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Serious adverse event of vaccine candidates
Vaccine-associated enhanced respiratory disease (VAERD) , or simply enhanced respiratory disease (ERD), is an adverse event where an
exacerbated
course of respiratory disease occurs with higher
incidence in the vaccinated population than in the
control group . It is a barrier against vaccine development that can lead to its failure.
[1]
Immunologically, VAERD is characterized with an exaggerated
Th2 response and
eosinophilic pulmonary
infiltrations .
[2] It may result from
antibody-mediated complement activation followed by weak
neutralization .
[3]
Historical instances of the phenomenon were seen in vaccine candidates for
respiratory syncytial virus (RSV),
SARS-CoV ,
Middle East Respiratory Syndrome (MERS), and some
influenza strains.
[1]
[4]
[5] Thus,
COVID-19 vaccine clinical research involved
monitoring for VAERD because the vaccine target,
SARS-CoV-2 , belongs to
the same viral subfamily as SARS-CoV and MERS . The effect was not shown in
phase III clinical trials for
Tozinameran or for the
Moderna vaccine .
[2]
[6]
^
a
b Acosta, Patricio L.; Caballero, Mauricio T.; Polack, Fernando P.; Papasian, C. J. (2016).
"Brief History and Characterization of Enhanced Respiratory Syncytial Virus Disease" . Clinical and Vaccine Immunology . 23 (3): 189–195.
doi :
10.1128/CVI.00609-15 .
ISSN
1556-6811 .
PMC
4783420 .
PMID
26677198 .
^
a
b Baden, Lindsey R.; El Sahly, Hana M.; Essink, Brandon; Kotloff, Karen; Frey, Sharon; Novak, Rick; Diemert, David; Spector, Stephen A.; Rouphael, Nadine; Creech, C. Buddy; McGettigan, John; Khetan, Shishir; Segall, Nathan; Solis, Joel; Brosz, Adam; Fierro, Carlos; Schwartz, Howard; Neuzil, Kathleen; Corey, Larry; Gilbert, Peter; Janes, Holly; Follmann, Dean; Marovich, Mary;
Mascola, John ; Polakowski, Laura; Ledgerwood, Julie; Graham, Barney S.; Bennett, Hamilton; Pajon, Rolando; Knightly, Conor; Leav, Brett; Deng, Weiping; Zhou, Honghong; Han, Shu; Ivarsson, Melanie; Miller, Jacqueline; Zaks, Tal (2021).
"Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine" . New England Journal of Medicine . 384 (5): 403–416.
doi :
10.1056/NEJMoa2035389 .
ISSN
0028-4793 .
PMC
7787219 .
PMID
33378609 .
^ Richard W. Compans; Michael B. A. Oldstone (8 October 2014).
Influenza Pathogenesis and Control - Volume I . Springer. pp. 315–320.
ISBN
978-3-319-11155-1 .
^ Agrawal, Anurodh Shankar; Tao, Xinrong; Algaissi, Abdullah; Garron, Tania; Narayanan, Krishna; Peng, Bi-Hung; Couch, Robert B.; Tseng, Chien-Te K. (2016).
"Immunization with inactivated Middle East Respiratory Syndrome coronavirus vaccine leads to lung immunopathology on challenge with live virus" . Human Vaccines & Immunotherapeutics . 12 (9): 2351–2356.
doi :
10.1080/21645515.2016.1177688 .
ISSN
2164-5515 .
PMC
5027702 .
PMID
27269431 .
^ Bottazzi, Maria Elena; Strych, Ulrich; Hotez, Peter J.; Corry, David B. (2020).
"Coronavirus vaccine-associated lung immunopathology-what is the significance?" . Microbes and Infection . 22 (9): 403–404.
doi :
10.1016/j.micinf.2020.06.007 .
ISSN
1286-4579 .
PMC
7318931 .
PMID
32599077 .
^
FDA Review of Efficacy and Safety of Pfizer-BioNTech COVID-19 Vaccine Emergency Use Authorization Request (PDF) . U.S.
Food and Drug Administration (FDA) (Report). 10 December 2020. Retrieved 11 December 2020 .