Abstract

Whether spike protein is present in skin, and where it comes from, has been asked twice: first of infected patients, then of vaccinated ones. Detection in the infection era rested on immunohistochemistry with reagents later shown, by one of the groups that used them, to stain pre-pandemic tissue. Nucleocapsid is actively secreted independently of virion assembly and circulates two orders of magnitude above free spike. Its presence in perfused tissue says nothing about local replication. Endothelial cells lack ACE2 and are not productively infected. This excludes local viral synthesis as a source of endothelial spike. Against this background, several vaccine-era reports share a feature the earlier literature lacks: spike positive with nucleocapsid negative, in patients whose infection has been serologically excluded. The intervals from mRNA injection range from 10 to 1,364 days.