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Existing literature suggests that eosinophils also can play a role in host antiviral responses, typically type 1 immune events, against multiple respiratory viruses, both directly through release of antiviral mediators and indirectly through activation of other effector cell types. One way to prime host immune responses toward effective antiviral responses is through vaccination, where typically a type 1\u2013skewed immunity is desirable in the context of intracellular pathogens like respiratory viruses. In the realm of breakthrough respiratory viral infection in vaccinated hosts, an event in which virus can still establish productive infection despite preexisting immunity, eosinophils are most prominently known for their link to vaccine-associated enhanced respiratory disease upon natural respiratory syncytial virus infection. This was observed in a pediatric cohort during the 1960s following vaccination with formalin-inactivated respiratory syncytial virus. More recent research has unveiled additional roles of the eosinophil in respiratory viral infection and breakthrough infection. The specific contribution of eosinophils to the quality of vaccine responses, vaccine efficacy, and antiviral responses to infection in vaccinated hosts remains largely unexplored, especially regarding their potential roles in protection. On the basis of current findings, we will speculate upon the suggested function of eosinophils and consider the many potential ways by which eosinophils may exert protective and pathological effects in breakthrough infections. We will also discuss how to balance vaccine efficacy with eosinophil-related risks, as well as the use of eosinophils and their products as potential biomarkers of vaccine efficacy or adverse events.<\/jats:p>","DOI":"10.1093\/jleuko\/qiae010","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T17:46:36Z","timestamp":1706636796000},"page":"224-243","source":"Crossref","is-referenced-by-count":5,"title":["Ally, adversary, or arbitrator? The context-dependent role of eosinophils in vaccination for respiratory viruses and subsequent breakthrough infections"],"prefix":"10.1093","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3287-3987","authenticated-orcid":false,"given":"Lauren A","family":"Chang","sequence":"first","affiliation":[{"name":"Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, New York, NY 10029 , United States"},{"name":"Department of Microbiology, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, Box 1124, New York, NY 10029 , United States"},{"name":"Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, Box 1124, New York, NY 10029 , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schotsaert","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, Box 1124, New York, NY 10029 , United States"},{"name":"Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, Box 1124, New York, NY 10029 , United States"},{"name":"Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai , 1425 Madison Avenue, Box 1630, New York, NY 10029 , United States"},{"name":"Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, New York, NY 10029 , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"2024072520195516500_qiae010-B1","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.3389\/fmicb.2020.01526","article-title":"Impact of vaccines; health, economic and social perspectives","volume":"11","author":"Rodrigues","year":"2020","journal-title":"Front Microbiol"},{"issue":"16","key":"2024072520195516500_qiae010-B2","doi-asserted-by":"crossref","first-page":"4031","DOI":"10.1073\/pnas.1704507114","article-title":"Simply put: vaccination saves lives","volume":"114","author":"Orenstein","year":"2017","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"1","key":"2024072520195516500_qiae010-B3","doi-asserted-by":"crossref","first-page":"3764","DOI":"10.1038\/s41467-022-31494-y","article-title":"Effect of vaccination on household transmission of SARS-CoV-2 delta variant of 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