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intermittent beeps and chirps. They walk past a gloved and goggled technician who sits at her bench, carefully pipetting drops of a bluish liquid out of a test tube and onto a test strip.

Jimmy stops beside a series of tall machines that are the size of closets and together resemble appliances in an ultramodern, high-end kitchen. He pats the side of the nearest one affectionately, as if it were an old pal he hadn’t seen in a while. “This puppy is the most sensitive mass spectrometer on the market, bar none. We ran your sample through the LC-MS, and lo and behold—”

“LC-MS?”

“Liquid chromatography mass spectrometry,” Jimmy says. “It’s all the rage in toxicology these days. Basically, it’s totally replaced gas chromatography, because with GC, you need your compounds to be volatile or at least heat stable for them to—”

Lisa cuts him off again with a raised hand. “I struggled in chemistry, Jimmy. It almost kept me out of med school. I totally believe you. I just want to hear what you found.”

Flashing a gap-toothed grin, Jimmy reaches into the basket beside the machine, pulls out a few printed sheets, and holds them up for Lisa to see. The first page shows a densely colored graph with various spikes and waves of reds, greens, purples, and blues.

Lisa squints at it. “What am I looking at?”

“A histogram of all the various components we found in your sample.” Jimmy flips through the next few pages, which show more bar charts, line graphs, and pie charts that mean nothing to Lisa, until he finally reaches a page with a list of medications that she does recognize.

Her heart is already in her throat when Jimmy says, “So, aside from the active vaccine protein itself, we also found—ranked highest to lowest in terms of their relative concentrates—sulfonamides, lamotrigine, allopurinol, fluconazole, carbamezapine, and traces of oseltamivir.”

“That can’t be right,” Lisa says as she gawks at the hodgepodge of medications listed on the printout. “You found all of those meds in the one syringe?”

“Yup.” He shrugs. “This wasn’t a vaccine so much as a drugstore sampler of some of the more common antibiotics and antiseizure drugs.”

“In other words, it was poisoned.”

“Well, technically, none of these are toxins. They’re all pharmaceuticals. But it’s about the most contaminated sample I’ve seen in a hell of a long time.”

The realization hits her with the shock of a hammer to her thumb. “There’s zero chance all these medications ended up in this syringe by accident.”

“Nada. There’s not a pharmaceutical company in the world that would release such a dirty vaccine from their plant. They’re legally mandated to test every single batch for quality control. And this sample would’ve set off a five-star alarm in testing.”

“So someone added these toxins to this particular syringe?”

“Or tampered with the vial of vaccine itself, yeah.” Jimmy scratches his beard. “But why? All of these medications are relatively benign.”

“Benign, maybe,” Lisa says as her stomach flips. “But each one of them is also strongly associated with Stevens-Johnson syndrome.”

CHAPTER 51

Lisa’s whole body feels numb as she drives away from the lab. She still can’t wrap her head around the implications of what the toxicologists found in a single drop of leftover vaccine.

Poisoned?

Before she left, Jimmy agreed to run urgent toxicological screens on as many of the hundreds of other used syringes from Mateo’s clinic as the lab could perform. He pointed out that they were lucky to be able to extract enough of a sample from Mateo’s syringe, and it would be hit-and-miss with each of the others. Moreover, if several of the other syringes were also poisoned, they would only need to randomly sample to estimate how many of the total were tainted. “Unless all of them were,” he added ominously. He also informed her that the process would be quicker now that they knew what toxins to look for.

The news should have been reassuring to Lisa. Unless the entire supply was poisoned—which she knows from Fiona’s exhaustive screening not to be the case—the revelation means that the vaccine itself is not dangerous. Potentially, it could even be reinstated on the front lines to prevent the spread of the lethal meningococcus. But that glimmer of hope is totally overshadowed by the dark intent behind what she just learned.

First, the cover-up to hide the complication. And now an even more malicious conspiracy to poison the vaccine itself. What kind of person or people would do this?

The triple buzz of her phone draws her attention. She glances over to the screen, where it’s mounted on a holder in the air vent.

“Olivia has a rash,” the text from her sister reads. “Taking her to Bellevue Hospital.”

Lisa’s stomach plummets. “Call Amber!” she screams at her car’s voice recognition system. But the line rings straight to voice mail.

“Oh no. Please, no,” Lisa mutters repeatedly as she tries her sister three more times without reaching her.

Lisa swerves into the right lane, to the angry honk of a truck she cuts off. Her pulse pounds in her temples as she zigzags through freeway traffic, driving more aggressively than Tyra at her most impatient, as she races toward the hospital.

She peels into the ER’s parking lot and abandons her car out front in an area clearly marked as ambulance parking. She runs into the ER and up to the triage desk, where she steps in front of an elderly woman who’s sitting in a wheelchair with oxygen tubing running up to her nostrils.

“Where is Olivia Dyer-Tegan?” Lisa demands of the triage nurse.

“How rude!” the elderly woman gripes.

The seemingly unflappable triage nurse smiles politely. “Ma’am, you will have to wait your—”

“I’m Dr. Dyer, the chief public-health officer.” Lisa plasters her ID tag against the Plexiglas that separates her from the nurse. “And this is a public-health emergency.”

The nurse consults her computer screen. “Bed fourteen.” She points to the set of metal doors to her right. “I’ll buzz you in.”

Lisa flies through electronically opening doors. She scans the numbers posted above the stretchers,

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