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ANTIBODY DEPENDENT ENHANCEMENT
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News regarding the readiness of the Indonesian government to immediately start the COVID-19 vaccination process for the wider community was welcomed by various groups. How could it not, it has been almost a year since the Indonesian people and people around the world have had to make major adjustments and restrictions on their lifestyle and activities that they have been doing. The COVID-19 pandemic has not only caused a negative impact on public health, but has also dragged various other aspects of life - such as financial and social - into a downturn. So it is not surprising that even the slightest good news will be welcomed happily by the public.
In previous articles, we have discussed the process of producing and testing vaccines, as well as vaccine candidates that are the target of the Indonesian government. In this article, we will discuss a phenomenon that has recently become a byword in the community, because it is one of the potential concerns of giving the COVID-19 vaccine.
The phenomenon we are going to talk about is called Antibody-Dependent Enhancement (ADE). If we look at the definition literally, this phenomenon is a condition in which there is an increase or acceleration of certain activities caused by the presence of an antibody. Unfortunately, the increase in this phenomenon is not a good thing and we want. What actually happens is an increase in the severity of a disease, which occurs as a result of the presence of certain antibodies in the body.
How can this phenomenon occur?
In the ADE phenomenon, vaccine administration will indeed form an antibody. However, these antibodies will not help our bodies fight infection, they will actually help viruses that enter the body more easily infect our bodies. With ADE, an infected body that has previously received vaccinations will have the potential to experience a more severe degree of disease.
The ADE condition is of course not just a theory. The potential for ADE itself has indeed appeared in the dengue haemorrhagic fever (DHF) vaccine. In 1977, Scott Halstead, a virologist at the University of Hawaii, noticed the unexpected, unknown phenomenon of dengue fever. Animals that have produced antibodies to one of the four strains of dengue fever virus got more sick when they were exposed to the disease the second time. It is thought that the cause is that the antibodies produced during the first exposure give the second virus a chance to enter the body.
Apart from the dengue vaccine, the ADE phenomenon has also appeared in the research of SARS, MERS, Ebola, RSV, and HIV vaccines in silico (computer simulation) and in vitro (experiments in laboratory petri dishes). In humans, the phenomenon of ADE in these vaccines cannot be proven because there is no adequate, long, and extensive research.
Although ADE is indeed a serious problem, there has been no evidence or reports of ADE in any clinical trials of the COVID-19 vaccine. Professor of UNPAD Faculty of Medicine who is also the Chair of the UNPAD COVID-19 Vaccine Research Team, Prof. Dr. Kusnandi Rusmil, dr., Sp.A (K), M.M. emphasized that until now, the phenomenon of ADE that is of concern has not appeared in any clinical trials of the COVID-19 vaccine. However, this is not a reason for us to be careless, as vigilance and monitoring of vaccine safety are a priority in the clinical trial process. In particular, taking into account that the vaccine manufacturing process is much shorter when compared to the manufacturing process of vaccines in general.
We all agree, of course, that we want a vaccine for COVID-19 to be found as soon as possible, so that we can 'return' to our pre-COVID-19 life. However, it must be said that a vaccine, whose safety and efficacy have not been tested, could be worse than the absence of a vaccine. We certainly do not want to receive a vaccine that has not been tested for safety and efficacy. We don't want our society to have a "false sense of security", triggered by the assumption that they "feel immune" from COVID-19, which tends to let people down and ignore health protocols. Because in fact, the vaccination we can most rely on at this time is to remain consistent and patient to carry out proper and correct health protocols.
Author
dr. Laras Prabandini Sasongko, AAAIJ
Email: laras@indonesiare.co.id
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