Adolfo García-Sastre
Director of the Institute for Global Health and Emerging Pathogens at Mount Sinai Hospital in New York
The article is of very good quality. A very detailed study is made of the repertoire of H5 antibody-producing cells already present in circulation in humans prior to exposure to H5 using state-of-the-art technology.
The article implies that we are prepared for our immune system to respond quickly if we are infected by H5 virus, which could reduce the cases of severe disease in the event of a pandemic.
The characterized cells are still a minority component and it is known that human infections with H5 can be fatal, as this has happened very infrequently in the past. Although the data indicate that we would respond very quickly to vaccination in a favorable manner, and that only one dose of vaccine is likely to be needed to achieve protection, it does not imply that if an H5 pandemic were to be triggered it would not be of even greater severity than SARS-CoV-2. We cannot be sure how severe such a pandemic would be, if it occurs, because even if the antibodies we already have help, we still need to expand these antibodies during infection to completely eliminate the virus, and if the virus replicates too quickly, the expansion of antibodies may come too late for some people, and severe disease may develop.