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1. What is your first name? (Required.)

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2. What is your last name? (Required.)

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3. What is your date of birth? (Required.)

Date

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4. 1.       Which companies (aside from Johnson & Johnson) helped created a COVID-19 vaccine? (Required.)

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5. How many people worldwide have died from COVID-19? (Required.)

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6. How was the COVID-19 vaccine developed so quickly? (Required.)

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7. What can you do to protect yourself if you are not yet vaccinated? (Required.)

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