Harnessing co‐operative immune augmentation by contact allergens to enhance the efficacy of viral vaccines

Abstract

Although the development of successful vaccines against coronaviruses may be achieved, for some individuals the immune response that they stimulate may prove to be insufficient for effective host defence. The principle that a relatively strong contact allergen will have an enhancing effect on sensitization compared with a less potent contact allergen if they are co-administered, may not, at first, appear relevant to this issue. However, this augmentation effect is thought to be due to the sharing of common or complementary pathways. Here, we briefly consider aspects of the shared and complementary pathways between skin sensitization induced by exposure to a contact allergen and the immune response to viruses, with particular reference to COVID-19. The relationship leads us to explore whether this principle, which we name here as "co-operative immune augmentation" may be extended to include viral vaccination. We consider evidence that even relatively weak contact allergens, used in vaccines for other purposes, can show enhanced sensitization, which is in keeping with a cooperative augmentation principle. Finally, we consider how the potent contact allergen diphenylcyclopropenone could be employed safely as an enhancer of vaccine responses.

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

“…Moreover, it should be mentioned that “COVID-arm” may appear atypical in ethnic groups other than Caucasians [ 71 ]. Of note, deliberately using contact allergens in vaccines to boost immunogenicity is a concept that was proposed by a group from the UK in 2020 [ 72 ]. This concept might further enhance hypersensitivity reactions to vaccines and, accordingly, has not entered standard care.…”