Empiricism vs. Vaccinophobia

Hi, I was wondering if you think the vaccines have overcome the problem of Antibody Dependent Enhancement. I saw several posts claiming that over the past 20 years, scientists have made many attempts to create coronavirus vaccines and all ended in failure because the animals in the studies got very sick and many died just like the children in the 1960's. Scientists such as Gert Vanden Bossche and Dolores Cahill to name a few say that we should not vaccinate younger healthy adults and that these vaccines provide no evidence that they have overcome the problems related to antibody dependent enhancement (ADE). Given that a healthy person under 60 has over a 99.5% chance of beating covid why should they take their chances with an EUA vaccine? Are you willing to say the chances of suffering from ADE is less than the .005 chance of dying from the virus? If so can you provide data backing up such a claim or is this just your opinion based on 4 months that the vaccine has been used. Can you please shed light on this, thanks?

First of all, I don’t understand what exactly you think the risk of the Covid vaccines is. In other words, what do you think “suffering from ADE” means? How is ADE exactly going to hurt you?

To get on the same page, here’s my understanding of ADE –

Antibody-dependent enhancement (ADE) means that antibodies in your body against a virus increase the chances of viruses entering your cells – the antibodies ENHANCE the viruses’ chances of infecting a cell. Viruses, of course, are intra-cellular parasites and they need to first enter a cell to cause infection. In the setting of a vaccine, the concern is that the vaccine can induce antibodies, which, after infection, will actually make you sicker than if you didn’t get the vaccine. Simply put, if a vaccine against virus XYZ causes ADE, then, after infection with XYZ, vaccinated pts get sicker than unvaccinated pts.

ADE is actually not a common thing in vaccinology or infectious diseases. Covid-19 itself may have a component of ADE. In the history of vaccinology, I know of 2 cases of ADE. One with RSV (respiratory syncytial virus) and the other with a weak version of the measles vaccine. Both occurred decades ago. None of the vaccines produced in the last 40 years is associated with ADE.

Still, ADE was certainly a concern at the start of this enormous vaccine experiment, but fortunately, we haven’t seen it.

Yes, at the start of the vaccine trials, I, like many, were concerned about this possibility. I was buoyed by the fact that we didn’t see ADE when we gave convalescent plasma, which, of course, had antibodies against SARS-CoV-2 and theoretically could have made things worse. The vaccine developers used the spike protein subunit because it appeared, in animal testing, to have to the lowest chance of inducing antibodies which would enhance infection.

But in the end, for ADE to occur, one needs to become infected and the Covid vaccines are excellent at preventing infection. And, of course, vaccinology, as is most of Medicine, is an empiric science, and empirically we just do not see ADE in vaccine recipients. We actually see the opposite. In those few vaccinates pts who have received the vaccine, the disease is less.

In other words, we just don’t see ADE.

I am not sure who Drs. Cahill and Bossche are, and I don’t know what their specific concerns are. But like all of Medicine, the proof is the pudding, and we have a ton of great tasting pudding. As the months have gone by, we haven’t seen people vaccinated several months ago getting sick or sicker than average as their antibody titers fall, but this is being looked for.

As for your decision to get the vaccine or not, well that’s personal. Of course, a few decades ago, it wasn’t personal. The government didn’t ask if you wanted to get the smallpox vaccine. Of course, also, smallpox was eradicated from the human population.

SMS

P.S. - I looked for data on ADE in other coronavirus vaccine development. I found only a few articles using the macaque model for SARS and several articles on feline infectious peritonitis virus. I don’t know much about FIPV, which causes peritonitis in cats. However, I do know some about SARS-CoV and macaques. They used an inactivated SARS-CoV vaccine and challenged with live SARS-CoV. Even in animals with low antibody titers at the time of challenge, ADE was not seen.