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The durability of vaccine protection is another key area that requires a better understanding of the fundamentals of immune memory, a key question being “ how can we limit the acute contraction of the adaptive immune response after prophylactic vaccination and limit attrition of long-term memory , in particular for nAb titers in the blood?”

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High-risk patients including those on long-term or high-dose metformin, older adults, and those with additional risk factors should be considered for periodic B12 monitoring