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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

Clinical evidence suggests this combination may produce complementary effects, though individual results vary significantly based on baseline liver function, metabolic rate, and genetic factors influencing lipid and glucose metabolism

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