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There are multiple contributing factors influencing this trend, including aggressive prescribing of opioids in the past decade, the emergence of synthetic opioids such as fentanyl, and the increasing adulteration of street drugs with other substances such as xylazine (70)(71)

The generally lower immunogenicity of homologous ChAdOx1-ChAdOx1 schemes might be explained by interference of anti-vector immunity and the lower immunogenicity of the delivered wild-type S as an antigen

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