Vaccination against SARS-CoV-2 and disease enhancement – knowns and unknowns. (2nd August 2020)

• Record Type: Journal Article
• Authors: Zellweger, Raphaël M.; Wartel, T. Anh; Marks, Florian; Song, Manki; Kim, Jerome H.
• Is Part Of: Expert review of vaccines. Volume 19:Number 8(2020)
• Page Start: 691
• Page End: 698
• Publication Date: 2020-08-02
• Subjects: Coronavirus -- SARS-CoV-2 -- COVID-19 -- disease enhancement -- vaccine safety; Vaccines -- Periodicals; Vaccination -- Periodicals; 615.37205
• DOI: 10.1080/14760584.2020.1800463
• Languages: English
• ISSNs: 1476-0584

Abstract

ABSTRACT: Introduction: The world is currently fighting a COVID-19 pandemic, perhaps the most disruptive infectious disease outbreak since the 1918 Spanish influenza. Governments have taken drastic measures to curb the spread of SARS-CoV-2, and the development of safe and efficacious vaccine candidates is being accelerated. The possibility of vaccine-mediated disease enhancement with coronavirus vaccines has been flagged as a potential safety concern, and, despite the urgent need, should be thoroughly assessed as vaccines against SARS-CoV-2 are being tested. Area covered: We review the in vivo evidence suggesting a theoretical risk of disease enhancement after vaccination with SARS-CoV and MERS-CoV vaccine candidates. We also identify knowledge gaps that need to be filled to maximize the chance of developing a safe vaccine and minimize the risk of encountering disease enhancement in vaccinated individuals after exposure to SARS-CoV-2. Expert opinion: We compile and propose avenues to investigate the risk of vaccine-mediated disease enhancement both during pre-clinical and early clinical development. While the pressing need for a vaccine against COVID-19 (and future epidemic coronaviruses) cannot be ignored, we advocate to keep safety at the center of the debate. Protecting individuals with effective and safe vaccines should be a priority, even during extraordinary times like the COVID-19 pandemic.