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Since the vaccine has been around such a long time, there are many reports on its potential adverse effects and the vaccine itself has been altered to minimize many of them

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Early warning signs of hypoglycemia may be less obvious in patients with hypoglycemia unawareness which can be due to a long history of diabetes (where deficiencies in the release or response to counter regulatory hormones exist), with autonomic neuropathy, intensified diabetes control, or taking beta-blockers, guanethidine, or reserpine