Vaccine-induced enhancement of viral infections

Abstract

Examples of vaccine-induced enhancement of susceptibility to virus infection or of aberrant viral pathogenesis have been documented for infections by members of different virus families. Several mechanisms, many of which still are poorly understood, are at the basis of this phenomenon. Vaccine development for lentivirus infections in general, and for HIV/AIDS in particular, has been little successful. Certain experimental lentiviral vaccines even proved to be counterproductive: they rendered vaccinated subjects more susceptible to infection rather than protecting them. For vaccine-induced enhanced susceptibility to infection with certain viruses like feline coronavirus, Dengue virus, and feline immunodeficiency virus, it has been shown that antibody-dependent enhancement (ADE) plays an important role. Other mechanisms may, either in the absence of or in combination with ADE, be involved. Consequently, vaccine-induced enhancement has been a major stumble block in the development of certain flavi-, corona-, paramyxo-, and lentivirus vaccines. Also recent failures in the development of a vaccine against HIV may at least in part be attributed to induction of enhanced susceptibility to infection. There may well be a delicate balance between the induction of protective immunity on the one hand and the induction of enhanced susceptibility on the other. The present paper reviews the currently known mechanisms of vaccine-induced enhancement of susceptibility to virus infection or of aberrant viral pathogenesis.

Inactivated virus vaccines from chemistry to prophylaxis: merits, risks and challenges

“…A poor immune response on vaccination can even lead to atypical or enhanced disease after infection of vaccinated recipients. This is most likely due to the poor induction of neutralizing antibody responses together with the formation of immune complexes between virus and antibodies, and further facilitated uptake and infection of these complexes by monocytic cells, termed antibody-dependent enhanced infection [36]. This is observed with inactivated measles [37] and RSV [34,38] vaccines.…”

Advances and challenges towards a vaccine against Chagas disease

“…Importantly, this situation is very similar to that of several other pathogens for which there is also concern about vaccine-increased susceptibility to infection. 71,72 A typical example is dengue virus, in which case antibody-dependent enhancement (ADE) caused by weakly neutralizing but cross-reactive antibodies is believed to favor a secondary infection by a heterologous serotype of the virus. While the mechanisms of these processes are still not understood in detail, these aspects are carefully taken into consideration in vaccine development to avoid such adverse effects.…”

Selection of Adjuvants for Enhanced Vaccine Potency

“…On the other hand, infinite enhancement of vaccine immunity may not the best choice for developing vaccines against certain viruses. This is because vaccines can actually enhance the susceptibility of the host to virus infection, such as certain flavi-, corona-, paramyxo-, immunodeficiency-, and lentivirus vaccines, likely due to antibody-dependent enhancement of viral entry [459].…”