In “Knife’s edge: Balancing immunogenicity and reactogenicity in mRNA vaccines, “four experts in the field of vaccine development discuss along with the positive, importantly some of the negative data points associated with the mRNA COVID-19 vaccines—adverse side effects, via an analysis into “mechanistic insights into immune responses and adverse effects.” What are the promises of mRNA vaccines plus what are the challenges when “balancing immunogenicity and adverse effects?” While the mRNA vaccines show remarkable promise, including actual real-world performance in reducing morbidity and mortality associated with SARS-CoV-2, challenges remain ague the authors. From inefficient B-cell targeting leading to challenges with breadth of performance, to the reality that an integrated robustly stimulated humoral response with effective T-cell mediated immunity continues to be an unobtainable goal, especially at mucosal sites. When it comes to adverse events associated with the mRNA-based COVID-19 vaccines the authors emphasize the absolute need to become safer, a recognition as to the problem of safety with the current batch of first-generation technologies. This recognition also is testimony to the vaccine injured, in many cases mandated to get the jab and then denied care, often gaslighted along the way. One mechanistic benefit also turns out to elicit a problem as natural killer (NK)/monocyte subsets, dendritic cell (DC) subsets, and NK T-like cells contribute to both mRNA vaccine effects (increasing neutralizing antibody titer) but also adverse side effects. These cells boost IFN-y-inducible chemokines. The authors raise the specter that the high effectiveness benefits, at least for a duration, associated with the mRNA vaccines may come at a safety cost—such be benefit are linked to numerous side effects. That “maintaining an appropriate balance of the two opposing responses” remans mission critical for any “suitable vaccine.”
Following, the authors of this paper published in Nature, summarize the downside costs of the upside benefits the mRNA COVID-19 vaccines, plus corresponding mechanism of action.
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