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> It's no longer theoretical that antibody dependent enhancement (ADE) is a concern for the vaccinated IMO this is too strongly worded and doesn't paint an acc

> It's no longer theoretical that antibody dependent enhancement (ADE) is a concern for the vaccinated IMO this is too strongly worded and doesn't paint an accurate picture. First of all, ADE is a concern for anyone infected by a virus, whether through vaccination or natural infection. Second, there is substantial literature showing that immune responses can still be protective even in the presence of ADE [1]. Third, OP uses a molecular modelling approach which places it mostly in the realm of theory and far from conclusive clinical evidence. Some quotes from [1] to support my point: > It is clear that after many years, and considerable attention, the understanding of ADE of disease after either vaccination or administration of antiviral antibodies is insufficient to confidently predict that a given immune intervention for a viral infection will have negative outcomes in humans. > Despite the importance that such information would have in the COVID-19 pandemic, in vitro assays do not predict ADE of disease. > Most animal models of vaccines and antibody interventions show protection, whereas those that suggest potential ADE of disease are not definitive and the precise mechanisms have not been defined. > Although ADE is a concern, it is also clear that antibodies are a fundamentally important component of protective immunity to all of the pathogens discussed here > Even when vaccine formulations such as formalin inactivation have shown disease enhancement, neutralizing antibodies with optimized properties have been protective. [1] A perspective on potential antibody-dependent enhancement of SARS-CoV-2 https://www.nature.com/articles/s41586-020-2538-8 https://www.nature.com/articles/s41586-020-2538-8

raphlinus 5y ago
More background, well written and accessible to a wider audience: https://blogs.sciencemag.org/pipeline/archives/2021/02/12/antibody-dependent-enhancement-and-the-coronavirus-vaccines https://blogs.sciencemag.org/pipeline/archives/2021/02/12/an... An interesting fact: concern about ADE is a significant reason all the vaccines target the spike protein rather than any of the others, such as N (nucleoprotein).
- willmadden 5y ago
  That article is from February 2021. If the author updated the article to include the paper I linked, he could no longer make this claim: "...and (so far) no sign of ADE even with the variant strains in different parts of the world. We have things to worry about in this pandemic, but as far as I can tell today, antibody-dependent enhancement does not seem to be one of them. I understand why people would worry about it, and want to avoid it. But if you’re coming across reports that say that it’s a real problem right now and that you should avoid getting vaccinated because of it, well, I just don’t see it. Some of that is well-intentioned caution, and some of it is probably flat-out anti-vaccine scaremongering. Anyone with different data or different impressions, well, that’s why the comments are open around here!" I'ld be curious to see how the author would update the article based on what we see from the molecular modeling in the paper that broke this week.
willmadden 5y ago
>First of all, ADE is a concern for anyone infected by a virus, whether through vaccination or natural infection. That's a false equivalency. Immunity in the unvaccinated but previously infected is broad. The immune system reacted to all parts of the virus, and the variants the unvaccinated were infected with are diverse. In the vaccinated the immunity is narrow, only to the spike protein section of the original Wuhan strain. It's a reasonable suggestion that the vaccinated are at greater risk of ADE (with very narrow immunity to the original strain's spike protein only) than those infected naturally from a later variant of the entire virus. Also, the data shows rising COVID cases in areas with more vaccination. I haven't heard a rational explanation for this phenomenon beyond political spin.

raphlinus 5y ago

More background, well written and accessible to a wider audience: https://blogs.sciencemag.org/pipeline/archives/2021/02/12/antibody-dependent-enhancement-and-the-coronavirus-vaccines https://blogs.sciencemag.org/pipeline/archives/2021/02/12/an... An interesting fact: concern about ADE is a significant reason all the vaccines target the spike protein rather than any of the others, such as N (nucleoprotein).

willmadden 5y ago
That article is from February 2021. If the author updated the article to include the paper I linked, he could no longer make this claim: "...and (so far) no sign of ADE even with the variant strains in different parts of the world. We have things to worry about in this pandemic, but as far as I can tell today, antibody-dependent enhancement does not seem to be one of them. I understand why people would worry about it, and want to avoid it. But if you’re coming across reports that say that it’s a real problem right now and that you should avoid getting vaccinated because of it, well, I just don’t see it. Some of that is well-intentioned caution, and some of it is probably flat-out anti-vaccine scaremongering. Anyone with different data or different impressions, well, that’s why the comments are open around here!" I'ld be curious to see how the author would update the article based on what we see from the molecular modeling in the paper that broke this week.

willmadden 5y ago

>First of all, ADE is a concern for anyone infected by a virus, whether through vaccination or natural infection. That's a false equivalency. Immunity in the unvaccinated but previously infected is broad. The immune system reacted to all parts of the virus, and the variants the unvaccinated were infected with are diverse. In the vaccinated the immunity is narrow, only to the spike protein section of the original Wuhan strain. It's a reasonable suggestion that the vaccinated are at greater risk of ADE (with very narrow immunity to the original strain's spike protein only) than those infected naturally from a later variant of the entire virus. Also, the data shows rising COVID cases in areas with more vaccination. I haven't heard a rational explanation for this phenomenon beyond political spin.