Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19

Introduction. The COVID-19 pandemic has entered a new phase with the roll-out of several vaccines worldwide at an accelerated phase. The occurrence of a more severe presentation of COVID-19 after vaccination may affect policymakers’ decision-making and vaccine uptake by the public. Vaccine-associate...

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Autores principales:	Rahajeng N. Tunjungputri, Erpryta Nurdia Tetrasiwi, Merlinda Veronica, Jacub Pandelaki, Fera Ibrahim, Erni Juwita Nelwan
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/c64001b677624cf493415f7f3fb91584
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spelling	oai:doaj.org-article:c64001b677624cf493415f7f3fb915842021-11-08T02:36:37ZVaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-191687-963510.1155/2021/9673453https://doaj.org/article/c64001b677624cf493415f7f3fb915842021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9673453https://doaj.org/toc/1687-9635Introduction. The COVID-19 pandemic has entered a new phase with the roll-out of several vaccines worldwide at an accelerated phase. The occurrence of a more severe presentation of COVID-19 after vaccination may affect policymakers’ decision-making and vaccine uptake by the public. Vaccine-associated disease enhancement (VADE) is the modified presentation of infections in individuals after having received a prior vaccination. Currently, little is known about the potential of vaccine-associated disease enhancement (VADE) following COVID-19 immunization. Case Illustration. We herewith report two patients admitted with confirmed COVID-19 pneumonia with a history of CoronaVac vaccination. The first patient with a relatively milder course of the disease had received two doses of CoronaVac, whereas the second patient with a more progressive course of the disease received only one dose before developing symptoms and being admitted to the hospital. Our observations suggest that vaccination could act in boosting the inflammatory process and reveal the previously asymptomatic COVID-19 illness. Theoretically, vaccines could induce VADE, where only suboptimal, nonprotective titers of neutralizing antibodies were produced or proinflammatory T-helper type 2 response was induced. Secondly, enhanced respiratory disease (ERD) could manifest, where pulmonary symptoms are more severe due to peribronchial monocytic and eosinophilic infiltration. Understanding VADE is important for the decision-making by the public, clinicians, and policymakers and is warranted for successful vaccination uptake. Conclusion. We report two cases of patients developing COVID-19 shortly after CoronaVac vaccination in which VADE is likely. We recommend that current vaccination strategies consider the measurement of neutralizing antibody titer as a guide in ensuring the safest strategy for mass immunization. Studies are needed to investigate the true incidence of VADE on vaccinated individuals as well as on how to differentiate between VADE and severe manifestations of COVID-19 that are unrelated to vaccination.Rahajeng N. TunjungputriErpryta Nurdia TetrasiwiMerlinda VeronicaJacub PandelakiFera IbrahimErni Juwita NelwanHindawi LimitedarticleMedicineRENCase Reports in Medicine, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Rahajeng N. Tunjungputri Erpryta Nurdia Tetrasiwi Merlinda Veronica Jacub Pandelaki Fera Ibrahim Erni Juwita Nelwan Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
description	Introduction. The COVID-19 pandemic has entered a new phase with the roll-out of several vaccines worldwide at an accelerated phase. The occurrence of a more severe presentation of COVID-19 after vaccination may affect policymakers’ decision-making and vaccine uptake by the public. Vaccine-associated disease enhancement (VADE) is the modified presentation of infections in individuals after having received a prior vaccination. Currently, little is known about the potential of vaccine-associated disease enhancement (VADE) following COVID-19 immunization. Case Illustration. We herewith report two patients admitted with confirmed COVID-19 pneumonia with a history of CoronaVac vaccination. The first patient with a relatively milder course of the disease had received two doses of CoronaVac, whereas the second patient with a more progressive course of the disease received only one dose before developing symptoms and being admitted to the hospital. Our observations suggest that vaccination could act in boosting the inflammatory process and reveal the previously asymptomatic COVID-19 illness. Theoretically, vaccines could induce VADE, where only suboptimal, nonprotective titers of neutralizing antibodies were produced or proinflammatory T-helper type 2 response was induced. Secondly, enhanced respiratory disease (ERD) could manifest, where pulmonary symptoms are more severe due to peribronchial monocytic and eosinophilic infiltration. Understanding VADE is important for the decision-making by the public, clinicians, and policymakers and is warranted for successful vaccination uptake. Conclusion. We report two cases of patients developing COVID-19 shortly after CoronaVac vaccination in which VADE is likely. We recommend that current vaccination strategies consider the measurement of neutralizing antibody titer as a guide in ensuring the safest strategy for mass immunization. Studies are needed to investigate the true incidence of VADE on vaccinated individuals as well as on how to differentiate between VADE and severe manifestations of COVID-19 that are unrelated to vaccination.
format	article
author	Rahajeng N. Tunjungputri Erpryta Nurdia Tetrasiwi Merlinda Veronica Jacub Pandelaki Fera Ibrahim Erni Juwita Nelwan
author_facet	Rahajeng N. Tunjungputri Erpryta Nurdia Tetrasiwi Merlinda Veronica Jacub Pandelaki Fera Ibrahim Erni Juwita Nelwan
author_sort	Rahajeng N. Tunjungputri
title	Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
title_short	Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
title_full	Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
title_fullStr	Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
title_full_unstemmed	Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
title_sort	vaccine-associated disease enhancement (vade): considerations in postvaccination covid-19
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/c64001b677624cf493415f7f3fb91584
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Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19

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