“…However, it is unclear whether these vaccines elicit tissue-resident memory T cell responses (T RM ) that are critical for preventing transmission and providing sustained protection against disease. Another important consideration in vaccine design is the possibility of vaccine associated enhanced respiratory disease (VAERD), which is the development of a more severe form of disease manifested after vaccination against the causative agent (DiPiazza et al, 2021; Halstead and Katzelnick, 2020; Liang et al, 2020; Seephetdee et al, 2021; Sekine et al, 2020) VAERD, which correlates with Th2 immune responses, is elicited by whole cell inactivated vaccines or Th1/Th2 skewing adjuvants such as alum. VAERD is reported as a side effect for inactivated vaccines against multiple pathogens, including respiratory syncytial virus (Graham et al, 1993; Kim et al, 1969), measles (Fulginiti et al, 1967; Nader et al, 1968), and SARS-CoV and MERS-CoV which are closely related to SARS-CoV-2 (Agrawal et al, 2016; Czub et al, 2005; See et al, 2006; Tseng et al, 2012).…”