THE FIGHT IS IN US

THE FIGHT IS IN US
After recovering from COVID-19 earlier this year, Boston Celtics guard
Marcus Smart decided to FIGHT IT FORWARD by donating his plasma
DONATE PLASMA | SAVE LIVES

FIGHT IT FORWARD

COVID-19 survivors: you’ve got a lot of fight in you.

Because your immune system fought off COVID-19, you now have antibodies in you that could help others fight it off too.

Please donate your COVID-19 plasma today. See if you qualify and find a donor center near you.

HOW IT WORKS

Donating blood plasma is a safe process that has been used for more than one hundred years to help save lives. Thousands of people safely and painlessly donate every day. Blood plasma donation is performed in a highly regulated environment by professionally trained staff using sterile, one-time-use, disposable materials. Facilities follow strict guidelines when collecting plasma to ensure the donor’s safety and comfort.

Here are some of the key steps to donate:

    1. ELIGIBILITY

You must have had COVID-19 documented by a laboratory test, an antibody test, or clinical diagnosis and meet other donor criteria. You must also be symptom free for at least 14 days prior to visiting a donor center.

    2. REGISTRATION

You will be asked to show proof of identification and share your contact information when you arrive at the donor center. Some centers may have additional registration requirements. All information will be kept strictly confidential.

    3. SCREENING

You must pass a pre-donation screening at every visit, including a brief exam to check your body temperature, blood pressure, and pulse rate. The goal of this screening is to make sure that the donation is safe for both you and the recipients of the final product.

    4. DONATION PROCESS

Once your eligibility is confirmed, you will move to a donation area where you will rest on a donor bed while connected to an automated machine that will collect your plasma. You will be carefully monitored by staff throughout the donation process. Your donor bed will be socially distanced at least six feet from other donors and/or personal protective equipment will be provided.

    5. PLASMA COLLECTION

Blood plasma is collected through an automated process that separates plasma from other blood components, then returns your red blood cells and platelets to you. This process continues until a target amount of plasma has been collected.

WHAT IS BLOOD PLASMA?

Plasma – the liquid portion of your blood – can be easily replaced by your body. It consists mainly of water, proteins and antibodies that help your body to function. If you have survived COVID-19 then your plasma includes antibodies that could help others fight the virus.

Pie chart showing that blood plasma is composed of:

55% plasma55% PLASMA

1% white blood cells1% White Blood Cells

44% red blood cells44% Red Blood Cells

plasma pie-chart

55% plasma55% PLASMA

1% white blood cells1% White Blood Cells

44% red blood cells44% Red Blood Cells

HOW IS BLOOD PLASMA USED?

Plasma from those who have recovered could be a key part of the fight against COVID-19. Once the COVID-19 plasma is donated, it can take one of two paths: be directly transfused into patients or be used to make a potential medicine. Learn more about the two paths here

Our values

About

COVID-19 is affecting every aspect of our lives – how we live, how we work, how we relate to one another. Moments like this can make us feel disempowered, especially when so many of us are physically separated from the loved ones who bring meaning to our lives. But it is these moments that shape us. They draw into focus the disparities between the world as it is and the world we want. They define who we are as a human family.

As business, non-profit and community leaders, we understand that this has not impacted all of us equally. This disease has disproportionately impacted people of color, not least of all because African Americans and other communities of color make up a high percentage of front-line workers in healthcare and other essential organizations. Many across America are bearing an unequal burden that is not unique to COVID-19, as recent demonstrations across the country have brought into sharp relief.

One action that you can take right now is to help COVID-19 survivors help others. If you or someone you know has recently recovered from COVID-19, a plasma donation can help those who are currently sick with the disease as well as aid in the development of potentially life-saving treatments. A coalition of more than 30 organizations has come together to create a national donor recruitment campaign – The Fight Is In Us – with the goal of connecting survivors with licensed blood and plasma donor centers. A simple online tool helps potential donors learn where to go and arrange free transportation to make it easy and convenient to share the antibodies that helped fight off infection. The Fight Is In Us was formed around a core set of principles to maximize the individual and societal benefit of convalescent plasma:

  • Engagement - We are committed to empowering all our members and the public to build trust and inspire us all to come together to ensure that survivors donate, collection capacity is maximized, and distribution is optimized.
  • Evidence – Science must be the foundation for addressing the pandemic, and we are committed to letting science be our guide in making non-partisan decisions about convalescent plasma for transfusion and (when available) hyperimmune globulin.
  • Equity – Ensuring equity in the development of and access to affordable, safe, and effective treatments for COVID-19 isn’t just the right thing to do, it’s also the most effective way to protect those whose lives are most at risk and to treat those who develop disease. We are committed to ensuring that convalescent plasma preventative interventions and disease therapies are prioritized for those who will benefit from them most and ensuring that the best treatments are available in the near and longer term.

You can read more on our site about how plasma works and the two approaches to fight COVID-19 utilizing convalescent plasma.

About

This is a united effort bringing together several coalitions and organizations, including academic medical institutions (the National COVID-19 Convalescent Plasma Expanded Access Program led by Mayo Clinic and including Johns Hopkins University, Michigan State University, and Washington University School of Medicine in St. Louis); plasma companies (Grifols and the CoVIg-19 Plasma Alliance, including those announced at its inception—Biotest, BPL, CSL Behring, LFB, Octapharma, and Takeda—and new members ADMA Biologics, BioPharma Plasma, GC Pharma, Liminal BioSciences, and Sanquin); national blood organizations (including AABB, American Red Cross, America’s Blood Centers, and Blood Centers of America); health benefits company Anthem Inc.; health care diagnostics company LabCorp; community and non-profit leaders including Stop the Spread and XPRIZE; marketing and media contributions from supporters including the CSL Behring, Grifols, and Takeda; and the National Basketball Association.

"The Fight Is In Us" is also supported by advisory and technology supporters. The Bill & Melinda Gates Foundation and the Lasker Foundation are providing advisory support. Microsoft is providing technology support for the recruitment website and self-qualification tool. The website and tool are hosted by The MITRE Corporation. MITRE is appreciative of the Microsoft AI for Health program for their support in MITRE’s hosting of the recruitment website and self-qualification tool in the Azure cloud. Uber Health is providing free, roundtrip Uber rides to and from the donor centers for those who are eligible to donate. Ashfield Healthcare is providing contact center service to support COVID-19 survivors.

QUESTIONS?

For questions about donation, please contact 877-PLASMA9 (877-752-7629). For press or partnership inquiries please contact info@thefightisinus.info.

PLANNING FOR YOUR DONATION

How should I prepare for my donation?

Donating blood plasma is similar to giving blood. If you can tolerate donating blood, or giving blood during medical appointments, you should be comfortable donating blood plasma. Highly trained staff will take great care to minimize any possible discomfort.

In rare occasions, some donors might feel faint or weak. Personnel at the donor center are trained to recognize and deal with any adverse event that might occur. Eating a healthy meal and drinking plenty of water before and after your donation will help you feel well after your donation. If you have a history of feeling faint at the sight of blood, please let the donor center staff know.

What precautions are blood and plasma donor centers taking to ensure the safety of donors?

Thousands of people safely donate plasma every day. The collection process uses sterile tubing and supplies for each donation. The tubing and supplies are discarded after each collection and are never reused. Blood does not come in contact with the collection machine.

These are a few of the extra precautions that donor centers are taking:

  • Pre-entry screening
  • Following social distancing guidelines
  • Enhanced personal protective equipment used by staff
  • Enhanced cleaning and disinfecting procedures
Where can I donate in the United States?

There are hundreds of FDA licensed donor centers across the United States. Find the nearest donor centers, sorted by distance from you, by clicking here.

Where can I donate in Europe?

The CoVIg Plasma Alliance is able to accept potential donors at plasma donor centers in Austria, Czech Republic, Germany, and Hungary. Find your nearest plasma donor center by clicking here and selecting your country from the dropdown menu at the top. Individuals in Europe who have recovered from COVID-19 and are interested in donating plasma can also contact their local blood donor center to inquire about making a donation appointment.

Can I donate more than once?

Individuals who have fully recovered from COVID-19 and are willing to donate their blood plasma are encouraged to donate as many times as allowed by the donor center. Donor centers may have additional guidelines.

I have young children. Can I bring them with me?

To help prevent the spread of COVID-19, donors are asked to visit blood and plasma donor centers without accompanying guests or children. This is for the health and safety of you and your loved ones as well as other donors and staff.

Do I need to change my diet?

It is recommended that you eat a light but healthy meal three hours before your donation. This means a meal that is high in protein (such as eggs, fish, or nuts), rich in iron (such as tuna, lean red meat, nuts, or beans), and low in fat (fatty or fried foods can interfere with laboratory testing). Since blood plasma is 90% water, you should also be well-hydrated, so drink plenty of water, juice, or other fluids and reduce your caffeine intake the day before your donation. Please do not drink any alcohol the night before or the day of your donation.

What do I need to bring with me to the blood and plasma donor center?

You must have had COVID-19 documented by a laboratory test, an antibody test, or clinical diagnosis and be symptom-free for at least 14 days prior to donation. You must also present one of the following:

  • A valid government-issued identification (Example: Driver's License, Military ID, etc.)

Some donor centers may have additional requirements. Call ahead to find out if you also need:

  • Proof of social security number (Example: Social Security Card)
  • If you are a resident of Mexico, please also provide a valid Border Crossing Card (BCC) or US Visa and government-issued document/identification indicating the CURP (Clave Unica de Registro de Poblacion) number
  • Proof of local residency (Example: Piece of mail postmarked in the past 30 days, current lease, utility bill, etc.)
Do I need to tell my insurance company that I am donating?

You do not need to inform your insurance provider. This is not a medical procedure and you will not be charged for your donation.

How can I get to and from the donor center?

Uber Health is providing free, roundtrip Uber rides to and from the donor centers for those who are eligible to donate. You will have an opportunity to indicate if you need a roundtrip Uber ride when you search for the nearest donor centers, sorted by distance from you, by clicking here.

UNDERSTANDING DONATION ELIGIBILITY

Why do you need to know if I am at least 18 years old?

Some centers set 16 years as the minimum age for donors, and some 18 years. Based on your answer, we surface the correct list of donor centers. If you are under the age of 18, parental consent may be required for blood collection.

Why do you need to know that I weigh at least 110 pounds?

The U.S. Food and Drug Administration ("FDA") require that this question be asked as the FDA requires donors to weigh at least 110 pounds.

Why do you need to know if I have ever had a confirmed positive test for HIV, or Hepatitis B or C?

The FDA requires that these questions be asked. A person who has tested positive for HIV is not eligible to donate. Never having had a positive test for Hepatitis B or C is also required by the FDA for donation at a plasma donor center. Your donated plasma will also be tested for transfusion-transmissible diseases, including HIV and Hepatitis B and C. Your responses to these question are used to determine donation eligibility.

Can I donate if I am pregnant? Can I donate if I recently gave birth?

A person who is currently pregnant is not eligible to donate for their safety. For six weeks after giving birth, a person is not eligible to donate at blood donor centers where their plasma will be used for transfusion. A person's blood will be tested for HLA antibodies, commonly seen after childbirth, which present no problems to the donor but pose a risk to patients receiving plasma transfusions. Additionally, for six months after giving birth, a person is not eligible to donate at a plasma donor center. Since their plasma is going to undergo additional manufacturing steps, they will not be tested for HLA antibodies. If you have any questions about eligibility, it is recommended that you call your local donor center.

ABOUT THE DATA COLLECTED

What is the role of Microsoft in the campaign?

Microsoft developed the donor recruitment website and self-qualification tool. The website and tool are hosted by The MITRE Corporation ("MITRE"), a not-for-profit organization that operates and manages federally funded research and development centers.

How will the data I enter be used?

MITRE will store the answers you provide and will share this non-personally identifiable data in an aggregated form with "The Fight Is In Us" campaign only to improve the COVID-19 plasma donation program. MITRE may also share aggregate findings with the public through journal publications, collaborations with other scientists, or postings to track developments in the fight against COVID-19.

Is any personally identifiable information ("PII") and/or protected health information ("PHI") collected or shared by MITRE?

No, PII and PHI are not collected or shared by MITRE.

Will MITRE sell my data?

No, MITRE will not sell your data.

Who should I contact if I have questions?

For questions about donation, please contact 877-PLASMA9 (877-752-7629). For press or partnership inquires please contact info@thefightisinus.info.

What is the role of Bio-Linked in the campaign?

Bio-Linked™ is a secure, online registry that allows individuals to volunteer a few details of their recent infection with COVID-19 so that they can be identified as potential donors of COVID Convalescent Plasma (CCP). It allows users to be linked with healthcare organizations in their local area that collect this type of blood donation, which is one of the few treatment options currently showing promise in caring for patients severely ill with the new coronavirus. CCP is also being sought to develop a drug (“hyperimmune globulin”) that may help COVID-19 patients in the near future. Registrants will be contacted by their chosen blood collection facility to discuss their eligibility to give CCP and to schedule appointments to donate. Participation is entirely voluntarily at each step in the process from registration through qualification and on to collection. Providing a streamlined process for recovered patients to give CCP, Bio-Linked speeds therapy to ill patients and helps assure sufficient CCP is available to all who may need it.

RESOURCES

COMMUNITY

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Survivor Stories

  • Hear from COVID-19 Survivors through Survivor Corps, the largest grassroots movement in US dedicated to actively ending this pandemic. They aim to help others by educating, connecting, motivating and mobilizing those affected by COVID-19 to support all ongoing scientific, medical and academic research to better understand the virus’ long term impacts on the body and help to develop treatments. By listening to these stories you will find a spirit of unity and solidarity that is urgently needed during this time of crisis.


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    Learn More

  • Find community resources to help COVID 19 survivors learn more about plasma donation. Help us educate those in the community about why they should donate, the process for donation, and the benefits. This simple to understand graphic walks anyone through the process and teaches them why donating plasma is so important.


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    Spread the Word

  • Help us share about the campaign and encourage those who have had COVID-19 to donate their plasma and save lives. Downloadable and printable for ease in helping spread the word about the campaign.


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    Participate in Regional & National Research Studies

  • Your involvement in medical, scientific and academic research is urgently needed. Survivor Corps outlines the wide range of COVID-19 related medical studies, clinical trials and surveys presently being conducted that will broaden our understanding of the disease.


  • PHYSICIAN EDUCATION

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    Update on Convalescent Plasma in COVID-19

    5/27/20 Philippe R. Bauer, MD, PhD

  • Grand Rounds 5/27/2020


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    Deployment of convalescent plasma for the prevention and treatment of COVID-19

    4/7/20 The Journal of Clinical Investigation

  • Guidebook published online April 7 in the Journal of Clinical Investigation to help hospitals scale up ability to deliver blood plasma therapy.


  • RESEARCH & OUTCOMES

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    COVID Clinical Trials Participation

    4/14/20 Clara Health

  • As researchers race to find vaccines, treatments, and better testing - they need your help. Clinical trials are for everyone. Sign up here to participate, and lets put an end to this pandemic together.


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    Emergency Use Authorization for CCP

    8/23/20 FDA

  • As of Aug 23, the FDA has issued an Emergency Use Authorization (EUA) to permit the emergency use of COVID-19 convalescent plasma (CCP) for some hospitalized patients. To learn more, please refer to the FDA’s Fact Sheet for Health Care Providers and Fact Sheet for Patients and Parents/Caregivers.


  • img
    Mayo Clinic launches neutralizing antibody test to advance COVID-19 therapies

    6/11/20 Mayo Clinic

  • Mayo Clinic launches neutralizing antibody test to advance COVID-19 therapies


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    Serological Analysis of New York City COVID-19 Convalescent Plasma Donors

    6/9/20 medRxiv

  • Serological Analysis of New York City COVID-19 Convalescent Plasma Donors | medRxiv


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    A Randomized Trial of Convalescent Plasma for COVID-19—Potentially Hopeful Signals

    6/3/20 JAMA

  • JAMA editorial. Published online June 3, 2020. The first randomized clinical trial of convalescent plasma in COVID-19, reported by Li et al in JAMA, showed no statistically significant benefit in clinical improvement at 28 days or mortality among all randomized patients, but does provide an important signal of possible benefit in the subgroup of severely ill patients and suggests that high titer antibody against SARS-CoV-2 may have antiviral efficacy.


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    Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19A Randomized Clinical Trial

    6/3/20 JAMA

  • SJAMA. Published online June 3, 2020. In this randomized clinical trial that included 103 patients and was terminated early, the hazard ratio for time to clinical improvement within 28 days in the convalescent plasma group vs the standard treatment group was 1.40 and was not statistically significant.


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    Convalescent plasma treatment of severe COVID-19: A matched control study (Preprint)

    5/22/20 medRxiv

  • Pre-print from MedRXiv: Icahn/Mt Sinai - outcomes of 39 hospitalized patients with severe to life-threatening COVID-19 who received convalescent plasma transfusion were compared against a cohort of retrospectively matched controls, concluding convalescent plasma transfusion is a potentially efficacious treatment option; data suggest that non-intubated patients may benefit more than those requiring mechanical ventilation.


  • img
    Effectiveness of convalescent plasma therapy in severe COVID-19 patients

    4/28/20 National Academy of Sciences

  • Effectiveness of convalescent plasma therapy in severe COVID-19 patients


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    Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma

    3/27/20 JAMA

  • Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma


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    Convalescent Plasma for COVID-19. A randomized clinical trial

    7/3/20 medRxiv

  • Most COVID-19 patients already have high neutralizing antibody titers at hospital admission. Screening for antibodies and prioritizing convalescent plasma to risk groups with recent symptom onset will be key to identify patients that may benefit from convalescent plasma.


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    The therapeutic effectiveness of Convalescent plasma therapy on treating COVID-19 patients residing in respiratory care units in hospitals in Baghdad, Iraq

    6/30/20 medRxiv

  • Patients received convalescent plasma showed reduced duration of infection in about 4 days, and showed less death rate, 1/21 versus 8/28 in control group.


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    Mortality reduction in 46 severe Covid-19 patients treated with hyperimmune plasma. A proof of concept single arm multicenter interventional trial

    5/29/20 medRxiv

  • Hyperimmune plasma in Covid-19 shows promising benefits, to be confirmed in a randomized controlled trial. This proof of concept study could open to future developments including hyperimmune plasma banking, development of standardized pharmaceutical products and monoclonal antibodies. (Italy)


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    Use of Convalescent Plasma in Hospitalized Patients With Covid-19 - Case Series

    6/19/20 American Society of Hematology

  • The current study suggests that CP use in severe and critically ill patients with Covid-19 may improve survival if given early in in the course of disease.


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    Hospitalized COVID-19 patients treated with Convalescent Plasma in a mid-size city in the midwest

    6/22/20 medRxiv

  • Results demonstrate that convalescent plasma is associated with reducing ventilatory requirements in patients with both severe and life-threatening disease, but appears to be most beneficial when administered early in the course of disease when patients meet the criteria for severe illness.


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    Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma

    5/27/20 Science Direct

  • Outcomes from this case series of 25 patients indicate that administration of convalescent plasma is a safe treatment option for those with severe COVID-19 disease.


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    Early Safety Indicators of COVID-19 Convalescent Plasma in 5,000 Patients

    5/14/20 medRxiv

  • COVID-19 transfused with convalescent plasma provides no signal of toxicity beyond what is expected from plasma use in severely ill patients suggesting suggest research should shift focus toward determining the efficacy of convalescent plasma.


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    WE, OUR AUTHORIZED THIRD PARTY PROVIDERS, AND OUR RESPECTIVE OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, SUPPLIERS, OR LICENSORS, MAKE NO WARRANTIES OR REPRESENTATIONS ABOUT THE CONTENT (INCLUDING THE USER CONTENT), INCLUDING BUT NOT LIMITED TO ITS ACCURACY, RELIABILITY, COMPLETENESS, TIMELINESS, OR RELIABILITY. NEITHER WE NOR OUR AUTHORIZED THIRD PARTY PROVIDERS SHALL BE SUBJECT TO LIABILITY FOR TRUTH, ACCURACY, OR COMPLETENESS OF ANY INFORMATION CONVEYED TO THE USER OR FOR ERRORS, MISTAKES OR OMISSIONS THEREIN OR FOR ANY DELAYS OR INTERRUPTIONS OF THE DATA OR INFORMATION STREAM FROM WHATEVER CAUSE. YOU AGREE THAT YOU USE THE SITE AND THE CONTENT (INCLUDING THE USER CONTENT) AT YOUR OWN RISK. NEITHER WE NOR OUR AUTHORIZED THIRD-PARTY PROVIDERS WARRANT THAT THE SITE WILL OPERATE ERROR FREE OR THAT THIS SITE, ITS SERVER, OR THE CONTENT (INCLUDING THE USER CONTENT) ARE FREE OF COMPUTER VIRUSES OR SIMILAR CONTAMINATION OR DESTRUCTIVE FEATURES. IF YOUR USE OF THE SITE OR THE CONTENT (INCLUDING THE USER CONTENT) RESULTS IN THE NEED FOR SERVICING OR REPLACING EQUIPMENT OR DATA, WE SHALL NOT BE RESPONSIBLE FOR THOSE COSTS. THE SITE AND CONTENT (INCLUDING THE USER CONTENT) ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS WITHOUT ANY WARRANTIES OF ANY KIND. WE AND OUR AUTHORIZED THIRD-PARTY PROVIDERS HEREBY DISCLAIM ALL WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE WARRANTY OF TITLE, MERCHANTABILITY, NON INFRINGEMENT OF THIRD PARTIES' RIGHTS, AND FITNESS FOR PARTICULAR PURPOSE. IN NO EVENT SHALL WE OR OUR AUTHORIZED THIRD PARTY PROVIDERS BE LIABLE FOR ANY DAMAGES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, INCIDENTAL AND CONSEQUENTIAL DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION) RESULTING FROM THE USE OR INABILITY TO USE THE SITE AND THE CONTENT (INCLUDING THE USER CONTENT), WHETHER BASED ON WARRANTY, CONTRACT, TORT (INCLUDING NEGLIGENCE), OR ANY OTHER LEGAL THEORY, EVEN IF A WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. YOU SPECIFICALLY ACKNOWLEDGE AND AGREE THAT NEITHER MITRE NOR ITS AUTHORIZED THIRD PARTY PROVIDERS SHALL BE LIABLE FOR ANY DEFAMATORY, OFFENSIVE OR ILLEGAL CONDUCT OF ANY USER OF THE SITE. YOUR SOLE AND EXCLUSIVE REMEDY FOR ANY OF THE ABOVE CLAIMS OR ANY DISPUTE WITH MITRE IS TO DISCONTINUE YOUR USE OF THE SITE. YOU AND MITRE AGREE THAT ANY CAUSE OF ACTION ARISING OUT OF OR RELATED TO THE SITE MUST COMMENCE WITHIN ONE (1) YEAR AFTER THE CAUSE OF ACTION ACCRUES OR THE CAUSE OF ACTION IS PERMANENTLY BARRED. BECAUSE SOME JURISDICTIONS DO NOT ALLOW LIMITATIONS ON HOW LONG AN IMPLIED WARRANTY LASTS, OR THE EXCLUSION OR LIMITATION OF LIABILITY FOR CONSEQUENTIAL OR INCIDENTAL DAMAGES, ALL OR A PORTION OF THE ABOVE LIMITATIONS MAY NOT APPLY TO YOU. IN SUCH JURISDICTIONS, OUR AND OUR AUTHORIZED THIRD-PARTY PROVIDER'S LIABILITY SHALL BE LIMITED TO THE GREATEST EXTENT PERMITTED BY LAW.

    General:

    These Terms of Use, and any rights and licenses granted hereunder, may not be transferred or assigned by you, but may be assigned by MITRE without restriction. These Terms of Use are governed by the internal substantive laws of the Commonwealth of Virginia, without respect to its conflict of laws provisions. You expressly agree to submit to the exclusive personal jurisdiction of the state and federal courts sitting in Fairfax County in the Commonwealth of Virginia.

    If any provision of these Terms of Use is found to be invalid by any court having competent jurisdiction, the invalidity of such provision shall not affect the validity of the remaining provisions of the Terms of Use, which shall remain in full force and effect. Failure by MITRE or our authorized Third Party Providers to act on or enforce any provision of the Terms of Use shall not be construed as a waiver of that provision or any other provision in these Terms of Use. No waiver shall be effective against us or our authorized Third Party Providers unless made in writing, and no such waiver shall be construed as a waiver in any other or subsequent instance.

    Except as expressly agreed by us and you, these Terms of Use constitute the entire agreement between you and us with respect to the subject matter hereof, and supersede all previous or contemporaneous agreements, whether written or oral, between the parties with respect to such subject matter. If any provision these Terms of Use is unlawful, void or unenforceable, the remaining provisions of these Terms of Use shall remain valid.