Science Abm3425

RESEARCH ARTICLES
Cite as: P. B. Gilbert et al., Science

10.1126/science.abm3425 (2021).
Immune correlates analysis of the mRNA-1273 COVID-19

vaccine efficacy clinical trial
Peter B. Gilbert1,2,3*†, David C. Montefiori4†, Adrian B. McDermott5†, Youyi Fong1,2, David Benkeser6, Weiping
Deng7, Honghong Zhou7, Christopher R. Houchens8, Karen Martins8, Lakshmi Jayashankar8, Flora Castellino8,
Britta Flach5, Bob C. Lin5, Sarah O’Connell5, Charlene McDanal4, Amanda Eaton4, Marcella Sarzotti-Kelsoe4,
Yiwen Lu1, Chenchen Yu1, Bhavesh Borate1, Lars W. P. van der Laan1, Nima S. Hejazi1,9, Chuong Huynh8,
Jacqueline Miller7, Hana M. El Sahly10, Lindsey R. Baden11, Mira Baron12, Luis De La Cruz13, Cynthia Gay14,
Spyros Kalams15, Colleen F. Kelley16, Michele P. Andrasik1, James G. Kublin1, Lawrence Corey1,17, Kathleen M.
Neuzil18, Lindsay N. Carpp1, Rolando Pajon7, Dean Follmann19, Ruben O. Donis8‡, Richard A. Koup5‡, on behalf
of the Immune Assays Team§, Moderna, Inc. Team§, Coronavirus Vaccine Prevention Network
(CoVPN)/Coronavirus Efficacy (COVE) Team§, and United States Government (USG)/CoVPN Biostatistics
Team§
1Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 2Public Health Sciences Division, Fred Hutchinson Cancer Research
Center, Seattle, WA, USA. 3Department of Biostatistics, University of Washington, Seattle, WA, USA. 4Department of Surgery and Duke Human Vaccine Institute, Duke
University Medical Center, Durham, NC, USA. 5Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD,
USA. 6Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 7Moderna, Inc., Cambridge, MA, USA.
8Biomedical Advanced Research and Development Authority, Washington, DC, USA. 9Division of Biostatistics, School of Public Health, University of California Berkeley,
Berkeley, CA, USA. 10Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA. 11Brigham and Women’s Hospital, Boston, MA, USA.
12Palm Beach Research Center, West Palm Beach, FL, USA. 13Keystone Vitalink Research, Greenville, SC, USA. 14Department of Medicine, Division of Infectious Diseases,
UNC HIV Cure Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. 15Division of Infectious Diseases, Department of Medicine,
Vanderbilt University Medical Center, Nashville, TN, USA. 16Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine and the Grady
Health System, Atlanta, GA, USA. 17Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA. 18Center for Vaccine Development and
Global Health, University of Maryland School of Medicine, Baltimore, MD, USA. 19Biostatistics Research Branch National Institute of Allergy and Infectious Diseases, National
Downloaded from https://www.science.org on December 02, 2021

Institutes of Health, Bethesda, MD, USA.
*Corresponding author. Email: pgilbert@fredhutch.org
†These authors contributed equally to this work. ‡These authors contributed equally to this work. §The members of the Immune Assays Team; Moderna, Inc. Team;
CoVPN/COVE Team; and USG/CoVPN Biostatistics Team and their affiliations are listed in the supplementary materials.
In the coronavirus efficacy (COVE) phase 3 clinical trial, vaccine recipients were assessed for neutralizing
and binding antibodies as correlates of risk for COVID-19 disease and as correlates of protection. These
immune markers were measured at second vaccination and 4 weeks later, with values reported in
standardized WHO International Units. All markers were inversely associated with COVID-19 risk and
directly associated with vaccine efficacy. Vaccine recipients with post-vaccination 50% neutralization
titers 10, 100, and 1000 had estimated vaccine efficacy of 78% (95% confidence interval 54, 89%), 91%
(87, 94%), and 96% (94, 98%), respectively. These results help define immune marker correlates of
protection and may guide approval decisions for mRNA COVID-19 vaccines and other COVID-19 vaccines.
Based on their demonstrated efficacy to prevent coronavirus more transmissible viral variants, highlight the need for a
disease 2019 (COVID-19) in phase 3 clinical trials, to date large armamentarium of safe and effective COVID-19
seven COVID-19 vaccines have been granted an Emergency vaccines (4, 5).
Use Listing by the World Health Organization (WHO) (1), The Coronavirus Efficacy (COVE) phase 3 trial
three have been granted an Emergency Use Authorization (NCT04470427) of the mRNA-1273 COVID-19 vaccine, which
(EUA) by the US Food and Drug Administration (FDA) (2), is being conducted in the United States in adults aged 18 and
and one has been formally approved by the FDA (3). over, showed estimated vaccine efficacy against COVID-19 of
However, the manufacturing challenges posed by the global 94% in the primary analysis (6). These efficacy data sup-
demand for doses, the need for affordable and accessible ported the US Food and Drug Administration’s EUA of
options that are safe and effective in diverse populations, the mRNA-1273 for prevention of COVID-19 in adults (7). The
current lack of efficacy data in certain populations (e.g., mRNA-1273 vaccine has been shown to be highly effective in
pediatrics, pregnant women, autoimmune or the elderly and in essential and frontline workers, including
immunocompromised individuals), and the emergence of healthcare workers (8), and to have non-inferior binding and
First release: 23 November 2021 science.org (Page numbers not final at time of first release) 1
neutralizing antibody responses in adolescents vs. adults (9). future analyses of how the current level of antibody correlates
Correlates of protection, which are immunological mark- with instantaneous risk of COVID-19. Such analyses may in-
ers that can be used to reliably predict the level of vaccine form how vaccine efficacy wanes as antibody levels wane and
efficacy against a clinically relevant endpoint such as COVID- as new variants emerge, which in turn may inform decisions
19 (10–12), are highly sought in vaccine research. The identi- about the timing of a potential third dose of vaccination
fication and validation of a correlate of protection would ex- and/or the need to update vaccine composition (26).
pedite the clinical evaluation and regulatory approval process
for existing vaccines for new populations, for vaccine regimen Antibody marker levels are lower in vaccine recipient
modifications, and for new vaccines. Neutralizing antibodies cases versus non-cases
(nAbs) or binding antibodies (bAbs) have been established as At Day 57, almost 100% of vaccine recipients had positive/de-
a correlate of protection for vaccines against many viral dis- tectable antibody response by all four markers (Table 1; table
eases (11). The hypothesis that antibodies, whether elicited by S3 shows assay limits for each marker). This was also true at
infection or by spike protein-based vaccines, are a correlate Day 29 for spike IgG and RBD IgG, whereas ID50 and ID80
of protection against COVID-19 is supported by diverse lines titers were detectable in 82% and 64% of vaccine recipients,
of evidence (13–25). For the mRNA-1273 vaccine, multiple se- respectively. Each marker was moderately correlated be-
vere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tween the Day 29 and Day 57 time points (Spearman rank r
antibody markers including IgG bAbs to the spike protein, = 0.53 to 0.62; fig. S4). Together the spike IgG and RBD IgG
IgG bAbs to spike receptor binding domain (RBD), and 50% markers were tightly correlated (Spearman rank r = 0.94, 0.97
(ID50) inhibitory dilution nAb titer, each correlated with pro- at Day 29, 57; figs. S5 and S6), as were the ID50 and ID80
tection against SARS-CoV-2 replication after challenge in vac- markers (r = 0.97, 0.96 at Day 29, 57; figs. S5 and S6). Accord-
cinated rhesus macaques (24). Here we assessed these same ingly, some results focus on spike IgG and ID50. Each binding
SARS-CoV-2 antibody markers, and in addition, 80% inhibi- antibody marker was correlated with each neutralization
tory dilution (ID80) nAb titer, as correlates of risk of COVID- marker at each time point (r = 0.73 to 0.80).
19 and as correlates of mRNA-1273 vaccine protection against Figure 1 and fig. S7 show the Day 29 and Day 57 marker
COVID-19 in the COVE trial. distributions by case/non-case status in vaccine recipients

(fig. S8 in placebo recipients); figs. S9 and S10 show marker
Results values by participant age. For all eight markers the geometric
mean was lower in vaccine breakthrough cases than in vac-
Participant demographics
cine recipient non-cases, with geometric mean ratios
Table S1 describes demographics of the randomly sampled
(cases/non-cases) and their 95% CI upper bounds all lower
immunogenicity subcohort (N = 1010 vaccine, N = 137 pla-
than one (Table 1).
cebo). Thirty-four percent of baseline SARS-CoV-2 negative
Figures S11 and S12 show reverse cumulative distribution
per-protocol participants were age 65 or over, 40% were
function curves of the eight markers, in the context of the
deemed to be at risk for severe COVID-19 illness (“at risk”),
overall vaccine efficacy estimates (27). Figure S13 shows the
47% were assigned female sex at birth, 32% were Hispanic or
Day 29 and/or Day 57 marker values of vaccine breakthrough
Latino, 46% White and Non-Hispanic, and 54% communities
cases by timing of COVID-19 endpoint diagnosis.
of color, with 18% Black or African American. Table S2 and
figs. S1 and S2 describe the ‘Day 29 marker case-cohort set’
COVID-19 risk of vaccine recipients decreases as anti-
and the ‘Day 57 marker case-cohort set’, which augment the
body marker level increases
immunogenicity subcohort with all vaccine breakthrough
Figure 2 shows Cox model-based covariate-adjusted COVID-
COVID-19 endpoint cases and comprise the sets of partici-
19 cumulative incidence curves for subgroups of vaccine re-
pants included in the analyses of antibody markers measured
cipients defined by tertile of Day 57 IgG spike or ID50 (Fig. 2,
at Day 29 or Day 57 as correlates, respectively.
A and B). Corresponding results for IgG RBD and ID80 are
shown in fig. S14. (Details on covariate adjustment are given
COVID-19 endpoints
in supplementary text, section S1; tables S4 to S7; and figs.
Analyses of Day 29 and Day 57 antibody markers as correlates
S15 and S16.) Multiplicity-adjusted p-values indicated signifi-
included vaccine breakthrough COVID-19 endpoints starting
cant inverse correlations with risk, with estimated hazard ra-
7 days post Day 29 (n=46) and post Day 57 (n=36), respec-
tios for upper vs. lower tertiles ranging between 0.20 and 0.31
tively (fig. S3). Average follow-up of vaccine recipients was
(Fig. 2C). For quantitative Day 57 markers, the estimated haz-
116 days post Day 29 and 88 days post Day 57. All immune
ard ratio per 10-fold increase in marker value ranged between
correlates analyses were prespecified as detailed in the Sta-
0.35 and 0.66 (Fig. 3A), with multiplicity-adjusted p-values
tistical Analysis Plan (SAP).
indicating significant associations. Generally, similar results
Note that COVE follows participants for 2 years, enabling
were obtained across pre-specified vaccine recipient sub- = 22% vs. 4%). Vaccine efficacy estimates also increased with
groups (Fig. 3, B and C, and fig. S17). Day 29 ID50 neutralization titers: 79% (−62, 90%), 93% (90,
The four markers at Day 29 were also significant inverse 95%), 97% (95, 99%), and 99 (97, 100%) at the same IU50/ml
correlates of risk, with estimated hazard ratios for upper vs. values (fig. S22).
lower tertiles ranging between 0.19 and 0.32 (figs. S18 and Figures S23 to S28 show these results for the other six an-
S19), and estimated hazard ratios per 10-fold increase in tibody markers. Conclusions for binding antibodies were sim-
marker value ranging between 0.19 and 0.54 (fig. S17). P-val- ilar to those for neutralizing antibodies, with vaccine efficacy
ues were smaller for Day 29 than Day 57 markers indicating increasing with IgG levels, for example at Day 57 spike IgG of
strengthened evidence for correlates of risk. If a Day 29 im- 33, 300, and 4000 BAU/ml, vaccine efficacy was 85% (31,
mune marker in recipients of two mRNA-1273 doses becomes 92%), 90% (77, 94%), and 94% (91, 96%), respectively. An-
established as a correlate of protection, it could be a more other conclusion of these analyses is that subgroups with
practical surrogate marker than a Day 57 marker. Of note, all neutralization titer 10 IU50/ml (Fig. 4C) or with anti-spike
participants in our correlates analysis received both dose 1 IgG 33 BAU/ml (fig. S24C) have about 75-85% reduction in
and dose 2, and thus the Day 29 correlates results reflect the COVID-19 risk compared to being unvaccinated. Given the
full effect of the two vaccine doses used in clinical practice. overall similarity of the binding antibody and neutralizing
The estimated cumulative incidence of COVID-19 by end antibody correlate of protection results, the potential value of
of blinded follow-up (100 days post Day 57) for the entire vac- the validated MSD binding antibody assay for aiding vaccine
cine group was 0.0033 (95% CI 0.0022, 0.0045). Based on approval decisions as a practical non-mechanistic CoP (12)
nonparametric threshold regression this cumulative inci- should be considered. This is because the MSD binding anti-
dence decreased across vaccinated subgroups with Day 57 body assay is sensitive (table S3), robust, high-throughput,
ID50 titer above a given threshold, with zero COVID-19 end- deployable and easily standardized across viral strains, even
points at ID50 titer above 1000 IU50/ml (Fig. 4A). The shape though validated sensitive binding antibody detection may
of cumulative incidence across threshold subgroups tracked lack the specific immune function such as neutralization.
the reverse cumulative distribution function of ID50 titer,
suggesting a smooth incremental change in risk with titer A sensitivity analysis further increases confidence that

(Fig. 4A). Based on the Cox model, Fig. 4B showed estimated vaccine efficacy increases with antibody marker levels
cumulative incidence of COVID-19 by end of blinded follow- A sensitivity analysis was conducted (supplementary text,
up across vaccinated subgroups with Day 57 ID50 titer at spe- section S2) assuming the existence of an unmeasured con-
cific titers, in contrast to Fig. 4A that considered vaccinated founder associated with both the antibody marker and
subgroups with titers above specific values. For vaccine recip- COVID-19 outcome that would make the estimated vaccine
ients with undetectable Day 57 ID50 titer, estimated cumula- efficacy by marker curve flatter, with specified amount of un-
tive incidence was 0.030 (0.010, 0.093), and decreased to measured confounding detailed in the SAP (Section 12.1.2).
0.014 (0.0067, 0.028) at titer of 10, to 0.0056 (0.0039, 0.0080) The analysis indicated that vaccine efficacy estimates still in-
at titer of 100, and to 0.0023 (0.0013, 0.0036) at titer of 1000 creased with Day 57 ID50 titer [90% (69, 96%) at undetecta-
(Fig. 4B). The generalized additive model also supported in- ble Day 57 ID50 titer, 95% (93, 97%) at Day 57 ID50 titer of
verse correlates of risk for all markers (figs. S20 and S21). 500, and 96% (93, 97%) at Day 57 ID50 titer of 1000] (fig.
S29C). A similar pattern of results occurred for all other neu-
Vaccine efficacy increases as antibody marker level in- tralizing antibody markers (fig. S29D and fig. S30, C and D).
creases In contrast, estimated vaccine efficacy appeared to vary only
Figure 4C shows ‘titer-specific vaccine efficacy’ across Day 57 minimally with each binding antibody marker when unmeas-
ID50 titer levels, which for a given titer level is the estimated ured confounding was assumed (fig. S29, A and B, and fig.
covariate-adjusted percent reduction in cumulative incidence S30, A and B). The sensitivity analysis based on E-values (29)
of COVID-19 by the end of blinded follow-up due to vaccina- of the vaccine recipient antibody tertile subgroups (supple-
tion generating the given titer level compared to being un- mentary text, section S2) supported the inference that vac-
vaccinated (28). Vaccine efficacy estimates increased with cine efficacy was generally higher for the upper vs. lower
Day 57 ID50 titer: At undetectable Day 57 ID50, vaccine effi- tertile subgroup (table S8), suggesting that vaccine efficacy
cacy was 51% (−51, 83%), and at Day 57 ID50 value of 10, 100, would have still increased with each antibody marker level
and 1000 IU50/ml, respectively, vaccine efficacy was 78% (54, even if additional (hypothetical) unmeasured confounders
89%), 91% (87, 94%), and 96% (94, 98%) (Fig. 4C). The in- had been present.
crease in vaccine efficacy from 78% to 96% at ID50 values of Given the overlap of marker distributions in vaccine
10 to 1000 IU50/ml, respectively, represents a 5.5-fold in- breakthrough cases and vaccine recipient non-cases (Fig. 1
crease in vaccine-risk reduction (one minus vaccine efficacy and fig. S7), our results do not support that a Day 29 or Day
57 antibody marker could be highly effective in guiding indi- against virologically confirmed influenza B/Victoria illness
vidual decisions of whether to be re-vaccinated or boosted. (31). As hemagglutination inhibition titer has been used to
Yet, if a vaccinated person has negative IgG response or un- guide influenza vaccine strain selection and approval, this de-
detectable neutralization response, based on our results it fines a potential benchmark for influencing COVID-19 vac-
would be rational for this person to be concerned about rela- cine approval decisions (32).
tively weak protection and hence prompting seeking out A possible interpretation also consistent with our results
other means of protection. is that neutralization as a biological function mediated a
large proportion of the vaccine efficacy, but the specific Day
Neutralizing antibodies mediate about two-thirds of the 29 ID50 and ID80 immune markers studied, measured with
mRNA-1273 vaccine efficacy a particular immunoassay, had inadequate sensitivity to
For binding antibodies at both time points, and for neutral- quantify low-level neutralization below the positivity cutoff
izing antibodies at Day 57, a challenging issue is understand- that could be present and functionally important. Passive
ing vaccine efficacy for vaccine recipients with transfer of purified IgG from mRNA-1273-immunized rhesus
negative/undetectable antibody level, given that fewer than macaques protected golden Syrian hamsters from disease af-
2% of vaccine recipients had negative or undetectable anti- ter SARS-CoV-2 challenge, suggesting functionally active an-
bodies. Consequently, the 95% confidence intervals about tibodies can mediate protection (24). However, additional
vaccine efficacy for these subgroups were wide and assess- immune markers are likely needed to fully explain the ob-
ment of mediation through these markers was not technically served vaccine efficacy in COVE, for example markers meas-
possible because of insufficient overlap of marker values in uring additional immune functions beyond neutralization
placebo and vaccine recipients. However, Day 29 ID50 and (e.g., Fc effector functions or functional T cells), markers not
ID80 titers could be assessed as mediators of vaccine efficacy measured fully in serum (e.g., mucosal), and/or anamnestic
by the Benkeser et al. method (30), given that 18% and 36% responses not fully represented by a single time point meas-
of vaccine recipients had undetectable titer, respectively, urement.
providing enhanced precision [e.g., estimated vaccine effi- Further clarification of functional mediation of protection
cacy 79% (95% CI 62, 90%) at undetectable ID50]. The quan- may be provided by future correlates analyses that study an-

titative ID50 and ID80 variables were studied. An estimated tibody markers over time in relation to the timing of break-
68.5% (58.5, 78.4%) of vaccine efficacy was mediated by Day through infections of variants with variable neutralization
29 ID50 titer and 48.5% (34.5, 62.4%) by Day 29 ID80 titer sensitivity, with the antibodies measured against the variants
(table S9). of concern as well as against the ancestral strain. In particu-
This result of positive vaccine efficacy for the undetecta- lar, future research in COVE aims to measure binding and
ble subgroup implies lack of full mediation of vaccine efficacy neutralizing antibodies to the delta variant in the same im-
through the Day 29 antibody marker (28), with an estimated munogenicity subcohort as examined in the current study,
68% of the overall vaccine efficacy mediated through Day 29 and in all additional vaccine breakthrough cases that occur
ID50 titer. Therefore if neutralizing antibodies circulating on during follow-up. This should enable analyses to assess con-
Day 29 could be removed but the other consequences of vac- sistency of an ancestral-strain correlate of protection for an-
cination remained, overall vaccine efficacy would be expected cestral-strain COVID-19 compared to a delta-variant correlate
to be reduced by 68% (on the log scale), from 92% to 56%. of protection against delta-variant COVID-19.
However, because more than 98% of vaccine recipients
achieved detectable neutralizing antibodies by Day 57, these Similar results are seen in a cross-trial/platform com-
Day 29 mediation results themselves do not reflect a comparison
plete deactivation of the neutralizing antibody response to Our use of validated assays, with all results reported in WHO
the level at both Day 29 and Day 57 (undetectable) that would International Units or calibrated to WHO International
have been obtained without vaccination. Yet, under the rea- Standards, enables comparison with other studies and vac-
sonable assumption that the vaccine’s effect on the risk of cine platforms. Immune correlates results for the COV002
COVID-19 operating through the Day 57 ID50 marker is trial (33), which is testing the AZD1222 chimpanzee adenovi-
nonnegative, 68% is a lower bound for the proportion of vac- ral-vectored vaccine (also called ChAdOx1 nCoV-19), are avail-
cine efficacy that is mediated through ID50 at both Day 29 able (19). The COV002 correlates results for spike IgG and
and Day 57 (see conditions in supplementary text, section S2). RBD IgG can be quantitatively compared to the COVE results
In comparison, hemagglutination inhibition titer against the by virtue of the same MSD assay platform, conversion of IgG
B/Brisbane/60/2008-like (Victoria lineage) strain of influ- concentration to WHO International Units/ml, and the same
enza virus (included in the trivalent inactivated influenza antibody measurement time: 4 weeks post second dose. Esti-
vaccine) mediated an estimated 57% of vaccine efficacy mated AZD1222 vaccine efficacy was 70% and 90% at spike
IgG levels of 113 (95% CI < LOD = 0.31, 245) and 899 (369, model where COVID-19 risk decreased incrementally with in-
NC) BAU/ml, respectively, and at RBD IgG levels of 165 (< creasing increments in antibody level, rather than a thresh-
LOD = 1.59, 452) and 2360 (723, NC) BAU/ml, respectively old model where an antibody cut-point sharply discriminated
(NC = not calculated) (19). For COVE, there is low precision risk.
at 70% vaccine efficacy because few vaccine recipients had Together with evidence from other studies, the current re-
IgG < 100 BAU/ml, such that we only compare results at 90% sults support that neutralization titer is a potential surrogate
vaccine efficacy. Estimated mRNA-1273 vaccine efficacy was marker for mRNA-1273 vaccination against COVID-19 that
90% at Day 57 spike IgG level 298 (1, 1786) BAU/ml and at can be considered as a primary endpoint for basing certain
Day 57 RBD IgG level of 775 (29, 2819) BAU/ml. While the provisional approval decisions. For example, an immunogen-
point estimates of IgG levels at 90% efficacy were about 3 icity non-inferiority approach has been proposed for adding
times higher for COV002 than for COVE, the overlapping con- vaccine spike variants and boosters (34). An advantage of a
fidence intervals are consistent with similar results across the non-inferiority approach is avoiding the need to specify an
two trials. absolute antibody benchmark for approval, such as based on
Pseudovirus neutralization results can also be compared percentage of vaccine recipients with ID50 titer above a
between the trials using ID50 titers calibrated to the Interna- threshold and geometric mean titer above a threshold. Yet,
tional Standard, where estimated AZD1222 vaccine efficacy some applications may be aided by an absolute benchmark if
was 70% and 90% at ID50 titer of 8 (< LOD = 2.42, 26) and data allowing head-to-head non-inferiority evaluation are un-
140 (43, NC) IU50/ml, compared to COVE results at ID50 titer available. Such a benchmark based on ID50 values from vac-
of 4 (< LOD = 2.42, 22) and 83 (16, 188) IU50/ml. These results cinated individuals in a bridging study could be based on
support that neutralizing antibody titers have a similar quan- predicted vaccine efficacy being sufficiently high, where, for
titative relationship with vaccine efficacy for the two vaccine example, predicted vaccine efficacy could be calculated based
platforms, which is promising for potential applications of a on the COVE correlates of protection results (e.g., Fig. 4C) and
neutralization biomarker. The materials and methods pro- averaging over the distribution of ID50 values.
vide a sensitivity analysis comparing correlate of protection The evidence level for justifying various bridging applica-
results between COV002 and COVE. tions differs across applications, where currently confidence

With the caveats of different study endpoints and hosts, is greatest for bridging short-term vaccine efficacy (i.e., over
the COVE results are also consistent with results on spike IgG 4-6 months) against COVID-19 to new subgroups for the same
and neutralizing antibody titers as correlates of protection vaccine (e.g., to young children), or for bridging to a modified
against SARS-CoV-2 replication in mRNA-1273-vaccinated dose or schedule for the same vaccine (e.g., completing the
rhesus macaques. For instance, all macaques with spike IgG primary series with a third dose). Less evidence is available
> 336 IU/ml at 4 weeks post second dose were protected from to buttress use of a humoral immune marker to predict long-
>10,000 subgenomic RNA copies/ml in bronchoalveolar lav- term protection, to bridge to a new vaccine within the same
ages (24), and in COVE, Day 57 spike IgG of 336 IU/ml corre- vaccine platform, or to bridge to new spike variant inserts for
sponded to 90% vaccine efficacy against COVID-19 (fig. S24). the same vaccine. An open question challenging the latter ap-
plication is whether higher neutralizing antibody responses
Concluding remarks to emergent SARS-CoV-2 variants such as delta will be
needed to achieve similar levels of vaccine efficacy, although
Our findings that all evaluated binding and neutralizing an-
modeling data are beginning to support the ability to make
tibody markers strongly inversely correlated with COVID-19
cross-variant predictions [e.g., (16)]. Less evidence still is
risk, and directly correlated with vaccine efficacy, adds evi-
available for justifying bridging to a new candidate vaccine
dence toward establishing an immune marker surrogate end-
in a different vaccine platform. When immune correlates re-
point for mRNA COVID-19 vaccines. Moreover, the pre-
sults are available from several COVID-19 phase 3 vaccine ef-
specification of the analyses and the absence of post-hoc
ficacy trials covering a multiplicity of vaccine platforms, it
modifications bolsters the credibility of our conclusions.
will be possible to conduct validation analyses of how well
For per-protocol recipients of two doses of mRNA-1273
antibody markers can be used to predict vaccine efficacy
COVID-19 vaccine in the COVE clinical trial, all four antibody
across platforms (35). Uncertainties in bridging predictions
markers at Day 29 and at Day 57 were inverse correlates of
can also be addressed by animal models that characterize im-
risk of COVID-19 occurrence through about 4 months post
munological mechanisms of vaccine protection and by post-
second dose. Based on any of the antibody markers, esti-
authorization/approval vaccine effectiveness studies [e.g.,
mated COVID-19 risk was about 10 times lower for vaccine
(36)]. Importantly, immune-marker based provisional ap-
recipients with antibodies in the top 10% of values compared
proval mechanisms require post-approval studies that verify
to those with negative/undetectable values. The nonparamet-
the vaccine provides direct clinical benefit, such that the
ric threshold analyses (e.g., Fig. 4A) suggested a continuum
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science.org/doi/10.1126/science.abm3425
ACKNOWLEDGMENTS Materials and Methods
Supplementary Text
We thank the volunteers who participated in the COVE trial. We also thank J. Figs. S1 to S30
Mascola, M. Hepburn, R. A. Johnson, M. Marovich, and M. Robb. Funding: Public Tables S1 to S9
Health Service, National Institute of Allergy and Infectious Diseases, National Immune Assays Team Collaborator List
Institutes of Health grant UM1AI068635 (PBG). Office of Research Infrastructure Moderna, Inc. Team Collaborator List
Programs (ORIP), National Institutes of Health grant (S10OD028685) (Fred CoVPN/COVE Team Collaborator List
Hutchinson Cancer Research Center). Moderna, Inc. Federal funds from the USG/CoVPN Biostatistics Team Collaborator List
Office of the Assistant Secretary for Preparedness and Response, Biomedical References (39–53)
Advanced Research and Development Authority, Contract No. MDAR Reproducibility Checklist
75A50120C00034 (Moderna, Inc.). Infectious Disease Clinical Research Statistical Analysis Plan
Consortium (IDCRC) Leadership Group through the National Institute for Allergy
and Infectious Diseases, grant UM1 AI148684-03 (KMN). Author contributions: 16 September 2021; accepted 16 November 2021
Conceptualization: PBG, DCM, ABM, YF, DB, DF, ROD, RAK. Data curation: PBG, Published online 23 November 2021
YF, DB, WD, HZ, YL, CY, BB, LvdL, NH. Formal analysis: PBG, YF, DB, YL, CY, BB, 10.1126/science.abm3425
LvdL, NH. Funding acquisition: PBG, ROD, RAK. Investigation: DCM, ABM, KM,
LJ, FC, BF, BCL, SOC, CM, AE, MS-K. Methodology: PBG, YF, DB, LvdL, DF.
Project administration: CRH, SOC, MS-K, CH, ROD, RAK. Resources: DCM, ABM,
JM, HMES, LRB, BM, LDLC, CG, SK, CFK, MPA, JGK, LC, KMN, RP, ROD, RAK.
Software: PBG, YF, DB, YL, CY, BB, LvdL, NH. Supervision: PBG, DCM, ABM, YF,
DB, DF, ROD, RAK. Validation: PBG, YF, DB. Visualization: PBG, YF, DB, YL, BB,
LvdL, LNC. Writing – original draft: PBG, LNC. Writing – review and editing: All
co-authors. Competing interests: All authors have completed the ICMJE
uniform disclosure form at www.icmje.org/downloads/coi_disclosure.docx and
declare: PBG, DCM, YF, CM, AE, MS-K, YL, CY, BB, LvdL, HMES, LRB, MB, CFK,
MPA, LC, and LNC had support (in the form of grant payments to their
institution) from the National Institutes of Health for the submitted work; RAK
had support (in the form of funds to the VRC to cover assay performance) from
the National Institutes of Health for the submitted work; MB, LDLC, and CFK had
Fig. 1. (A) Anti-spike IgG concentration and (B) pseudovirus neutralization ID50 titer by COVID-19 outcome
status. Data points are from baseline negative per-protocol vaccine recipients in the Day 29 marker or Day 57
marker case-cohort set. The violin plots contain interior box plots with upper and lower horizontal edges the 25th
and 75th percentiles of antibody level and middle line the 50th percentile, and vertical bars the distance from the
25th (or 75th) percentile of antibody level and the minimum (or maximum) antibody level within the 25th (or 75th)
percentile of antibody level minus (or plus) 1.5 times the interquartile range. Each side shows a rotated
probability density (estimated by a kernel density estimator with a default Gaussian kernel) of the data. Positive
response rates were computed with inverse probability of sampling weighting. Pos.Cut, Positivity cut-off. LoD,
limit of detection. ULoQ, upper limit of quantitation; ULOQ = 10,919 for ID50 (above all data points). Positive
response for spike IgG was defined by IgG > 10.8424 BAU/ml. Positive response for ID50 was defined by value
> LoD (2.42). Post Day 57 cases are COVID-19 endpoints starting 7 days post Day 57 through the end of blinded
follow-up (last COVID-19 endpoint 126 days post dose 2); Intercurrent cases are COVID-19 endpoints starting 7
days post Day 29 through 6 days post Day 57.
Fig. 2. COVID-19 risk by antibody marker level. The plots and table show covariate-adjusted cumulative
incidence of COVID-19 by Low, Medium, High tertile of Day 57 IgG concentration or pseudovirus
neutralization titer in baseline SARS-CoV-2 negative per-protocol participants. (A) Anti-spike IgG
concentration; (B) ID50 titer; (C) IgG (spike, RBD) and (ID50, ID80). The overall p-value is from a
generalized Wald test of whether the hazard rate of COVID-19 differed across the Low, Medium, and High
subgroups. Baseline covariates adjusted for: baseline risk score, at risk status, community of color status.
Fig. 3. Hazard ratio of COVID-19 as antibody marker level increases. The table and plots show
covariate-adjusted hazard ratios of COVID-19 per 10-fold increase in each Day 57 antibody marker
in baseline negative per-protocol vaccine recipients overall and in subgroups. (A) Inferences for
IgG (spike, RBD) and (ID50, ID80); (B) Forest plots for spike IgG; (C) Forest plots for ID50.
Baseline covariates adjusted for: baseline risk score, at risk status, community of color status.
Fig. 4. Further analyses of Day 57 ID50 level as a correlate of risk and as a correlate of protection. (A)
Covariate-adjusted cumulative incidence of COVID-19 by 100 days post Day 57 by vaccinated baseline SARS-
CoV-2 negative per-protocol subgroups defined by Day 57 ID50 level above a threshold, with reverse cumulative
distribution function (CDF) of Day 57 ID50 level overlaid in green. The red dots are point estimates at 35
threshold values equally spaced over quantiles of the observed marker values, linearly interpolated by solid black
lines; the gray shaded area is pointwise 95% confidence intervals (CIs). The upper boundary of the green shaded
area is the estimate of the reverse cumulative distribution function (CDF) of Day 57 ID50 level in baseline SARS-
CoV-2 negative per-protocol vaccine recipients. The vertical red dashed line is the Day 57 ID50 threshold above
which no post Day 57 COVID endpoints occurred. (B) Covariate-adjusted cumulative incidence of COVID-19 by
100 days post Day 57 by Day 57 ID50 level. The dotted black lines indicate bootstrap point-wise 95% CIs. The
upper and lower horizontal gray lines are the overall cumulative incidence of COVID-19 from 7 to 100 days post
Day 57 in placebo and vaccine recipients, respectively. (C) Vaccine efficacy (solid black line) by Day 57 ID50
level, estimated using the method of Gilbert, Fong, and Carone (28). The dashed black lines indicate bootstrap
point-wise 95% CIs. The horizontal gray line is the overall vaccine efficacy from 7 to 100 days post Day 57, with
the dotted gray lines indicating the 95% CIs (this number 92.8% differs from the 94.1% reported in (6), which
was based on counting COVID-19 endpoints starting 14 days post Day 29). In (B) and (C), the green histograms
are an estimate of the density of Day 57 ID50 level in baseline negative per-protocol vaccine recipients. LOD, limit
of detection. Baseline covariates adjusted for: baseline risk score, at risk status, community of color status.
Table 1. Anti-spike and anti-RBD IgG response rates and Geometric Mean Concentrations (GMCs) and pseudovirus calibrated neutraliza-
tion titer ID50 and ID80 response rates and Geometric Mean Titers (GMTs) by COVID-19 outcome status. Analysis based on baseline nega-
tive per-protocol vaccine recipients in the Day 29 marker or Day 57 marker case-cohort sets. Median (interquartile range) days from dose one to
Day 29 was 28 (28 to 30) and from Day 29 to Day 57 was 28 (28 to 30).
COVID-19 Cases* Non-Cases in Immunogenicity Subcohort Comparison

Visit Marker N Response Rate GMC or N Response Rate GMC or GMT Response Ratio of GM
for (95% CI) GMT (95% (95% CI) (95% CI) Rate Differ- (Cases/Non
Marker CI) ence (95% -Cases)
CI) (95% CI)
Day 29 Anti spike IgG 46 97.8% 183 1005 98.6% 318 -1% 0.57
(BAU/ml) (85.4%, 99.7%) (126, 266) (97.4%, 99.2%) (292, 347) (-13, 1%) (0.39, 0.84)
Day 29 Anti RBD IgG 46 97.8% 207 1005 98.4% 327 -1% 0.63
(BAU/ml) (85.4%, 99.7%) (147, 293) (97.2%, 99.1%) (302, 354) (-13, 2%) (0.44, 0.90)

Day 29 Pseudovirus-nAb 46 65.2% 7.6 1005 81.7% 13.0 -17% 0.59
ID50 (IU50/ml) (50.1%, 77.8%) (5.4, 10.8) (78.8%, 84.3%) (11.9, 14.1) (-32, -4%) (0.41, 0.84)
Day 29 Pseudovirus-nAb 46 43.5% 18.0 1005 63.9% 29.0 -20% 0.62
ID80 (IU80/ml) (29.7%, 58.4%) (13.3, 24.2) (60.4%, 67.3%) (27.1, 31.0) (-35, -5%) (0.46, 0.84)
Day 57 Anti spike IgG 36 100.0% 1890 1005 99.4% 2652 1% 0.71
(BAU/ml) (100.0%, (1449, 2465) (98.2%, 99.8%) (2457, 2863) (0, 2%) (0.54, 0.94)
100.0%)
Day 57 Anti RBD IgG 36 100.0% 2744 1005 99.4% 3937 1% 0.70
(BAU/ml) (100.0%, (2056, (98.3%, 99.8%) (3668, 4227) (0%, 2%) (0.52, 0.94)
100.0%) 3664)
Day 57 Pseudovirus-nAb 36 100.0% 160 1005 98.7% 247 1% 0.65
ID50 (IU50/ml) (100.0%, (117, 220) (97.6%, 99.3%) (231, 264) (1, 2%) (0.47, 0.90)
100.0%)
Day 57 Pseudovirus-nAb 36 97.2% 332 1005 98.3% 478 -1% 0.69
ID80 (IU80/ml) (81.6%, 99.6%) (248, 444) (97.1%, 99.1%) (450, 508) (-17, 2%) (0.52, 0.93)
*Cases for Day 29 marker correlates analyses (Intercurrent cases + Post Day 57 cases) are baseline SARS-CoV-2 negative per-protocol vaccine
recipients with the symptomatic infection COVID-19 primary endpoint diagnosed starting 7 days after Day 29 through the end of the blinded
phase. Cases for Day 57 marker correlates analyses (Post Day 57 cases) are baseline SARS-CoV-2 negative per-protocol vaccine recipients with
the symptomatic infection COVID-19 primary endpoint diagnosed starting 7 days after Day 57 through the end of the blinded phase. The last
COVID-19 endpoint within the blinded phase occurred 100 days after Day 57.
N for Non-Cases in Immunogenicity Subcohort is the number of participants with Day 1, 29, 57 antibody marker data included in both the Day 29
and Day 57 marker correlates analyses. N for Cases for Day 29 marker analyses is the number of vaccine breakthrough cases with Day 1, 29 anti-
body marker data included, and N for Cases for Day 57 marker analyses is the number of vaccine breakthrough cases with Day 1, 29, 57 antibody
data included. See fig. S2.
CI, confidence interval; GM, geometric mean; GMC, geometric mean concentration; GMT, geometric mean titer.
Immune correlates analysis of the mRNA-1273 COVID-19 vaccine efficacy clinical trial
Peter B. GilbertDavid C. MontefioriAdrian B. McDermottYouyi FongDavid BenkeserWeiping DengHonghong ZhouChristopher R.
HouchensKaren MartinsLakshmi JayashankarFlora CastellinoBritta FlachBob C. LinSarah O’ConnellCharlene McDanalAmanda
EatonMarcella Sarzotti-KelsoeYiwen LuChenchen YuBhavesh BorateLars W. P. van der LaanNima S. HejaziChuong
HuynhJacqueline MillerHana M. El SahlyLindsey R. BadenMira BaronLuis De La CruzCynthia GaySpyros KalamsColleen
F. KelleyMichele P. AndrasikJames G. KublinLawrence CoreyKathleen M. NeuzilLindsay N. CarppRolando PajonDean
FollmannRuben O. DonisRichard A. Koup, and Oleg Borisov, and Brett Chromy, and Mark Delvecchio, and Tremel Faison,
and Corey Hoffman, and Tom Hu, and Pennie Hylton, and Aparna Kolhekar, and James Little, and Jeanne Novak, and Carol
Sabourin, and Evan Sturtevant, and Xiaomi Tong, and John Treanor, and Danielle Turley, and Leah Watson, and Gian King,
and Andrew Li, and Najaf Shah, and Smruthi Suryaprakash, and Jue Xiang Wang, and Patricia D’Souza, and Janie Russell,
and David Beaumont, and Kendall Bradley, and Jiayu Chen, and Xiaoju Daniell, and Thomas Denny, and Elizabeth Domin, and
Kelsey Engel, and Wenhong Feng, and Juanfei Gao, and Hongmei Gao, and Kelli Greene, and Sarah Hiles, and Leihua Liu,
and Kristy Long, and Kellen Lund, and Francesca Suman, and Haili Tang, and Jin Tong, and Olivia Widman, and Christopher
S. Badorrek, and Gregory E. Rutkowski, and Akua Abrah, and Obrimpong Amoa-Awua, and Manjula Basappa, and Robin
Carroll, and Erykah Coe, and Jevone Fentress, and Suprabhath Gajjala, and Nazaire Jean-Baptiste, and Christopher Moore,
and Mursal Naisan, and Muhammed Naqvi, and Sandeep Narpala, and Abhinaya Srikanth, and Clare Whittaker, and Weiwei
Wu, and Shu Hahn, and Di Lu, and James Zhou, and Jessica Andriesen, and Andrew Fiore-Gartland, and Ying Huang, and
Yunda Huang, and Ellis Hughes, and Ollivier Hyrien, and Holly E. Janes, and Michal Juraska, and April K. Randhawa, and
Brian Simpkins, and Brian D. Williamson, and Michael P. Fay, and Martha Nason, and Marco Carone, and Kendrick Li, and
Wenbo Zhang, and Alex Luedtke, and Iván Díaz, and Atoya Adams, and Eric Miller, and Bruce G. Rankin, and John Hill, and
Steven Shinn, and Marshall Nash, and Sinikka L. Green, and Colleen Jacobsen, and Jayasree Krishnankutty, and Sikhongi
Phungwayo, and Richard M. Glover II, and Stacy Slechta, and Troy Holdeman, and Robyn Hartvickson, and Amber Grant, and
Terry L. Poling, and Terry D. Klein, and Thomas C. Klein, and Tracy R. Klein, and William B. Smith, and Richard L. Gibson, and
Jennifer Winbigler, and Elizabeth Parker, and Priyantha N. Wijewardane, and Eric Bravo, and Jeffrey Thessing, and Michelle
Maxwell, and Amanda Horn, and Jennifer Whitaker, and Catherine Mary Healy, and Christine Akamine, and Laurence Chu,
and R. Michelle Chouteau, and Michael J. Cotugno, and George H. Bauer Jr., and Greg Hachigian, and Masaru Oshita, and
Michael Cancilla, and Deborah Murray, and Kristen Kiersey, and William Seger, and Mohammed Antwi, and Allison Green,
and Anthony Kim, and Michael Desjardins, and Jennifer A. Johnson, and Amy Sherman, and Stephen R. Walsh, and Judith
Borger, and Ryan Starr, and Scott Syndergaard, and Nafisa Saleem, and Joel Solis, and Martha Carmen Medina, and Westly

Keating, and Edgar Garcia, and Cynthia Bueno, and Nathan Segall, and Nathan Segall, and Jon Finley, and Mildred Stull,
and Douglas Scott Denham, and Thomas Weiss, and Ayoade Avworo, and Parke Hedges, and Cynthia Becher Strout, and
Rica Santiago, and Yvonne Davis, and Patty Howenstine, and Alison Bondell, and Kristin Marks, and Grant Ellsworth, and
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Whitney West, and Luke Friesen, and Paul Cramer, and Frank Steven Eder, and Ryan Little, and Victoria Engler, and John
Tarbox, and Heather Rattenbury-Shaw, and David Jon Ensz, and Tavane Harrison, and Allie Oplinger, and Brandon James
Essink, and Jay Meyer, and Frederick Raiser III, and Kimberly Mueller, and Roni Gray, and Keith William Vrbicky, and Charles
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P. Vachris, and Mark Hutchens, and Stephen Daniels, and Margaret Wells, and Mimi Van Der Leden, and Peta Gay Jackson
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and Anderson Victoria, and Nga Le, and Sara Berech, and Jose Castillo-Mancilla, and Kristine Erlandson, and Laurel Ware,
and Josie Marshall, and Stephen Bartlett, and Hillary Dunlevy, and Shane Glade Christensen, and Christopher Mickelson,
and Jessica Shaw, and Emily Raming, and Amy Nelson, and Gabrielle Lewis, and Jenessa Folsom, and Mikaela Jones, and
Dylan Owen, and Rachel Pugmire, and Jennifer Bradley, and Annjanette Kemp, and Krista Marti, and Allyson Christensen,
and Madison Ellis, and Holly Anderson, and Emily Bloomquist, and Ross Brunetti, and Thomas Conner Jr., and Gina Cox, and
Diana Grazulis, and Wesley Lewis, and James Longe, and Christopher Matich, and Bryan Nelson, and Sarah Scott, and John
Witbeck, and Stephen Wood, and Laurence Chu, and Jennifer Bacchi, and Maria Barrientes, and Lamar Box, and Christian
Casas, and R. Michelle Chouteau, and Katherine Davis, and Tambra Dora, and Cindy Duran, and Pamela Fidler, and Ruth
Fitch, and Brooke Harris, and Isaiah Knight, and Jennifer Leyva, and Michelle Listz, and Jennifer Montes, and Javier Perez,
and Jessica Ruff, and Dean Skiles, and Sean Turnbow, and Francesca Vigil, and Breana Wade, and Kelly Weber, and Jesse
L. Clark, and Sandy MacNicoll, and Somaieh Talebi, and Timothy Hall, and Steven Shoptaw, and Emery Chang, and Michael
Li, and David Goodman, and Paul Adamson, and Oladunni Adeyiga, and Inez Bentancourt, and Susan Reed, and Christopher
Blades, and Jasmin Tavares, and Demetria Villanueva, and Simone Riley, and Jonathan Veloz, and Schuyler Thomas, and
Will Hernandez, and Jennifer Baughman, and Mitchell Stern, and Michele Vertucci, and Michael J. Cotugno, and Kyra Lawson,
and Kim Harper, and Edwin Adamson, and George H. Bauer Jr., and Julie Bilich, and Brenda Lawson, and Brandon Illickal,
and Lois Eaglin, and Heather Salisbury, and Jeff Segner, and Clarence Buddy Creech II, and Shanda Phillips, and Naomi
Kown, and Katherine Sokolow, and Wendy Winn, and Katherine Wright, and Shannon Walker, and Stephanie Rolsma, and
Anna Gallion, and April Hanlotxomphou, and Deborah Myers, and Robert Adkisson, and Natalia Jimenez, and Cindy Trimmer,
and Roberta Winfrey, and Matthew Donio, and John Oleis, and Donna Torr, and Shelly McGehee, and Robert Samuels, and
Sandra Yoder, and Eric Brady, and Isaac Thomsen, and Madeleine Guy, and Emma Alexander, and Lana Howard, and Krisha
Alexander, and Shane Moore, and Tacora Wright, and Tara Evans, and Ursula Powell, and Jenna Caserta, and Valerie Mitchell,
and Meryk Moore, and Melissa Lehman, and Diane Anders, and Constance Dotye, and Crystal Rice, and Lamar Bowman, and
Sherri Hails, and Monique Bennett, and Nicki Soper, and Leigh Howard, and Joseph D. Davis, and Sandra Kelman, and Sandra
Braden, and Sabrina Bolland, and Mia Munoz, and Jose Barocio, and Brendan Levy, and Dhwani Shah, and Neil Pearson, and
Stephanie Catanzaro, and Nathan Alderson, and Susan DeCraene, and Maureen Godfrey, and Skyla Clark, and Amy Ford, and
Taylor Wilson, and Cindy Smith, and Austin Lambert, and Erin Zeiler, and Kaelyn Rowland, and Marlee Smith, and Suzanna
Studdard, and Zandra Hamilton, and Meredith Benfield, and Sara Poff, and David Godwin, and Elizabeth Everette, and Steven
Clemons, and Kayla Peay, and Stephanie Gilreath, and Douglas Scott Denham, and Thomas Weiss, and Parke Hedges, and
Ayoade Avworo, and Kay Scroggins, and Leisel Koerber, and Antonio Gutierrez, and Nathan Cortez, and Andrea Gomez, and
Darlington Akahara, and Michelle Smith, and Kristy Trevino, and Beatriz Herrera, and Shaiane Dickerson, and Kerry de Jesus,
and Matthew Korte, and Cynthia Ramos, and Reanna Martinez, and Erica Leal, and Shakera Flores, and Paul Esparza, and
Brian Hemming, and Melinda Axton, and D’Andre White, and Terri Perez, and Carolina Coronado, and Rebecca Many, and
Clayton Stone, and Kimberly Evans, and Anshumaan Maharaj, and Stephen Brick, and Steffanie Barrera, and Staci Poettgen,
and Dawn Killian, and Gerardo Pena, and Karol Perez, and Victoria Hernandez, and Kevin Martinez, and Amy Griffith, and
Nolan Payton, and Quincey Hogue, and Jamie Padilla, and Emily Mendez, and Lily Hays, and Maristelle Co, and Nicholas
Trinidad, and Ismael Rodriguez, and Amy Lewis, and Cindi Nellis, and Lele Simmons, and Marissa Johnson, and David Joseph
Diemert, and Linda Witkin, and Aimee Desrosiers, and DeEnna Wedding, and Bertran Walton, and LaKeisha Queen, and Ryan
Mouton, and Caroline Thoreson, and Manya Magnus, and Jennifer Wald, and Erika Faust, and Nicholas Heredia, and Robbie
Kattappuram, and Hira Qadir, and Chelsea Ware, and Hannah Yellin, and Kegan Dasher, and Daniel Mullen, and Jeanne
Jordan, and Taylor Ladson, and Madison Lintner, and Kaitlyn Macnair, and Bitana Saintilma, and Kelly Thomas, and Samantha
Walker, and Neha Rampally, and Madhu Balachandran, and Elissa Malkin, and David Parenti, and Hana Akselrod, and Marc
Siegel, and Gary Simon, and Afsoon Roberts, and Aileen Chang, and Susanne Doblecki-Lewis, and Maria Luisa Alcaide,
and Jose Gonzalez-Zamora, and Stephen Morris, and Yimy Puerto, and Annie Salvarrey, and Claudia Balgas, and Claudia
Santos, and Katherine King, and Brahian Steven Erazo, and Mayra Fernandez, and Leopoldo Cordova-Garcia, and Elisa Corzo-
Sanchez, and Edgar Fernandez, and Loreta Padron, and Stefani Ann Butts, and Kenia Moreno, and Juan Casuso, and Maria
de Pilar Valanzasca, and Thomas Tanner, and Marilyn Fernandez, and Mary Aloise, and Inza Patton, and Vivian Pastrana, and
Sendy Puerto, and Irma Barreto Ojeda, and Junlin Long, and Barbara Huang, and Gilianne Narcisse, and Vanessa Perez, and
Matthew W. Doust, and Denise Sample, and Sandra Erickson, and Nate Alderson, and Adrian Alejo, and Stephanie Catanzaro,
and Susan DeCraene, and Cassie Enricco, and Sandra Erickson, and Alex Guereque, and Shauna Harrell, and Shana Harshell,
and Stephanie Junker, and Stephanie Laufenberg, and Madison Mikulak, and Makayla Morra, and Nicole Olson, and Neil
Pearson, and Jasmin Redden, and Monique Romo, and Denise Sample, and Dhwani Shah, and Sahara Vega, and Emma Kar,
and Valentine Mbepson Ebuh, and Elwaleed Elnagar, and Georgette Ebuh, and Genevieve Iwuala, and Catina Adams, and
Marissa Cervenka, and Ezgar Del Real, and Shraddha Dubal, and Elwaleed Elnagar, and Jenifer Fiatte, and Kathy Harrell, and

Genevieve Iwuala, and Vicki Martinez, and Robert Miranda, and Brennan Opanasenko, and Destiny Robinson, and Liz Ruiz,
and Amy Sheets, and Shoniece Wallace, and Frank Steven Eder, and Ryan Little, and Victoria Engler, and John Tarbox, and
Heather Rattenbury-Shaw, and Deborah Hubish, and Jessie Taylor, and Debra Gabrielson, and Jessica Fellows, and Jennifer
Molstead, and Kathe Olmstead, and Ashley Conover, and Tammy Kohn, and Chelsea Briar, and Corrine Young, and Collen
McVannan, and Kelli Quick, and Shaylynne Hubanks, and Kimber Breeden, and Ann Marie Sampson, and Traci Hull, and
Tarin Gordon, and Susan Owen, and Kate Macarak, and Tonya Rackett, and Jacob Blattstein, and Partidge Jane Aton, and
Nicole Croft, and Carolyn Grausgruber, and Rebecca Miller, and Ryan Little, and Victoria Engler, and John Tarbox, and Heather
Rattenbury-Shaw, and Nathan Kimball, and Courtney Heisey, and Ginny McNew, and Abigail Wine, and Cindi VanKuren, and
Jared Frick, and Tammy Dennis, and Andrew Kimball, and Jennifer A. Whitaker, and C. Mary Healy, and Christine Akamine,
and Wendy A. Keitel, and Robert L. Atmar, and Annette Nagel, and Sandra Francisco, and Thea Marie Cordero, and Janet
Brown, and Jennifer Christensen, and Caroline Doughty-Skierski, and Connie Rangel, and Carrie Kibler, and Coni Cheesman,
and Lisreina Toro, and Chanei Henry, and Chianti Wade Bowers, and Pedro Piedra, and Kathy Bosworth, and Kayla Burrell,
and Jesus Banay, and Tykel Eddy, and Trent Davis, and Shetel Anassi, and Yvette Rugeley, and Olga Rybina-Willis, and
David Jon Ensz, and Pamela Allen, and Taylor Bergh, and Kimber Breeden, and Avery Dunn, and Brandon Essink, and Debra
Gabrielson, and Rylea Gulick, and Tavane Harrison, and Courtney Heisey, and Andrew Kimball, and Shelby Klaschen, and
Jessica Knight, and Makayla Langston, and Meagan Miller, and Allie Oplinger, and Heather Persinger, and Alison Pierce, and
Kathryn Stoddard, and Kayla Sturgeon, and Jamie Thompson, and Melissa Wiseman, and Brandon James Essink, and Jay
Meyer, and Frederick Raiser, and Kimberly Mueller, and Roni Gray, and Riley Brockman, and Tabitha Campbell, and Carrie
Essink, and Laura Falcone, and Roni Gray, and Linda Layton, and Jay Meyer, and Kimberly Mueller, and Tiffany Nemecek,
and Frederick “Fritz” Raiser III, and Jessica Satorie, and Chelsea Steinmetz, and Nicole Osborn, and Cassie Heisey, and Maria
Nguyen, and Gregory J. Feldman, and May-Yin Suen, and Brittany Cooksey, and Madison Fowler, and Sarah Chynoweth, and
Gary Clemons, and Laura Jolly, and Charlie Jordan, and Heather Allison, and Steve Clemons, and Amber Brittany Belcher,
and Allison Kelly, and Marsha Gossett, and Wendy Taylor, and Amy Witt, and Kendal Nelson, and Jeffrey Witt, and Jacqueline
Muenzner, and Elizabeth Everette, and Supinder Channa, and Allison Ayers, and Joseph Boscia, and Farhan Siddiqui, and
Carl J. Fichtenbaum, and Maggie Powers-Fletcher, and Michelle Saemann, and Sharon Kohrs, and Kimberly Mullins, and
Lindsay Davis, and Moises Huaman, and Angela Snyder, and Kristin Weghorn, and Brenda Miller, and Elizabeth Costea, and
Lisa Schira, and Romana Saeed, and Helen Shelton, and Kathleen Ballman, and Laura Browning-Cho, and Sherry Donaworth,
and Chris Goddard, and Jeanine Goodin, and Elizabeth Niederegger, and Lisa Hachey, and Tamara Maus, and Pam Fletcher,
and Makayla Bishop, and Victoria Straughn, and Shaina Horner, and Carrie Christofield, and Dana Burns, and Jason Mayes,
and Kelly Windholtz, and Lisa Proffitt, and Faizan Qureshi, and Michelle O’Neil, and Arustamyan Lisa, and Sarah Trentman,
and Eva Whitehead, and Jennifer Baer, and Linda Hinds, and Jaasiel Chapman, and D’Vaughn House, and Gary Frazier, and
Judy Houston, and Lisa Altenau, and Mary Burns, and Dorice Smith, and Justin Ragle, and Eric Mueller, and Cynthia Nypaver,
and Jaime Robertson, and Anissa Moussa, and Geronimo Feria Garzon, and Sierra Bennett, and Marlena Petrie, and Carlos
A. Fierro, and Mazen Zari, and Celia Gonzalez, and Natalia Leistner, and Mary Easley, and Mary Provost, and Krista Estrada,
and Ann Geier, and Amy Thompson, and Heather Barker, and Karol Moore, and Kelly Moen, and Monica Atwood, and Amber
Wolf, and Brandi Dickerson, and Manyvohn Rinehart, and Dina Hammine, and Angela Eichler, and Casey Johnson, and Nathan
Arthur, and Veronica G. Fragoso, and Lisa Holloway, and Cecilia McKeown-Bragas, and Teresa Becker, and Vicki Miller, and
Leena Mir, and Elton Oliveira, and Moez Talpur, and Enya Rentas-Sherman, and Gabriela Maria Becerra, and Dewayne Hicks,
and Robert Krbashyan, and Shakira Barr, and Ashraf Jafri, and Herman Ortiz, and Zohair Harianawala, and Chandra Tobin,
and Norma Gonzalez, and Saji Perinjelil, and Khorshid Amirkhosravi, and Tracy Kowalski, and Biman Goswami, and Waheeda
Sureshbabu, and Amy Anderson, and Berenice Ferrero, and Simeen Khan, and Chen-Ho Yang, and Nazanin Zarinkamar, and
Scott Ward, and Crystal Reese, and Miyosha Lewis, and Olga Konshina, and Lorrian Yates.Joel Cano, and Quiana Wilson,
and Kara Sikes, and Diana Chehab, and Joanna Quezan, and Maryam Rabbani, and Sadaf Batla, and Abbyssinia Moges, and
Diego Carrington, and Matthew Joseph, and Laura Grissanty, and Dean Jang, and Dustin McFadden, and Misbah Baloch, and
Elisa Moralez, and Abdeali Dalal, and Frances Saubon, and William Fernandez, and Jenny Toress, and Blessing Felix, and Zain
Rizvi, and Ian Frank, and Annet Davis, and Eileen Donaghy, and Nicole Sundo, and Juan Ramirez, and Laura Schankel, and
Dana Brown, and Katharine Bar, and Dana Brown, and Christopher Chianese, and Gillain Constantino, and Dovie Watson, and
Kathleen Degnan, and Helen Koenig, and William Short, and Petra Alexander, and Eileen Mergliano, and Jie Ho, and Michele
Wisniewski, and Debora Dunbar, and Liani Santini-Lopez, and Rosemarie Kappes, and Angela Cabassa, and Tammy Chen,
and Berry SotoVega, and Deborah Kim, and Devon Cliett, and Kate Kearns, and Jillian Baron, and Vivian Leung, and Florence
Momplaisir, and Sarah Wood, and Tameka Matthews, and David Metzger, and Richard Tustin, and Sharon E. Frey, and Irene
Graham, and Getahun Abate, and Daniel Hoft, and Heather Douds, and Cassandra Zehenny, and Joan Siegner, and Helay
Hassas, and Kim Cooper, and Shirley Dettlebach, and Sabrina DiPiazza, and Carol Duane, and Linda Eggemeyer-Sharpe, and
Lauren Foreman, and Jerry Hutter, and Ryan Kerr, and Kate Liefer, and Tracy Montauk, and Karla Mosby, and Janice Tennant,
and Nicole Purcell, and Kiana Wilder, and Kathleen Chirco, and Sharon Irby-Moore, and Kathleen Koehler, and Melissa Loyet,
and Thomas Pacatte, and Susan Stewart, and Azra Blazevic, and Tamara Blevins, and Chase Colbert, and Christopher
Eickhoff, and Lainey Mejia Jauregui, and Keith Meyer, and Krystal Meza, and Amanda Nethington, and Huan Ning, and Brittany
Williams, and Mei Xia, and Yinyi Yu, and Stanley Doublin, and Mary Pat Eastman, and Eric Eggemeyer, and Mikayla Frye,

and Michelle Harris, and Aleshia McCoy, and Donna Duncan, and Gwendolyn Tatum, and Nicole Purcell, and Kiana Wilder,
and Tammy Grant, and Claudia Castillo Paredes, and Rong Hou, and Jin Wang, and Qian Wang, and Sarah George, and
David Wohl, and Joseph Eron Jr., and Andrew Thorne, and Michelle Floris-Moore, and Christopher Hurt, and David Wohl, and
Chidinma Okafor, and Janette Goins, and Ulrike Adam, and Ekundayo Nylander-Thompson, and Anna Furlong, and XinHong
Ao, and Kathy Guerrero, and Melinda Hart, and Kathleen Loeven, and Rachael Mossey, and Esther Speight, and Rachel
White, and Chloe Twomey, and Kristen Gray, and Miriam Chicurel-Bayard, and Susanne Henderson, and Patti Vasquez,
and April Welch, and Camille O’Reilly, and Maureen Furlong, and Noshima Darden-Tabb, and Elizabeth DuBose, and Marie
Oriol, and Dynesha Perry, and Maria Stetson, and Maria Bullis, and Shelby Turner, and Ebony Harrington, and Michael Herce,
and Suzanne Blevins, and Alexander Bradley, and Susan Pedersen, and Becky Straub, and Sandra Barnhart, and Felicia
Barriga Munante, and Nazneen Howerton, and Tevnan Keller, and Mandy Tipton, and Abigail Riddick, and Kristi Kirkland, and
Maggie Harman, and Tania Hossain, and Centhla Washington, and Erin Hoffman, and Carolina Pastrana Medina, and William
Johnson, and Samantha Earnhardt, and Amy James Loftis, and Catherine Kronk, and Yaa Ofori-Marfoh, and Julie A. Nelson,
and Nicole Maponga, and Lina Rosengren-Hovee, and William Zhao, and Jennifer Thompson, and Sarah Law, and Holly Milner,
and Jonathan Oakes, and Rachel Cook, and Erin Cardot, and Oesa Vinesett, and Victoria Rucinski, and Joy Wannamaker,
and Tanailly Giralt Smith, and Eliza DuBose, and Chidinma Okafor, and Richard M. Glover II, and Stacy Slechta, and Troy
Holdeman, and Robyn Hartvickson, and Amber Grant, and Jennifer Bennett, and Lindsey Brewer, and Janelle Brown, and
Kelsey Burden, and Melissa Burton, and Brianna Burton, and Jordan Danby, and Sheri Duncan, and Amber Grant, and Robyn
Hartvickson, and Lisa Hemmelgarn, and Sherry Henning, and Jeri King, and Riley King, and Colton King, and April Kitterman,
and Shannen Lassiter, and Cayla Lawless, and Janna Martinez, and Ragene Moore, and Marissa Mueller, and Aaron Nguyen,
and Justin Phillips, and Jordan Reheis, and Rebecca Ring, and Katherine Saengerhausen, and Shannon Thomas, and Dylan
Thomas, and Cindy Thome, and Denae Villines, and Amber Wenzel, and Eilleen Wilbert, and Avi Woods, and Caressa Presley,
and Brianna Newport, and Olivia Allen, and Miranda Santiago, and Cheryl Sauerwein, and Jill Longstaff, and Sadie Allen, and
Candace Heckart, and Gregory Mark Gottschlich, and Melissa Gottschlich, and Steven Anderson, and Gregory Mark Gottschlich
II, and Mary Woeste, and Kate Harden, and Cindy Young, and Michael Pordy, and Audrius Ruksenas, and Lacy Baird, and Kim
Krogman, and Lori Stanton, and Melissa Fuson, and Mason Urban, and Christine Watson, and Richard Powell, and Mary Smith,
and Jacob Sekinger, and Diamond Russell, and Nicole Lim, and Mylene Asmar-Rios, and Yusef Museitif, and Craig Mitchell,
and Tarik Whitham, and Zachary Rutledge, and Troy Porter, and Andrea Newlands, and Jami Ramsey, and Mary Frances
Curry, and Nishay Holloman, and Crystal Barket, and Michelle Spear, and Shelley Mahan, and Taeleigha Greene, and Zachary
Eardley, and Gen Moussa, and Mary Ann Gottschlich, and Sinikka L. Green, and Julie Hamilton, and Alex Fuller, and Jeanette
Dickhaus, and Colleen Jacobson, and Triny Cooper, and Michelle Jackson, and Taylor Evans, and Tabitha Judd, and Kathryn
Alexander, and Megan Rosallo, and Sikhongi Phungwayo, and Robin Dotson, and Dana Finley, and Michael Vasquez, and
Cyndi Foster, and Gregg Lucksinger, and Sarah Smiley, and Jayasree Krishnankutty, and Ray Coon, and Grishma Dhimmer,
and Melanie Wilkerson, and Tatum Shawver, and Marcedes Coffman, and Devin Teal, and Laura Crenshaw, and Carl P. Griffin,
and William Schnitz, and Andrea Romero, and Kim Hamilton, and Raymond Cornelison, and Angela Genovese, and Shelly
Brunson, and April Green, and Lacey Dietz, and Kim Calloway, and Chris Hyatt, and Destiny Heinzig-Cartwright, and Chalimar
Rojo, and Sharee Wright, and Kathi Shaw, and Michael Pojezny, and Avery Keller, and Krystal Hightower, and Dalia Tovar, and
Shanda Gower, and Milton Haber, and Maria Candelario, and Martha Bunnell-Pollak, and Lauren Wade, and Jackie Ziegler, and
Deena Ramirez, and Perla Avalos, and Maria Drada, and Jasmine Ali, and Jessica McDowell, and Kehinde Busari, and Patricia
Church, and Ronald Meza, and Marco Vela, and Esteban Zurita, and Chris Connolly, and Ruben Del Bosque, and Alisha Lutat,
and Chelsea Fleming, and Brett Potthoff, and Anita Suri, and Cynthia Priester, and Brenda Hernandez, and Veronica Procasky,
and Eva Cerreta, and Matt Honold, and Melinda Rodriguez, and Maria Regalado, and Jordan Stauffer, and Greg Hachigian,
and Michael Cancilla, and Ricardo Castellanos, and Angela Cuellar, and Yaman Darmarathne, and Shaila Faulker, and Yana
Gordeyeva, and Michelle Hisey, and Ashley Jungsten, and Kristin Kiersey, and Pawandeep Nagra, and Nav Nagra-Kooner, and
Jazmin Nauta, and Masaru Oshita, and Kenneth Quick, and Julie Raygoza, and Amanny Sadek, and Melisa Tinder, and Jhoana
Torres, and Deborah Murray, and Kristen Kiersey, and Laurie J. Han-Conrad, and Brandon Baldwin, and Lucian Cappoli, and
Tenisha Garcia, and Ella Grach, and Brenda Grande, and Nicolle Mendez, and Natalie Moy, and Matthew Musikanth, and Karen
Mylerberg, and Brennan Opanasenko, and Mark Pulera, and Patti Sanchez-Emery, and Mireles Sarah, and Todd Simmons,
and Denis Tarakjian, and Wayne Lee Harper, and Toni Bland, and Lori Bridges, and Lucian Cappoli, and Lisa Cohen, and
Leah Corts, and Annie Craft, and James Earnhardt, and Lynn Eckert, and Aubrey Farray, and Laura Hoer, and Matthew Hong,
and Chris Hoyle, and Jenee Jiggetts, and Brian Joseph, and Bradley Killebrew, and Kendra Lisec, and Lucie Mangala, and
David Musante, and Adnan Nasir, and Amanda Olsen, and Brennan Opanasenko, and Marci Parks, and Marion Peoples, and
Katherine Schuch, and Judith Shand, and Sabine Ucik, and Douglas Wadeson, and Barbara Wheeler, and Ripley R. Hollister,
and Jeremy Brown, and Brandy Ball, and Jeremy Brown, and Valerie Dyster, and Dalia Jeronimo, and Shelby Pickle, and
Michael Pojezny, and Melody Ronk, and Kathi Shaw, and Bobbi Shofner, and Jami Wagner, and Meghan York, and Jill York,
and Lisa A. Jackson, and Marilyn Nguyen, and Maya Dunstan, and Barbara Carste, and Sarah Friend, and Diana McFeters, and
Lynn Gross, and Mohamed Ajenah, and Jana Ffitch, and Audra Mccoy, and David Skatula, and Susan Lasicka, and Kimberly
Brinker, and Karen Sherwin, and Melissa Scheer, and Paula Lins, and Roger Calvert, and Roxanne Erolin, and Stella Lee,
and Vi Tran, and Stephanie Pimienta, and Bruce Douglas, and Lee Barr, and Colin Fields, and Erika Kiniry, and Joe Choe,

and Janice Suyehira, and Joyce Benoit, and Michael Witte, and Rebecca Lau, and Greg Wilson, and Kyle Rybczyk, and Katie
Crumbo, and Carly Griffin, and Latoya Hannah, and Amy Kerrigan, and Valerie Mitchell, and Jenna Caserta, and Mary Downey,
and Nicole Swindle, and Shonda Sumner, and Amber Massey, and Trudy Sullivan, and Rita Smith, and Cindy Nochowicz, and
Eric Olson, and Christian Warren, and Josh Simmons, and Dana King, and Gwendolyn Rees, and Matt Donio, and Jesse Case,
and Keith Richardson, and Jarissa Greenard, and Valeria D. Cantos, and Sheetal Kandiah, and Carlos del Rio, and Christina
Bacher, and Hannah Huston, and Juliet Brown, and Divya Bhamidipati, and Nithin Gopalsamy, and Brittany Lynn Speigel, and
Elizabeth (Betsy) Hall, and Brandon Spratt, and Kiran Dhillon, and Caitlin Moran, and Michael Chung, and Felecia Wright, and
Marcia Peters, and Rondell Jaggers, and Vanessa Soliman, and Ron Gaston, and Christopher Foster, and Sarah Wiatrek, and
Bezuayehu Mandefro, and Pamela Weizel, and Pamela Lankford-Turner, and Anandi Sheth, and John Gharbin, and Catherine
Abrams, and Philip Powers, and Paulina Rebolledo, and Christin Root, and Tiraje Lester, and Sha Yi, and Damien Swearing,
and Fred Ede, and Isaac Perez, and Kelly Likos, and Meen Dhir, and Aastha KC, and Gabriela Georgial, and Tucker Colvin, and
Nabeel Yar Khan, and Valarie Hunter, and D’Jamel Young, and Felecia Atkinson, and Christina Kennelly, and Jacob Coleman,
and Brittany Bundeff, and Melissa C. Hennessey, and Kenneth Owen, and Caroline Wilds Wilds, and Jennifer Womack, and
Susan Martello, and Chiedza Hooker, and Robert Brownlee, and Melissa James, and Deborah Wesley-Farrington, and Lori
Whiteheart, and Hala Webster, and David Framm, and Cortney Fretz, and Gwyn Gibson, and Susan Donahue, and Kelly
Woodell, and Linda McCarty, and Jim Vesely, and Scott Chatterton, and Andrew Ottesen, and Enrico Belgrave, and Krishna
Shah, and James Chester Alexander, and Brittain Callahan, and Shishir Kumar Khetan, and Taja Adams, and Tanya Alexander,
and Tanya Alexaner, and Sydney Barmoy, and Jake Bart, and Kira Bell, and Ira Berger, and Jemario Blackwell, and Priscilla
Buahin, and Bounphone Chanthavong, and Juliana DeVito, and Azure Erskine, and Brandon Essink, and Laura Falcone, and
Debra Gabrielson, and Beau Garland, and Barb Geiger, and Tiana Oliver, and Courtney Heisey, and Sucharita Katikala, and
Andrew Kimball, and Heather Lang, and Jeanette Lee, and Asefa Mekonnen, and Devan Myers, and Kimberly Nieves, and
Allison O’Brien, and Oyebisi Olanrewaju, and Nicole Osborn, and Adunola Oshiyoye, and Rahul Patel, and Alan Pollack, and
April Poole, and Collin Smith, and Kathryn Stoddard, and Chao Wang, and Sean Whelan, and Jonathan Whelan, and Graciela
Zapata, and Nan Zhai, and Murray A. Kimmel, and Alexa Diec, and Ann Riley, and Bette Denmat, and Bram Swarr, and
Christina Raidl, and Dania Billman, and Denise Dixon, and Donald Dawson, and Elaine Crudo, and James Crowley, and Katrina
Carlson, and Kaylie Worzick, and Laura Worth, and Lisbeth Gordon, and Marion Oliver, and Robert Holt, and Simmy Pinto, and
Taylor Atkinson, and Traci Mitchell, and Lana Ghomrawi, and Norma Rokoff, and Judith L. Kirstein, and Jared Bradshaw, and
Krista Forster, and Jeanette Dickhaus, and Marcia Bernard, and Erica Sanchez, and Nikki Abels, and Cynthia Kunakom, and
Vanessa Vandergoot, and Jessica Fisher, and Carol Remigio, and Jourdan Manfred, and Frederick Lloyd, and Tiffany Williams,
and Clarisse Baudelaire, and Lovette Cherelle, and Nolan Mackey, and Alan Valenzuela, and Theodore Wyman, and Alyssa
Taber, and Karen Myers, and Craig Koch, and Michael J. Koren, and Shannon Trull, and Amanda Elwood, and Mary Strickland,
and Ivy Gulliermo, and Chistopher Ganzhorn, and Sonia Gerardo, and Taylor Johnson, and Victoria Kaposchansky, and Cassie
Lawler, and Laura Little, and Amanda Pratt, and Sheldon Warren, and Andrea West, and Emery Noles, and Nathanial Grant,
and Jillian Agnew, and Lori Alexander, and Brenda Anderson, and Deirdre Arrington, and Sara Benner, and Lisa Carl, and
Allison Crain, and Nafisa Ishaku, and Robert Nix, and Sharon Smith, and Amber Devries, and Sandy Salceiro, and Opara
Chukwudi, and Mikaela Karney-Trull, and Ramil Castillo, and David Graham, and Gail Lowe, and Alexander Hill, and Carolyn
Tran, and Jeffry Jacqmein, and Darlene Bartilucci, and Alpa Patel, and Janet Garvey, and Mitchell Rothstein, and Kenneth
Aung-Din, and Margaret Gannaway, and Arman Mughal, and Sandra Fuit, and Jolenne Wolfer, and Erin Schelhorn, and Jacob
Wolfer, and Madison Martinez, and Melissa Parks, and Patricia Neal, and Karen L. Kotloff, and Matthew Laurens, and Milagritos
Tapia, and Lisa Chrisley, and Cheryl Young, and Barbara Albert, and Robin Barnes, and Shernel Barrett, and Andrea Berry,
and Melissa Billington, and Shannon Bittner, and Colleen Boyce, and Faith Pa’Ahana Brown, and James Campbell, and Regina
Carpenter, and Jamonie Carter, and Ginny Cummings, and Brenda Dorsey, and Jorge Flores, and DeAnna Friedman-Klabanoff,
and Shirley George, and Nancy Greenberg, and Hassan Haji, and Elizabeth Hammershaimb, and Susan Holian, and Leslie
Howe, and Myounghee Lee, and Alyson Kwon, and Kirsten Lyke, and Alma Valle Maldonado, and Jennifer Marron, and Kaitlin
Mason, and Monica McArthur, and Rosa McBryde, and Sherry McCammon, and Sandra Molina, and Daniele Nitkowski, and
Justin Ortiz, and Rekha Rapaka, and Mardi Reymann, and Toni Robinson, and Wanda Somrajit, and Mark Travassos, and
Mark E. Kutner, and Amanda Colina, and Isett Caro, and Frances Beltran, and Jessie Downs, and Jonathan Fernandez, and
Mariete Renden, and Mirnaya Mujica-Alabaci, and Susel Figueredo, and Yanelis Dominguez, and Jaime Blandon, and Bryan
Ruiz, and Leidy Montoya, and Edgardo Rodriguez, and Jessie Downs, and Jason Rothscheld, and Janett Acle, and Yaime
Martinez, and Soraya Ricardo, and Maria Hernandez Moran, and Eloisa Guerra, and Heidie Perez, and Claudia Rodriguez, and
Victoria Moreno, and Vanessa Hechavarria, and Saray Carvajal, and Daniel Lopez, and Carlos Iviricu, and Neiner Enriquez,
and Paola Garcia, and Chris Hoyle, and Marianela Carvajal, and Janet Mendez, and Edisleidy Mesa, and Marco Ramirez, and
Dalila Del Valle, and Jennifer Ortega, and Yeni Hernandez, and Jhobana Vargas, and Carmen Amador, and Juan Delgado,
and Maury Santos, and Meredith Arguelles, and Leyanis Coello, and Vanessa Ansorena, and Jorge Caso, and Stacy Machado,
and Raydel Valdes, and Giann Lightbourn, and Dayami Dovales, and Alain Chang, and Mimi Van Der Leden, and Chrishea
Harvey, and Tricia Oyeyemi, and Aicha Moutanni, and Stephanie Melton, and Peta-Gay Jackson Booth, and Jennifer Yoon,
and Gloria Kim, and Atanas Filev, and Francis Uwandi, and Meyling Lopez, and Janice Spreitzer, and Courtney Gennes,
and Xiangfei Cheng, and Matthew Van Sickle, and Nick Bart, and Brianne Okunji, and Frank Maloba, and Michael L. Levin,

and Brennan Opanasenko, and Yajaira Ramos, and Shonda Lester, and Rebecca Boucher, and Shawn Harrell, and Shon
Boucher, and Patti Sanchez, and Nina Scharbach, and Alex Sanchez, and Shyane Raniello, and Wendy Guerra, and Krystal
Tyner, and Kimberly Temple, and Ruby Ortiz, and Daniel Terreault, and Amy Kill, and Jade Odynski, and Adolfo DeLeon,
and Debbie Carter, and Eduardo Rodriguez, and Julia Gass, and Sara Esparza, and Sierra Dansbee, and Tammy Harrison,
and Marcy Kulic, and Lucian Cappoli, and Mora Kim, and Matthew Fenner, and Heather Jimenez, and Shraddha Dubal, and
Julie Hussey, and Michael Lewis, and Nancy Mohler, and Mai Pham, and Ron Waldorf, and Elham Ghadishah, and Samantha
Feril, and Stella Lee, and Dzuyen Nguyen, and Ruoxiang Wang, and Justine Velandria, and Benjamin Dreskin, and Joseph
Yusin, and Lauren Vigil, and Sara Wong, and Suchi Tiwari, and Joseph Pisegna, and Sunita Dergalust, and Wayman Lee,
and Krissa Caroff, and Gregg H. Lucksinger, and Jaleh Ostovar, and Craig Koch, and Danuel Hamlin, and Kelly Chase, and
Jeanette Dickhaus, and Edward Kerwin, and Frederick Forde, and Allison Alvord, and Dawn Stewart, and Dan Hamlin, and
Kevin Parks, and Ryan Israelsen, and Kary Kelly, and Tiffany Smith, and Melissa Myers, and Ryan Rackley, and Audrey Kuehl,
and Savannah Peterson, and Hannah Hall, and Jay Weisbart, and Alison Dodenhoff, and Emily Kelly, and Mary Beth Manning,
and Carol Salango, and Alec Ireland, and Lisa Hoagland, and Jeanette Dickhaus, and Toby Briskin, and Joan Rothenberg,
and Michael Gaston, and Sharita Tedder-Edwards, and Denise Roadman, and Megan Sokolowski, and Tina Shickluna, and
Katherine Bielanski, and Samantha Hood, and Talia Chandler, and Brianna Arman, and Melinda DeLong, and Naqib Ahmad,
and Karly Tarase, and Jade Svoboda, and Lisle Merriman, and Melisa Sebera, and Emma Landskroner, and Amy Maroun, and
Brooke Glivar, and Jennifer Gaston, and Sarah Dzigiel, and Cassiandra Uminski, and Karol Sabol, and Devan Patel, and Nick
Zarbo, and Briana Jackson, and Brian Sharpe, and Nicole Baitt, and Kaitlyn Duffy, and Gabrielle Jacobs, and Ann Czuprun,
and Tracee Cash, and Diamond Ivey, and Kaitlyn Rubeli, and Kristen Marks, and Grant Ellsworth, and Tina Wang, and Timothy
Wilkin, and Mary Vogler, and Carrie Johnston, and Marshall Glesby, and Roy Gulick, and Ole Vielemeyer, and Rebecca Fry,
and Todd Stroberg, and Caitlin Rhoades, and Noah Goss, and Shaun Barcavage, and Valery Hughes, and Jonathan Berardi,
and Caroline Greene, and Sarah Galloway, and Caique Mello, and Ashley Machado, and Mia Crowley, and Monique Williams,
and Katherine Fee, and Elizabeth DeJesus, and Andrew Yu, and Minkyung Lee, and Susan Herder, and Mary Ann Zweibel,
and Patrice Weller, and Antonio Rivera-Lopez, and Edward Kenny, and Hetal May, and Natella Fridman, and Parul Shah, and
Ruby Lee, and Venus Fernandez, and Victoria Lesina, and Celine Arar, and Byron Bullough, and Kinge-Ann Marcelin, and Brian
Mangano, and Jessenia Fuentes, and Jiamin Li, and Genessi Rodriguez, and Catherine Jerry, and Nadi Islam, and Liqun Cai,
and Wayne Burns, and Akinbayo Caulcrick, and Andrika Thomas, and Barbara Batog, and Guoan He, and Sara Yoder, and
Tamara Crowder, and Gianna Resso, and Sophia Alvarez, and Tahera Begum, and Elizabeth Connolly, and Roxanne Rosario,
and Paul Kim, and Steven Wang, and Vasilika Koci, and Judith Martin, and Alejandro Hoberman, and Timothy Shope, and
Gysella Muniz, and Sonika Bhatnagar, and Kumaravel Rajakumar, and Anne-Marie Rick, and Peri Unligil, and Jennifer Nagg,
and Melissa Andrasko, and Mary Ann Sieber, and Jennifer Opal, and Lalicia Roman, and Spenser Kinsey, and Michelle Burke,
and Matthew Lee, and Dominic Kramer, and Linette Milkovich, and Emily Dougherty, and Emily Carney, and Shannon Mance,
and Nader Shaikh, and Diana Kearney, and Jamie Fries, and Lisa Vavro, and Shayla Goller, and John W. McGettigan Jr., and
Walter Patton, and Jennifer Schnider, and Riemeka Brakema, and Heeten Desai, and Mikell Brett Karsten, and Patricia Jalomo,
and Cindy Finch Benoy, and Karin Choquette, and Jonlyn McGettigan, and Yvonne De Los Reyes, and Melissa Cozzens, and
Amanda Hermosillo, and Cindy Montgomery, and Susan Tarwid, and Annette Elzy, and Tianna Young, and Saysamone Banks,
and Cristina Fernandez, and Damaris Atondo, and Zoe Sesma, and Norma Barrientos, and Maggie Tono, and Kisha Adams,
and JoAnn Wilkins, and Arianna Bermudez, and Carol Sayer, and Julie McDowell, and Angelina Navarro, and Mercedes
Sullivan, and Crystal Mata, and Sheldon Gingrich, and Aaliyah Sestiaga, and Gia Longo, and Mark Montgomery McKenzie,
and Tiffany Jewell, and Zackery Harmon, and Michael Elizabeth, and Christy Sweet, and Teresa Deese, and Catherine Schon,
and Misti Earwood, and Lou Cappoli, and Brennan Opanasenko, and Lisa Guider, and Michelle Forgey, and Justian Jarrett,
and Rachel Scott, and Elizabeth Michael, and Erica Osmundsen, and Andrew Wood, and Shelly Brooks, and Gisela Heintz,
and Lilian Nukuna, and Vicki E. Miller, and Sajjad Naqvi, and Soofia Masood, and Fredric Santiago, and Sonia Guerrero,
and Subhash Koneru, and Nirja Shah, and Andrea Torres, and Ramani Gali, and Talha Baig, and Heather Leary, and Afifah
Ayub, and Nayab Goher, and Patti Tate, and Reagen Reed, and Muhammad Irfan, and Amy Starr, and Alefiyah Motiwala, and
Julia Kenny, and Victoria Aguilar, and Jessica Arguijo, and Insiya Valika, and Victoria Aguilar, and Jagruti Patel, and Anna
Pena, and Faryal Mahmood, and Blanca Gomez, and Nancy Torres, and Kristyn Latil, and Tarori Mark, and Laura Djampou,
and Lindsey Kueng, and Marianne Tadros, and Mohammad Millwala, and Monica Murray, and Murtaza Marvi, and Shivani
Shah, and Vanessa Gonzalez, and Zohair Harianawala, and Zainab Rizvi, and Ambily Dileep, and Jaquelyn Gonzales, and
Ragen Powell, and Carolina Deandres, and Syed Fahad Ali Kazmi, and Sandra Natalia Perez, and Shannon Amacker, and
Shiela Varghese, and Gowdhami Mohan, and Rodolfo Barrera, and Emma Partin, and Kelly White, and Ashley Rochester,
and Charles Thompson, and Stefanie Tyson, and Ashten Sheriff, and Alyssa-Kay Peay, and Kayla Corn, and Barbara A.
Richardson, and Kristin Miller, and Steven Clemons, and Cameron King, and Emma Partin, and Gary Clemons, and Brianna
Starr, and Danyel Johnson, and Taylor Davis, and Niki Tyson, and Kathleen M. Mullane, and David L. Pitrak, and Cheryl Nuss,
and Karen Cornelius, and Randee Estes, and Amy Luckett, and Michelle Moore, and Judi Pi, and Stephen Schrantz, and Jill
Stetkevych, and Joseph Lee Newberg, and Mary Reyes, and Nicole Leahy, and Victoria Andriulis, and Herbert Whinna, and
Patricia James, and Lana Ghomrawi, and Carole Kempfer, and Miriam Arroyo, and Maria Castro, and Anna Maddox, and
Reuben Martinez, and Jacquilyn McCormick-Burks, and Laura Pearlman, and Rosalinda Vazquez, and Shaheera Suleiman,

and Neha Atal, and Rosalind Vazquez, and Richard M. Novak, and Regina Harden, and Maria Schwarber, and Michael Pacini,
and Rebeca Gansari, and Margie Villarreal, and Stephanie Martin, and Michelle Lee, and Richard Morrissy, and Taylor Ellis,
and Samuel Rene, and Tara Cobbs, and Claudia Preciado, and Scott Borgetti, and Maximo Brito, and Olamide Jarrett, and
Mahesh Patel, and Tracy Cable, and Charity Ball, and Maryann Holtcamp, and Rodrigo Burgos, and Sarah Michienzi, and
Emily Drwiega, and Mikayla Johnson, and Fischer Herald, and Benjamin Ladner, and Minseung Chu, and Carolyn Dickens, and
Alfredo Mena Lora, and Stockton Mayer, and Andrea Wendrow, and Habiba Sultana, and Nanu Nunwar, and David Chan, and
Marla Schwarber, and Khandaker Anwar, and Mahmood Ghassemi, and Md Ruhul Amin, and Doris Carroll, and Rosa Valencia,
and Michelle Agnoli, and Elena Llinas, and Samuel Rene, and Liam Morrissy, and Adrian Raygoza, and Addis Mekkonnen, and
Lisa Lindemann, and Daniel Meslar, and Karen Pacini, and Corey Ringhisen, and Amy Kennedy-Krage, and Claudia Miller, and
Lorna Sanchez McCann, and Gizelle Alvarez, and Nia Moragne-Oneal, and Nusirat Williams, and Ian Feather, and Nikki Griffith,
and Wardrick Nealon, and Renyce Powell, and Nila Safaeian, and Monica Gingell, and Diana Bahena, and Gerald Beck, and
Brad Farrington, and Rod Reyes, and Monica Wilson, and Juline Wondrasek, and Kimberly Shapiro, and Shannon Whitted,
and Victoria Roehl, and Braulio Carrasco, and Michael Chen, and Olivia Murray, and Yasiel Lacalle, and Tessa Eckley, and
Anna Schluckebier, and Kevin Cao, and Elise DeBruyn, and Paul Joseph Nugent, and Leonard Singer, and Jennifer Jones,
and April Smith, and Georgettea Geuss, and Lana Ghomrawi, and Christine Bennett, and Norma Blevins, and Linda Brotherton,
and Michele Byrd, and Krista Doss, and Victoria Holden, and Christine Hull, and Jean Montgomery, and Nancy Cipollone,
and Savanah Torline, and Brandon Brown, and Meagan Thomas, and Katie Ziska, and Dana Sias, and Hannah Wagner, and
Jeffrey Scott Overcash, and Hanh Chu, and Kia Lee, and Karla Zepeda, and John Rodriguez, and Adam Prince, and Yashveer
Dubbula, and Elizabeth Tomatsu, and Michael Voskanian, and Crystle Rajania, and Stephanie Ramirez, and Claudia Camacho,
and Lauren Arnett, and Kecia Darbeau, and Ashley Smith, and Kimberly Quillin, and Cesar Ramirez, and Daniel Robitaille,
and Erica Sanchez, and Allie Davis, and Michael Waters, and Pat Kappen, and Valerie Horne, and Thao Vuong, and Andrew
Dennis, and Nikki Abels, and Dominique Panis, and Richard McQuaid, and Whitley Harbison, and Erika Trujillo, and Andrea
Garcia, and Jose Jacob Esparza, and Carlos Vera, and Raquel Taitingfong, and Cathy Meza, and He Pu, and Jackielynn Smith,
and Shandel Odom, and Zahira Nieves, and Ashliegh Lindsay, and Ariana Nasatka, and Jose Cazarez, and Nora Martinez, and
Angela Hunt, and Antonio Delgado, and Linda Vega, and Angela Anorve, and Erica Martinelli, and Melania Riordan, and Sylvia
Lindholm, and Gina Ciezkowski, and Grecia Perez, and Jacob Pineda, and Nathan Tyler, and Ranya Salem, and Amara Yilmaz,
and Jessica Gonzales, and Zabrina Ruiz, and Laura Castillo, and Yajaira Contreras, and Angelica Guzman, and Makenna Orel,
and Jeffery Alvarez, and Gordon Bovee, and Roxana Ramirez, and Joan Esquivel, and James Todd Peterson, and Christopher
Mickelson, and Madeline Maldonado, and Alison Charlton, and Ashley Bragg, and Sean Hansen, and Emily Wilcox, and Colby
Bostock, and Megan Henry, and Pam Iwasaki, and Bradley Young, and Katelyn Walker, and Joy Nguyen, and Lindsey Bevan,
and Megan Grimmett, and Madeline Grote, and Heather Littell, and Natalie Bee, and Alexander Clark, and Shana Eborn, and
Susan Edwards, and Dan Henry, and Heather Jackson, and Gerald Kelty, and Issac Pena-Renteria, and Jacqueline Rohrer,
and Jack Taylor, and Brooke Barrick, and Ty Henry, and Anna Dansie, and Kenadie Hamblin, and Paul Pickrell, and Susan
Bonner, and Blaire Graham, and Staci Taggart, and Hussain Malbari, and Tiffany Lemuz, and Ethan Shotton, and Andrew
Bell, and Megan Malek, and David Pampe, and Carol Ann Linebarger, and Michelle Peterson, and Brandi Chalman, and John
Luna, and Elizabeth Santellanes, and Christina Martinez, and Lisa Johnson, and Lisa Savage, and Melissa Winn, and Wendi
McKenzie, and Eileen Euperio, and Stefanie Mott, and Paul Menefee, and Katie Caballero, and Darrell O’Brien, and Morgan
Schulle, and Kate Jurek, and Olivia Hapanowicz, and Terry L. Poling, and Meenakshi (Kavya) Natesan, and Patricia Contreras,
and Denise Hole, and Avi Woods, and Jill Hiebert, and Melissa Burton, and Olivia Eagleson, and Laura Holz, and Terri Ford,
and Cindy Thome, and Terry D. Klein, and Gregory Greer, and Diandra Henriques, and Tracy R. Klein, and Thomas C. Klein,
and Christa Shue, and Gina Young, and Brenna Sprout, and Bruce G. Rankin, and Jennifer Dittman, and Lora Parahovnik,
and Crystal Paccione, and Melissa Hodges, and Katina Marchione, and Matt Maxwell, and Any Dominy, and Diana Toney, and
Andrea Marrafino, and Laura Isbell, and Leandro Fernandez, and Claxton Copeland, and Michelle Tutt, and Adam VanDeusen,
and Kevin Feldman, and Clark Mason, and Tifany Huertas, and Over Seijas, and Jennifer Cline, and Christian Beierschmitt,
and Ryan Hobbick, and Jessica Gilliam, and Jeanette de Leon, and Iman Mencia, and Daniel Layish, and Vienna Bauer, and
Shatonia Fields, and Albert Garcia, and Carrie Rycort, and Tasha Brocato, and Marshall Nash, and Samantha Watts, and Amy
Houck-Dominy, and Angela Hammerle, and Teresa Logsdon, and Erika Wierzbicki, and Taylor Martin, and Ranie Hutchins,
and Fadhel Alyunis, and Gail Lavine, and Jeffery Hood, and Robert Duran, and Michelle Jones, and Ginny McClanahan, and
Heather Jackson, and Leandra Fernandez, and Douglas Winter, and Antonio Rivera, and Amber Vasquez, and Thais Truffa,
and Daniel Campbell, and Grace Newcomb, and Elizabeth Orlando, and Steven Shinn, and John Hill, and Christina Isbell,
and Dhaneshwar Oomrow, and Alicia Cevera, and Michele Diane Reynolds, and Jennifer Bashour, and Robert Schmidt, and
Cynthia Mayeux, and Uvoka Huffman, and Lisa Nicholson, and Jacklyn Newton, and Lynn Yauch, and Cathy Monroe, and
Kathleen Carty, and Angelica Banks, and Taylor Werner, and Pamela Echols, and Pauline Jackson, and Chana Hines, and
Lorine Cook, and Cristina Puig, and Patrick Brooks, and Jennifer Ruiz, and Deanna Bowman, and Ladina Garcia, and Rambod
Rouhbakhsh, and John Johnston, and Richard Calderone, and Tasha Stevenson, and Tameka Fortune, and Brandi Pace, and
Adreanna Pou, and Jerrica Sullivan, and Yolanda Lewis, and April Rouse, and Tiffany Jefferson, and Elizabeth Danford, and
Jeff Repper, and Mason Boutwell, and Alexycia Washington, and Krista Hirth, and Meagan Grabel, and Nadine Rouphael, and
Renata Dennis, and Tigisty Girmay, and Michelle Wiles, and Sharon Curate-Ingram, and Lauren Hewitt, and Alexis Ahonen, and

Mari Hart, and Sarah Bechnak, and Erin Carter, and Lauren Nolan, and Daniel Sans Graciaa, and Geoffrey Kamau, and Easton
Beshears, and Sy Tran, and Mary Atha, and Mary Bower, and Ghina Alaaedine, and Brandy Johnson, and Jacob Usher, and
Eileen Osinski, and Erin Scherer, and C. Tae Stallworth, and Stephanie Ramer, and Rose Pope, and Esther Park, and Francine
Dyer, and Laura Clegg, and Rebecca Gonzalez, and Stacey Wheeler, and Susan Rogers, and Vy Ngo, and Vanessa Soliman,
and Kristen Unterberger, and Bernadine Panganiban, and Christopher Huerta, and Juton Winston, and Ali Alvarez, and Jianguo
Xu, and Paulina Rebolledo, and Nicholas Scanlon, and Jessica Traenkner, and Matthew Collins, and Hollie Macenczak, and
Cassie Grimsely-Ackerley, and Tiffany Lee, and Amy Anderson, and Michele Paine McCullough, and Hannah Huston, and
Daniella Carter, and Lisa Harewood, and Srilatha Edupuganti, and Varun Phadke, and Mindee Adamson, and Jeanne Allen, and
Debbie Bartenfeld, and Lily Berz, and Amy Cromwell, and Sergio Cruz, and Fred Ede, and Monica Godfrey, and Evan Gutter,
and Angelle Ijeoma, and Sara Jo Johnson, and Vinit Karmali, and Dean Kleinhenz, and Jennifer Kleinhenz, and Alexandra
Koumanelis, and Maranda Leary, and Tiraje Lester, and Juliet Alise Morales, and Shashi Nagar, and Julia Paine, and Dilshad
Rafi Ahmed, and Brittany Robinson, and Amanda Rosner, and Renee Silver, and Trevor William Simon, and Talib Sirajud-Deen,
and Damien Swearing, and Maliya Tolbert, and Pamela Turner, and Chia Uzuegbunam, and Claire Wan, and Dongli Wang,
and Erika Wimberly, and Jean Winter, and Joy Winters, and Yong Xu, and Sha Yi, and Richard Rupp, and Amber Stanford,
and Megan Berman, and Laura Porterfield, and Gerianne Casey, and Hala Ghoson, and Doreen Jones, and Michael Willig, and
Cori Burkett, and Robert Cox, and Amy McMahan, and Diane Barrett, and Kristin Pollock, and Jamshid Saleh, and Matthew
Miles, and Rafael Lupercio, and Vicky Martin, and Marla Clark, and Matthew Pohlmeyer, and Ruba Zanaid, and Veronica
Blevins, and Tara Ulberg, and Carlyee Chambers, and Marisol Corrales, and Emily Crews, and Mohamed Yassin, and Sarah
Sandberg, and Frank Chen, and Mandy Swanson, and John W. Sanders, and Stacy Harpe-Hall, and Jesse Hopkins, and Ann
Schweppe, and Jaymous Fayssoux, and Kathryn Bender, and James Peacock, and Katharine Pearsall, and Brandy Snyder,
and Deidre Knox, and Megan Thorpe, and Melissa Ellingson, and Brittany Bundeff, and Lisa Ashworth, and Meredith Hiatt,
and Ritu Rathee, and Stacy Woodliff, and Brian Strittmatter, and Amanda Wright, and Daisy DeWeese-Gatt, and Caryn Morse,
and John Williamson, and Samantha Wheeler, and Lori Whiteheart, and Susan Donahue, and James Lovette, and Kaitlyn Van
Leuvan, and Kelly Ledbetter, and Scott Chatterton, and Julio Nasim, and Amie Sidberry, and Ashley Davis, and Carter Noecker,
and Chie Hooker, and Johanna Breenan, and Sam Cable, and Anna Bowman, and Stephanie Boothe, and Shea Overcash,
and Howard I. Schwartz, and Carlos Valladares, and Jocelyn Morrera, and Yulexis Amestoy, and Tori Wallenburg, and Thelma
Beltran, and Terry Piedra, and Monica Garces, and Alexandra Galvis, and Wanda Delgado, and Catherine Casas, and Lesly
Miguel Sosa, and Vivian Rosales, and Jose Fernando Henriquez, and Mikael Yaniz, and Beatriz Rivera, and Peter Ventre, and
Gabriella Huyke, and Maria Companioni, and Jessie De Vega, and Brianna Gamez, and Stephanie Diaz, and James Jean-
Mary, and Americo Padilla, and Nikita Notise, and Yorlina Luquetta, and Monifa Wilson-Morris, and Kenia Gutierrez, and Roilan
Garcia, and Karla Pentzke, and Leyda Valentin, and Lazara Novas, and Marilein Camacho, and Jazmin Henfield, and Laymis
Alvarez, and Myriam Rosado, and Maxine Bryant, and Maria Pinero, and Laura Raucci, and Francisco Ramirez, and Angelic
Gamez, and Mailin Perez, and Yasmin Baddour, and Hary Leon Joseph, and Yaquelin De la Cruz, and Dunia Torres, and
Rosaidaliz Carreira, and Chanella Garcia, and Surisaday Mederos, and Jose Muniz, and Karenda Plotka, and Sara Gomez, and
Maria Soto, and Cathy Cruz, and Nelia Sanchez-Crespo, and Jennifer Schwartz, and Barbara Corral, and Matthew Muniz, and
Dayana Deltejo, and Ana Castro, and Reem Hassan, and Nathan Segall, and Michelle Sowell, and Nancy Levine, and Erynn
McKinley, and Hannah Smith, and Karen Hickson, and Elizabet West, and Patrizia Greene, and Jon Finley, and Mildred Stull,
and Susan Jones, and Jennifer LeBrun, and Pamela Talbott, and Kwannda Whatley, and Jeffrey Jones, and Michelle Binns,
and Donna Toepfer, and Cynthia Steele, and Grace Newville, and Gillian Waite, and Cynthia Pinckney, and Karen Yangapatty,
and Kiara Tyner, and Kimberly Cobb, and Kourtney Richardson, and William Seger, and Kimberly Pullen, and Jean Seignon,
and Anthony Kim, and Mohammed Antwi, and Allison Green, and Lizzy Seger, and Elizabeth Boydston, and Abdur Rafay Qadri,
and Deborah Devlin, and Tasha Todd, and Oluwatosin Akingbala, and Alma Guel, and Tisha Davis, and Melody Dufrene, and
Samantha Loudermilk, and Virginia Loudermilk, and Crystal Starr, and John Villegas, and Ben Seger, and Katherine Hollie, and
Neil Parmanand Sheth, and Kenneth Stell, and David Beckett, and Enitt Gonzalez, and Donna McGunigal, and Amanda Burns,
and Nancy Wood, and Shelley Miceli, and Christina Avila, and Rebecca Baker, and Laura Vigliotti, and Sarah Kading, and
Samer Salama, and William B. Smith, and Richard L. Gibson, and Jennifer Winbigler, and Elizabeth Parker, and Madison Watts,
and Suzann Cloninger, and Talya Thomas, and Joel Solis, and Martha Carmen Medina, and Xavier Morales, and Hank Heller,
and Blake Torrence, and Joanna Gurrola-Mahoney, and Cynthia Bueno, and Heather Holloway, and Irving Salinas, and Joel
Perez, and Paola Garcia, and Erica Canales, and Blanca Urbina, and Brancisilio Gutierrez, and Carolina Cantu, and Chelsea
Vargas, and Cindy Vasquez, and Cody McIntire, and Gabriela Gutierrez, and Hugo Sosa, and Irvin Munoz, and Jessica Estrada,
and Jonna Lopez, and Kaegan Knox, and Mirella Melendez, and Natalia Valle, and Natalie Echavarria, and Nicole Litton, and
Amber Victor, and Nancy Torrence, and Madhu Shreya, and Mathew Maran, and Asfak Alam, and Westly Keating, and Tara
Green, and Devora Torrence, and Gerardo Sedas, and Shruti Konda, and Prem Jangam, and Mario Echavarria, and Alejandro
Silva, and Anne McNulty, and Daniel Contreras, and Daniel Gomez, and Edgar Garcia, and Elizabeth Weber, and Luis Lopez,
and Samuel Ramirez, and Kayla Lopez, and Pedro Penalo, and Angel Salinas, and Jaime Solis, and Shannon Moyer, and
Aryana Ibarra, and Guadalupe Gurrola, and Jenna Anastasiades, and Uchechi Ehiemua, and Sara Solorzano, and Stephen A.
Spector, and Amaran Moodley, and Jill Blumenthal, and Baharin Abdullah, and Christina Addington, and Juan Carlos Alcantar,
and Deyna Arellano, and Bernadette Cale, and Brendan Costello, and Tammelita Cotlon-Pineda, and Fanny Delebecque, and

Karen Deutsch, and Aram Dimayuga, and Son Do, and Yasmeen Esshaki, and Aileen Everhart, and Cindy Ewing, and Veronica
Figueroa, and Medardo Gaytan, and Crystal Groom, and Carolyn Hernandez, and Heather Huitema, and Benjamin Hull, and
Sylvia Isaac, and Jaclyn Jaskowiak, and Cindy Knott, and Leander Lazaro, and Thuan Le, and Megan Loughran, and Michelle
Madey, and Rosalva Martha-Patten, and Colleen McLellan, and Jeff Ledford-Mills, and Asami Mimura, and Patty Moraes, and
Jennifer Morales, and Jessica Nasca, and Phirum Nguyen, and Marielys Padilla-Martinez, and Dennis Perpetua, and Mike
Pizza, and Shannon Ransom, and Emily Rizo, and Carlos Rojas, and Thaine Ross, and Marie Sagrado, and Eugene Sato, and
Lisa Stangl, and Ji Sun, and Nancy Tang, and Mina Trivedi, and Rodney Trout, and Donna Voss, and Lindsey Woronicz, and
Cynthia Becher Strout, and Rica Santiago, and Yvonne Davis, and Patty Howenstine, and Alison Bondell, and Jaime Robertson,
and Anissa Moussa, and Geronimo Feria Garzon, and Sierra Bennett, and Marlena Petrie, and Shobha Swaminathan, and
Amesika Nyaku, and Tilly Varughese, and Rondalya Deshields, and Michelle L. DallaPiazza, and Elise Lewis, and Jennifer
Punsal, and Mario Portilla, and Malithi Desilva, and Christina Daliani, and Susana Rivera, and Aidan Ziobro, and Andressa
Rebellatto, and Brian Murloy, and Christina Ninan, and Ernest Pianim, and Eunice Wang, and Merit Henen, and Muhammad
Usman, and Rebecca Kim, and Shiao Wang, and Gener Eric Cruz, and Bethany Birago, and Joyell Arscott, and Dina Meawad,
and Christie Lyn Costanza, and Francesca Escaleira, and Zoraida Cruz-Barahona, and Jared Khan, and Valeria Cadorett,
and Jamir Tuten, and Travis Love, and Eric Asencio, and Sukhwinder Singh, and Ramy Joseph Toma, and Olivia Graves,
and Josiah Robinson, and Patricia Hammonds, and Lana Ghomrawi, and Kara Quinnelly, and Shaun O’Conor, and Michael
Lambe, and Rachell Stewart, and William Kirby, and Pink Folmar, and Rachel Culbreth, and Heidi Leblanc, and Julie McDaniel,
and Rian Montgomery, and Andrea Woodle, and Samantha Williams, and Hunter Russell, and Shereen Lowe, and Maureen
Mayer, and Hollis Ryan, and Elaine Reese, and Timothy P. Vachris, and Mark Hutchens, and Stephen Daniels, and Margaret
Wells, and Sandra Clancy, and Rebecca Martinez, and Jessica Buot, and Merissa Daugherty, and Julie Hamilton, and Kimberly
Hernandez, and Ashli Alejandro, and Amy Collins, and Monique Gawlik, and Patricia Johnson, and Maria Moreno, and Ashley
Washington, and Tina Rountree, and Daniel Dore, and Ravi Davuluri, and Ashlee Brunaugh, and Jorge Martinez, and James
Hermon, and Vianai Carreno, and Mia Rountree, and Colleen Coelho, and Keith William Vrbicky, and Charles Harper, and
Chelsie Nutsch, and Wendell Lewis III, and Cathy Laflan, and Linden DeBoer, and Kayla Andal, and Misty Appeldorn, and
Jenniger Grebe, and Russell Herstein, and Catherine King, and Samantha Wieseler, and Alisha Kiepke, and Christy Lee, and
Kelsey Kelley, and Kelli James, and Ashley Frisch, and Courney Green, and Taysha Hingst, and Jeni Hoppe, and Kimber
Breeden, and Debra Gabrielson, and Ginny McNew, and Larkin T. Wadsworth III, and Ashley Dale, and Christy Schultz, and
Rebecca Munsch, and Anya Penly, and Liz Garner, and Stephanie Tesson, and George Cherniawski, and Angie Kean, and Dan
Reed, and Courtney Kubiak, and Maureen Dempsey, and Heather Cherniawski, and Breanna Galibert, and Kristin Branson, and
Laura Hartupee, and Karen Knapp, and Horacio Marafioti, and Lyly Dang, and Jennifer Berry, and Lauren Clement, and Megan
Dandurand, and Jordan L. Whatley, and Patricia Whatley, and Christopher Dedon, and Anika Payne, and Amie Shannon, and
Kristen Losavio, and Nicole Harrell, and Mary Margaret Dobson, and Lindsey Hall, and Chaney Bennett, and Crystal Rowell,
and Mimi Dimmick, and Amy Thomassie, and Kimber Breeden, and Cody LaFleur, and Makaylea Truitt, and Taryn Collett, and
Emily Best, and Alexandra Caillouet, and Judith White, and Amy Edridge, and Chelsea Montalvo, and Eugenia Clark, and Lisa
Russell, and Zahra Somji, and Lesli Leimer, and Robert Meyer, and Christine Murphy, and Prity Patel, and Sejal Patel, and
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Cite as: P. B. Gilbert et al., Science

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