**6. Safety of Anti-IL-13 Vaccination**

In light of the above-detailed roles of IL-13 and IL-4, it is both highly significant and reassuring that a large double-blind controlled study on almost 180 patients did not find any effect of tetanus vaccine-induced specific IgG formation after twelve weeks of dupilumab treatment [65]. Furthermore, emerging post-marketing surveillance data of patients on dupilumab confirms an approximately 10% incidence of conjunctivitis. In one recent real-world review of 54 patients, 2 patients had to discontinue due to, or for reasons related to, conjunctivitis symptoms [66]. Since this drug-specific side effect had already been recognised during pre-marketing phase II–III studies and continues to be non-reported in any anti-IL-13 treated cohort, it is highly likely that conjunctivitis will not be associated with long-term IL-13 elimination. Furthermore, a growing array of meta-analyses, and systematic reviews of anti-IL-13 MAb-treated patients fail to uncover target-related limiting adverse events in large patient groups [27,67–69].
