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  • The identification of elevated IL-6 levels in patients with severe COVID-19 led to the rapid development of clinical trials targeting this cytokine. Overall, these trials do not support the widespread use of IL-6 antagonists in hospitalized patients with mild-to-moderate disease, but IL-6 antagonists may be beneficial when rapidly deployed in patients with severe COVID-19, as we discuss here.

    • Simon A. Jones
    • Christopher A. Hunter
  • This Comment outlines how the recently licensed vaccines for COVID-19 activate innate immune mechanisms to promote immune memory to SARS-CoV-2. The authors also consider future challenges that could limit vaccine efficacy.

    • John R. Teijaro
    • Donna L. Farber
  • Reassuring data from accidental pregnancies that have occurred in the clinical trials of approved COVID-19 vaccines indicate that vaccination does not harm fertility or increase the rate of miscarriage.

    • Victoria Male
  • The COVID-19 pandemic has stressed the importance of understanding species such as bats that can serve as reservoirs for emerging viral threats. Here, Wang and colleagues call for greater consensus among the bat immunology community in five key areas.

    • Lin-Fa Wang
    • Akshamal M. Gamage
    • Emma C. Teeling
  • Here, Veldhoen and Simas discuss why immunity to SARS-CoV-2 in populations may ultimately be driven by the endemic presence of the virus and not rely on continued mass vaccination programmes.

    • Marc Veldhoen
    • J. Pedro Simas
  • Neurological symptoms are increasingly being observed in patients with COVID-19; this Comment article considers whether cross-reactive antibodies might contribute to the pathology associated with SARS-CoV-2 infection.

    • Jakob Kreye
    • S. Momsen Reincke
    • Harald Prüss
  • During the current COVID-19 pandemic, the concept of herd immunity has become a topic of much debate. This Comment examines the factors that determine it, discusses how far we have come and considers what it will take to reach herd immunity safely.

    • Arnaud Fontanet
    • Simon Cauchemez
  • In this Comment, Jeong Seok Lee and Eui-Cheol Shin discuss contradictory results regarding the downregulation or upregulation of type I interferon responses in patients with COVID-19 and the implications for therapies that target this pathway.

    • Jeong Seok Lee
    • Eui-Cheol Shin
  • In this Comment article, Becker and colleagues consider how the excessive release of reactive oxygen species by neutrophils may perpetuate red blood cell dysfunction, thrombosis and tissue damage in severe cases of COVID-19.

    • Mireille Laforge
    • Carole Elbim
    • Chrystel Becker
  • Recent studies have shown T cell reactivity to SARS-CoV-2 in 20–50% of unexposed individuals; it is speculated that this is due to T cell memory to common cold coronaviruses. Here, Crotty and Sette discuss the potential implications of these findings for disease severity, herd immunity and vaccine development.

    • Alessandro Sette
    • Shane Crotty
  • Rebecca Chandler from the Uppsala Monitoring Centre discusses how the COVID-19 pandemic could be the catalyst that propels vaccine safety surveillance into the twenty-first century.

    • Rebecca E. Chandler