Lecture abstract: My talk will focus on the care of patients with long COVID and vaccine injury and discuss clinically relevant biomarkers to guide or monitor the effects of therapies. I will talk about the potential correlation between spike antibody levels, severity of symptoms, and changes in symptoms in response to various treatments. Based on this, I will explore implications for practice, including support for the effects of autophagy, validation of exposure to a shedding event as a possible cause of new or increased symptoms, and/or an indication to evaluate and treat close contacts of recently vaccinated patients. Finally, I will discuss therapeutics that can reduce spike levels and/or reduce symptoms.