CONCERN VACCINE STRENGTHENS DISEASE
EBioMedicine. 2020 Apr 16 : 102768.
doi: 10.1016/j.ebiom.2020.102768 [Epub ahead of print]
Impact of immune enhancement on Covid-19 polyclonal hyperimmune globulin therapy and vaccine development
Ruklanthi de Alwis,a,b Shiwei Chen,a Esther S. Gan,a and Eng Eong Ooia,b,c,d,?
While development of both hyperimmune globulin therapy and vaccine against SARS-CoV-2 are promising, they both pose a common theoretical safety concern .
Experimental studies have suggested the possibility of immune-enhanced disease of SARS-CoV and MERS-CoV infections, which may thus similarly occur with SARS-CoV-2 infection
Indeed, vaccines that produce low titers of neutralizing antibodies elicited more severe peritonitis and higher mortality rates in vaccinated kittens .
Concerns were also raised on the possibility of ADE for SARS-CoV and MERS-CoV infections .
Besides dengue, several other viruses have shown clinical or epidemiological evidence to support the notion of ADE. Two notable examples of vaccine-induced ADE are respiratory syncytial virus (RSV) , , ,  and atypical measles [30,31], where severe disease was more prevalent following vaccination with inactivated virions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161485/#bib0011