July 4, 2022

Q&A #17 : What advice could one offer to vaccinees in the event that an immune escape Sars-CoV-2 variant adapts to the highly vaccinated population such as to enable high infectiousness combined with high virulence?

Even though few people seem to understand the threat, I am convinced that we’ll soon have to deal with tons of cases of ADEI-mediated enhancement of C-19 disease in vaccinees, leading to enhancement of severe disease. We’ll need tons of antivirals. However, in order for antivirals to be efficient in these patients, they should not be administered prophylactically, but after the onset of first symptoms. In that way they enable the virus to train innate immunity without boosting the non-neutralizing antibodies, which I am convinced will soon lose their virulence-inhibiting effect. When that happens, their infection-enhancing effect will simply precipitate severe disease and death.

The ‘Infection and treat’ protocol is well known in the veterinary field. Livestock is sometimes infected on purpose and then treated when symptoms appear as a way to immunize against diseases known to be partially controlled by cell-mediated innate immunity. We do this when no live attenuated vaccines are available. However, even if we had live attenuated C-19 vaccines available, they would not be helpful as they would simply make the situation worse due to boosting of the infection-enhancing antibodies. When the “Infection and treat” protocol is applied at the very first signs of disease, it enables the stimulation of innate immunity without triggering adaptive immunity. This way, one can at least train the innate immune system to take out a big chunk of the viral load upon next exposure. This will allow vaccinees to improve training of their innate immune system up to a level where the ‘remaining’ viral load will eventually no longer suffice to recall their infection-enhancing antibodies (because of ‘antigenic sin’). This protocol should eventually allow us to significantly decrease the risk of severe disease and death in vaccinees, even without early antiviral treatment.

Of course, administering antivirals prophylactically, before the onset of symptoms, will not have that effect, and might even lead to generating resistance, thereby preventing any progress!

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Geert Vanden Bossche received his DVM from the University of Ghent, Belgium, and his PhD degree in Virology from the University of Hohenheim, Germany. He held adjunct faculty appointments at universities in Belgium and Germany. After his career in Academia, Geert joined several vaccine companies (GSK Biologicals, Novartis Vaccines, Solvay Biologicals) to serve various roles in vaccine R&D as well as in late vaccine development.

Geert then moved on to join the Bill & Melinda Gates Foundation’s Global Health Discovery team in Seattle (USA) as Senior Program Officer; he then worked with the Global Alliance for Vaccines and Immunization (GAVI) in Geneva as Senior Ebola Program Manager. At GAVI he tracked efforts to develop an Ebola vaccine. He also represented GAVI in fora with other partners, including WHO, to review progress on the fight against Ebola and to build plans for global pandemic preparedness.

Back in 2015, Geert scrutinized and questioned the safety of the Ebola vaccine that was used in ring vaccination trials conducted by WHO in Guinea. His critical scientific analysis and report on the data published by WHO in the Lancet in 2015 was sent to all international health and regulatory authorities involved in the Ebola vaccination program. After working for GAVI, Geert joined the German Center for Infection Research in Cologne as Head of the Vaccine Development Office. He is at present primarily serving as a Biotech / Vaccine consultant while also conducting his own research on Natural Killer cell-based vaccines.


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