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COVID-19 vaccines: concerns beyond protective efficacy and safety.
Lai, Chih-Cheng; Chen, I-Tzu; Chao, Chien-Ming; Lee, Ping-Ing; Ko, Wen-Chien; Hsueh, Po-Ren.
  • Lai CC; Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.
  • Chen IT; Department of Pharmacy, National Taiwan University Cancer Center, Taipei, Taiwan.
  • Chao CM; Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
  • Lee PI; Department of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
  • Ko WC; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • Hsueh PR; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Expert Rev Vaccines ; 20(8): 1013-1025, 2021 08.
Article in English | MEDLINE | ID: covidwho-1284827
ABSTRACT

INTRODUCTION:

Several vaccine candidates have been developed using different platforms, including nucleic acids (DNA and RNA), viral vectors (replicating and non-replicating), virus-like particles, peptide-based, recombinant proteins, live attenuated, and inactivated virus modalities. Although many of these vaccines are undergoing pre-clinical trials, several large clinical trials investigating the clinical efficacy and safety of coronavirus disease 2019 (COVID-19) vaccines have produced promising findings. AREAS COVERED In this review, we provide a status update on COVID-19 vaccines currently undergoing clinical trials and discuss issues of concern beyond vaccine efficacy and safety, including dosing regimens, the mixed vaccine strategy, prior severe acute respiratory syndrome coronavirus-2 infection, antibody levels, cellular immunity and protection, variants of concern, COVID-19 vaccine distribution, vaccination willingness, herd immunity, immunity passports, and vaccine indications. EXPERT OPINION Four vaccines have obtained emergency use authorization, 87 are at the clinical development stage, and 186 are in pre-clinical development. While the knowledge and development of COVID-19 vaccines is rapidly expanding, the benefits of COVID-19 vaccines must outweigh the potential risks of adverse events. To combat the COVID-19 pandemic, clinicians should consistently update COVID-19-associated information, and healthcare authorities and manufacturers should work together to provide adequate and appropriate vaccinations for the prevention of COVID-19. PLAIN LANGUAGE

SUMMARY:

What is the context?Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused a global pandemic the coronavirus disease 2019 (COVID-19) outbreak. The development and implementation of the COVID-19 vaccine could be an important measure to control the COVID-19 pandemic.What is new?Several phase 3 clinical trials have demonstrated the effectiveness and safety of COVID-19 vaccines for the prevention of SARS-CoV-2 infections. Several COVID-19 vaccines have obtained emergency use authorization and been implemented in many countries. Although concerns regarding unusual blood clots and low platelet counts have been raised, the benefits of COVID-19 vaccines outweigh the potential risks of adverse events.What is the impact?Except for children, the COVID-19 vaccine is recommended for all people, including those pregnant or immunocompromised. Healthcare authorities should advise people receiving the vaccine that they must seek medical attention if they have associated thromboembolism and thrombocytopenia symptoms. More studies are necessary to determine the appropriate vaccine dose and regimen strategy, as well as the effectiveness of COVID-19 vaccines against variants of concerns. A global effort must be made to achieve widespread vaccination and herd immunity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Safety / COVID-19 Vaccines / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Limits: Animals / Female / Humans / Male / Pregnancy Language: English Journal: Expert Rev Vaccines Journal subject: Allergy and Immunology Year: 2021 Document Type: Article Affiliation country: 14760584.2021.1949293

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Safety / COVID-19 Vaccines / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Limits: Animals / Female / Humans / Male / Pregnancy Language: English Journal: Expert Rev Vaccines Journal subject: Allergy and Immunology Year: 2021 Document Type: Article Affiliation country: 14760584.2021.1949293