A historic vaccination campaign is picking up speed in Germany. But in addition to the hope of an end to the pandemic, questions also arise. The doctor Dr. Woodpecker on facts and myths about vaccination. This time: Could those who have been vaccinated be more likely to get a corona variant? A vaccine is considered the drug of choice in the fight against Sars-CoV-2. However, experience with other pathogens shows that vaccination can also backfire. This was shown by the setback with the dengue vaccine in the Philippines. It is now believed that the vaccination contributed to people dying from tropical fever. Variants of the dengue virus played an important role. In the case of Sars-CoV-2, different variants are now circulating – could a vaccination also do more harm than good in this case?

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The Philippines are particularly hard hit by the dengue virus-induced disease. Hundreds of thousands fall ill every year, many of them children. It was therefore this island state that began using the new dengue vaccine Dengvaxia for the first time for mass vaccinations in 2016. But after more than 800,000 children were vaccinated, problems arose. The government stopped the vaccination program. She later discovered that 130 vaccinated children had died – 19 of them had dengue fever. One reason could be the ADE phenomenon – it stands for Antibody-Dependent Enhancement, for example antibody-dependent disease enhancement. “The ADE phenomenon cannot be understood immediately, it doesn’t sound logical,” says the doctor and tropical medicine specialist Dr. Christoph Specht ntv.de. “There are four different serotypes, ie different variants of the dengue virus, which essentially cause the same clinical picture.” If you get sick with one serotype first, symptoms such as fever and chills appear, but these are usually not severe. “If you are then infected with a second serotype of dengue, you will often find that the second course of the disease is significantly worse,” says Specht. This could lead to a hemorrhagic disease in which – similar to Ebola – the blood vessels break open.

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But how does ADE come about? Normally, antibodies should prevent an infection. Not so with ADE. “This can be explained by the fact that the antibodies formed against one serotype make the infection easier for the second serotype, that is, another virus variant, which can have a destructive effect,” explains Specht. A vaccine can have similar consequences in people who have never been infected with the dengue virus. “It has been seen that it is worse when you vaccinate than if you hadn’t done it,” said the doctor, referring to the vaccination debacle in the Philippines. The risk of ADE was also taken into account when developing Covid-19 vaccines, said Specht. “But animal experiments already showed that this phenomenon did not occur.” Even with the many millions of people who have been vaccinated so far, this has not yet been observed. Conclusion: “The risk of ADE is currently unlikely with a Covid 19 vaccination,” says Specht. However, it cannot be ruled out whether that will change if there are various other serotypes. “At the moment, this problem does not seem to exist.”

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