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The potential danger of suboptimal antibody responses in COVID-19

There are now multiple vaccine candidates (including nucleic acid vaccines, viral vector vaccines & subunit vaccines) in the preclinical & clinical trial stages as researchers and institutes from all over the world come together to accelerate the development of a SARS-CoV-2 vaccine. Recent studies of antibody responses in patients w/COVID-19 have associated higher titres of anti-N IgM & IgG at all time points following the onset of symptoms with a worse disease outcome16. Moreover, higher titres of anti-S and anti-N IgG & IgM correlate with worse clinical readouts and older age, suggesting potentially detrimental effects of antibodies in some patients. We argue that ADE should be given full consideration in the safety evaluation of emerging candidate vaccines for SARS-CoV-2. In addition to vaccine approaches, monoclonal antibodies could be used to tackle this virus. Unlike vaccine-induced antibodies, monoclonal antibodies can be engineered w/molecular precision. Safe & effective neutralizing antibodies could be produced on a mass-scale for delivery to populations across the world in the coming months.

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