Negative Evidence for Antibody-Dependent Enhancement of COVID-19 Discussed in Journal of American Physicians and Surgeons

TUCSON, Ariz., March 28, 2022 (GLOBE NEWSWIRE) — Antibody-dependent enhancement (ADE) is the puzzling paradox in which virus-specific antibodies, instead of neutralizing the virus, enhance its entry to cells and its replication. Vaccine-related ADE (VADE) is a potential concern with COVID-19 vaccines because it occurred in animals receiving a vaccine against the related SARS-CoV-1 virus, writes Jane Orient, M.D., in the spring issue of the Journal of American Physicians and Surgeons.

The desired outcome of vaccination against a specific pathogen is to prevent illness or at least to prevent severe illness, she writes. In case the vaccine does not induce a strong enough response, an unexpected severe breakthrough illness may occur. But in case of VADE, the result is paradoxically a much more severe illness than if the person had been unvaccinated.   

The clinician can suspect VADE in any vaccinated patient with an unusually severe illness. Even though the treatment will be the same as for any severe case, VADE is very significant because it indicates that vaccination can cause more harm than benefit, Dr. Orient states.   

The lack of reports of VADE seems to be reassuring, but Dr. Orient asks, “Does this constitute ‘negative evidence’?”   

The term “negative evidence” means “evidence for a theory provided by the nonoccurrence or absence of something.” It is not the same thing as mere absence of evidence, she points out. Rather, the lack of expected data constitutes evidence of deliberate hiding of information. Hence, negative evidence must be assiduously sought by astute investigators.

Because the VADE phenomenon is well-known and has occurred in similar circumstances, there should be a plethora of studies underway to find COVID vaccine-related ADE (CVADE) or rule it out, Dr. Orient writes. But this is not happening. We may not see evidence of CVADE not because it does not exist but because no one is looking for it.     

She concludes: “Why is this question being pursued at a turtle’s pace rather than at warp speed?” Is this negative evidence of an attempt to cover up an inconvenient answer?     

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.