Anonymous, Sucharit Bhakdi, Michael Palmer

Many countries are currently experiencing a wave of COVID-19 “breakthrough cases” in spite of high vaccination rates. In this paper, we explain the fundamental reason why such cases had to be expected: the antibodies induced by intramuscular vaccination will only circulate in the bloodstream, but they will not reach the surface of the mucous membranes in the upper airways. We also briefly discuss possible mechanisms of vaccine-induced immunopathology.