Implications of antibody-dependent enhancement of infection for SARS-CoV-2 countermeasures

“ADE has been observed with dengue virus, Zika virus, Ebola virus and, importantly in the context of COVID-19, coronaviruses (CoVs)… We believe that it is important to consider ADE in the context of efforts to develop countermeasures against the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Indeed, data from previous CoV research strongly suggest that ADE may play a role in the virus’s pathology… 

Although efficacy data on human CoV vaccines are lacking, results from preclinical models suggest that certain vaccine designs are more likely to induce ADE immune responses than others… 

In fact, preclinical studies employing various animals, including mice, hamsters, ferrets and macaques, provided evidence that SARS-CoV vaccines are capable of causing an ADE response… 

Although the development of vaccines and therapeutics for SARS-CoV-2 remains urgent, we must proceed with caution, using the full armory of vaccine and protein design tools at our disposal to rationally minimize the risk of ADE.”