ADE

Importantly when a vaccinated person subsequently gets infected this is not automatically evidence of ADE. Here are reasons indicating why ADE.

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ADE is when a disease is made worse or more severe in a person who was already exposed to the virus through a previous infection or vaccination compared to people who were never exposed or vaccinated.

ADE. Antibody-dependent enhancement ADE sometimes less precisely called immune enhancement or disease enhancement is a phenomenon in which binding of a virus to suboptimal antibodies enhances its entry into host cells followed by its replication. Might COVID-19 vaccines sensitize humans to antibody-dependent enhanced ADE breakthrough infections. Antibody-dependent enhancement ADE has not been identified as a concern related to SARS-CoV-2 infection or following COVID-19 vaccination.

This is unlikely because coronavirus diseases in humans lack the clinical epidemiological biological or pathological attributes of ADE. The suboptimal antibodies can result from natural infection or from vaccination. While expanded trophism of SARS-CoV-2 represents a possible ADE.

Instead these antibodies act as a Trojan horse allowing the pathogen to get into cells and exacerbate the immune response. ADE occurs when the antibodies generated during an immune response recognize and bind to a pathogen but they are unable to prevent infection. In addition ADE with mast cells likely plays a role in MIS-C for infants and possibly older MIS-C and MIS-A patients.

ADE risks may be associated with antibody level which can wane over time after vaccination and also if the antibodies are derived from prior exposures to other coronaviruses.

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