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. 2022 Aug 10;13:932408. doi: 10.3389/fmicb.2022.932408

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Copyright © 2022 Bigay, Le Grand, Martinon and Maisonnasse.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Proposed mechanisms leading to vaccine-associated enhancement of disease. (A) Antibody-dependent enhancement (ADE), in which cross-reactive vaccine-elicited antibodies fail to neutralize the dengue virus and instead promote viral replication in FcR-bearing cells. (B) Immune complex accumulation and deposition in the lungs, promote (1) an inflammatory environment, (2) the production of antibodies, and (3) activation of the complement cascade. (C) Skewing of the immune response toward a Th2 phenotype, followed by eosinophil infiltration and accumulation in the lungs. Created with BioRender.com.