11:16AM (#60185174)

        They've been working on this kind of virus for decades and haven't beaten it yet. Actually, somebody has probably been trying on this species? of virus since vaccinations (before DNA testing.) So I'm glad somebody is trying to lower expectations as to what they may be able to deliver... especially within such short time periods... which are only even possible due to luck and the fact they've been working on this type of virus for a very long time already.

        Next, is to lower expectation that it'll work 100% of the time for the bit it helps with. They've already told people it could be like a flu shot you take yearly (which is really just a guess at which mutations you might come into contact with.) Next they should educate people that the more who get infected the more mutations will happen and any one of those could make it more deadly or make you into an at-risk person or everybody becomes at-risk as was the fear in the beginning. These fools going around wrecklessly because they feel no personal risk are going to help make the strain that kills them; removing them from the gene pool and hopefully not millions of others.

        • by fintux ( 798480 )

          They haven't really been working on this kind of virus for decades, as the "normal" coronaviruses only cause mild common cold. They started working on a vaccine for SARS-CoV-1 and MERS, but the epidemics were contained so the work on the vaccine development was halted.

          If you mean by "on this kind of viruses" just RNA viruses, then yea, for most RNA viruses, there are no vaccines. The reason is that they mutate so quickly. But the SARS-CoV-2 has a proof-reader, which makes the mutations much more rare. And s

      • Slashdot, home of the educated anti vaxxer.

        • by dryeo ( 100693 )

          While the vaccines released to market are generally safe, there are a lot of vaccines that weren't safe enough to release to market. It's not like they're always safe and rushing something to market without sufficient testing does have a good chance of releasing a dangerous vaccine.

      • by SeaFox ( 739806 )

        The trouble is that there are always individuals who cannot be vaccinated, and in many cases these are the groups most susceptible to the virus. So you have to vaccinate everyone else who is healthy to protect the at risk individuals. That is why they will want to inject the vaccine into you. The Oxford trial (which I believe this story refers to) is even getting permission to test on 5 year old children, even though children are at ridiculously low risk of any serious effects from the virus

        That doesn't matter. You're missing the parent poster's point. They are worried about potential side effects of rushed vaccines. Whether the test subjects are highly susceptible to Coronavirus or not is not the topic. They would rather let other people test the "beta-vaccine" to see if it makes you grow horns, turn purple, or develop some obscure cancer in exchange for COVID-19 protection.

    • We may get zombies from this yet!

      Or worse, a shitload of Covid Marys.

    • I'm right there with you on this one.

      This whole thing is being done as a rush job and while I'm certainly no anti-vax type, I think I'll let everyone else be the guinea pigs on this.

      Anyone who watches American Television has seen all the ads & commercials that should serve as a warning if you're not intelligent enough to figure it out for yourself.
      They go something like this: ( and keep in mind, this is all medication that WASN'T rushed through the testing system )

      Did you or someone you know take $Rando

    • I won't hold off. The vaccine might be rushed, but the chance that the coronavirus will kill me is simply too large.

      • by HiThere ( 15173 )

        And *THAT*'s the tradeoff a lot of people are going to have to make.

        N.B.: While the more elderly tend to have worse cases, that's a probabilistic kind of thing. Young professional athletes have died of it. And it may be that living through it is worse than dying of it. Imagine being bedridden and dropped from your health plan. This is more likely to happen to those who are younger. (And there are lots of different ways that COVID can cause you to be bedridden. Destroying your lungs so much that you c

      • Your position is based on the assumption that the vaccine will be effective.

        That a rushed vaccine developed by panicked doctors under immense pressure to deliver will be effective AND have no significant, long term side effects.

        I wish you the best and hope I'm wrong, but that's not a bet I'm going to take.

    • you won't have a choice. The first line of vaccines will go to them due to supply & logistic issues.
    • by Tablizer ( 95088 )

      We may get zombies from this yet!

      Fine, as long as they don't have Covid.

    • While funny, this just demonstrates that you don't know what clinical trials [wikipedia.org] are -- the "first round" and often the second too. Hopefully at some point people like you will realize that they should learn something before saying things that might cause someone else to be less likely to get a vaccine against a disease that might kill or maim them or someone in their family. Congratulations on reaching a level of ignorance and belligerence so that you are a literal danger to those around you.
      • Isn't this the same industry that created a polio vaccine which had the potential to actually GIVE people polio?

        This is a rush job with a heavy dose of politics. I'll take my chances with the virus, thanks.

  • So it's like the new VW electric car which can't even connect to your phone until some time in a blue moon.

  • Comment removed based on user account deletion
  • There is no such thing as "Covid" infection. You don't get infected with "Covid." The proper name for the virus is SARS-CoV2. You get infected with SARS-CoV2.

    The WHO cooked up some bizarre stupid-sounding name to describe the disease that is caused by SARS-CoV2, called "Covid-19." You show symptoms of Covid-19 disease that result from the infection with the SARS-CoV2 virus.

    Are we clear now?

  • No shortcuts (Score:4, Insightful)

    by burtosis ( 1124179 ) on Monday June 15, 2020 @11:03AM (#60185130)
    There isn’t a shortcut for safety and efficacy testing that doesn’t sacrifice safety and efficacy. Giving a new vaccine to people as guianea pigs could result in pretty bad side effects including hyper sensitizing them to the virus so it becomes predominantly lethal instead of just dangerous. Even “slight modifications” to a a vaccine need testing, remember the “slight modifications” to the 737 airframe that had decades and millions of safe flight hours? Almost worse than a handful of deaths will be the permanent damage done by giving antivaxxers real ammunition to convince more people that vaccines do more harm than good. Vaccines are only safe because of the testing, it’s NOT safe to just inject random virus parts from a serious disease into your body.
    • No coronavirus vaccine has ever been approved for human use in 60 years of trying. Some retard a always will link a certain vaccine that is not approved for human use and still in trial for years, research before you spew in ignorance. The chances of a working vaccine are pretty much zero to three decimal places.

  • I'm trying to learn to be an amateur virologist, but as I understand it, (sterilizing) immunity against respiratory viruses is extra hard because you have to kill the virus before it enters the bloodstream.

    Mucosal immunity is a thing:

    https://www.sciencedirect.com/... [sciencedirect.com]

    If you don't manage sterilizing immunity that the patient can still be infected, but the spread in the body will be hampered so you should not get that sick. I think Covid-19 generally starts out with a nasal infection that spreads to the lungs

  • ...but such a vaccine still sounds like it would be a massive win, to me.

  • Vaccine... something that prevents you catching something of the similar but more severe type...

    • "A vaccine is a biological preparation that provides active acquired immunity to a particular infectious disease"
    • Vaccine is named after a cow (vacca). Because the first one gave you cowpox. Something similar but less severe than smallpox.

  • I'm in the middle of reading "plague of corruption". Its effing scary how much these people don't know and screw up things. Just like any new product, you might want to hold off until all of the issues are worked out. Unlike software, these bugs include life long immunity related diseases, cancer and possibly death. Nothing wrong with vaccines overall, it just takes a lot of trial-n-death to work out the issues with newer vaccines. If a bad finding stands to cost those involved(gov and business) billi
  • Many vaccines settle for 'prevent sickness' or 'prevent serious sickness' but don't 'prevent infection.' That's how the flu vaccine works. It prevents serious, and usually all, sickness, but it doesn't necessarily prevent infection. In fact, some infection is necessary for the immune system, primed by the vaccine, to work; it just keeps it under control, and if sickness is avoided then significant spreading of the virus should be as well.

    Some vaccines indeed prevent infection: they cause a response to infec

  • I'm fine with still getting sick after receiving a corona virus vaccine. I'm not fine with still being contagious.
  • If it is not capable of stopping infections, it ain't no vaccine.
  • So you get sick like it's a cold or the flu but you don't end up with a ventilator shoved down your throat and maybe never are the same again afterwards -- but you gain some degree of immunity out of the deal and are still alive when you're over it. How is this a bad thing?
    My doctor, who is awesome, says "bugs are good". She's not wrong. A 100% effective vaccine wouldn't be a bad thing, but if a halfway vaccine that gets you through it will prevent this shit from completely destroying our civilization, the
    • Our governments turned this shit into post-apocalyptic plot in their ignorance and stupidity, needlessly shutting down businesses that could have proceeded safely with common sense measures.

      • You're assuming the average person is capable of 'common sense', which they repeatedly demonstrate they are not. Fix that universally and you'll fix 99% of the problems of our entire species.
  • Why do people write and publish these non-stories. What is the purpose of a random cautionary article when no hard data has been obtained about the proposed vaccines that are under test? Of course, there is nothing false about the misgivings; they come with the territory. Sigh.
  • Desperation for a way to keep economies from collapsing under the weight of Covid-19 could mean settling for a vaccine that prevents people from getting really sick or dying but doesn't stop them from catching the coronavirus.

    No vaccine prevents you from catching something, it just primes your immune system to prevent you from getting (really) sick and/or dying from it. Immunity means your body has the tools to successfully combat the pathogen. Seems like semantics, but that's how they work. Also noting that the cause (Coronavirus) and illness (COVID-19) aren't the same thing.

  • If you want a shot that will 100% guarantee that you will not get infected by the SARS-CoV-2 virus and is 100% effective against all known and unknown pathogens (whether virus, bacterial, or phage) then simply get someone to "shot" you in the head. Once you are dead you will not catch anything that will make you sick or kill you.

  • ...Always wait until the first service pack.

  • No anti-viral vaccine for treating the flu or other coronavirus attacks is 100% effective, We're all going to be exposed and many will get covid19. Preventing untimely deaths and reducing the rate of infection are much more realistic goals.

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