The COVID-19 vaccine development: A pandemic paradigm

• Published in: Virus research 2021-08, Vol.301, p.198454-198454, Article 198454
• Main Authors: Carneiro, Diego C., Sousa, Jéssica D., Monteiro-Cunha, Joana P.
• Format: Article
• Language: English
• Subjects: Antibodies, Neutralizing; Antibodies, Viral; Antibody-Dependent Enhancement; Coronavirus; COVID-19 - prevention & control; COVID-19 - virology; COVID-19 Vaccines; Emergency use; Humans; Pandemics - prevention & control; SARS-CoV-2; SARS-CoV-2 - immunology; Vaccine safety; Vaccine strategies
• ISSN: 0168-1702; 1872-7492
• DOI: 10.1016/j.virusres.2021.198454

•The use of state-of-the-art sequencing and reverse genetics can reduce the development time of conventional vaccines during epidemics.•The platform, adjuvant(s), form of administration, age, and pre-existing cross-reactive immunity essentially determine the safety of a vaccine.•Vaccine-resistant variants might emerge, meaning that COVID-19 vaccines may need an update.•Vaccination needs to achieve sufficient equality between all countries for the world to return to a pre-pandemic status. COVID-19 pandemic has resulted in millions of deaths and a social-economic crisis. A worldwide effort was made to develop efficient vaccines for this disease. A vaccine should produce immune responses with specific and neutralizing antibodies, and without harmful effects such as the antibody-dependent enhancement that may be associated with severe acute respiratory syndrome. Vaccine design involves the selection of platforms that includes viral, viral-vector, protein, nucleic acid, or trained immunity-based strategies. Its development initiates at a pre-clinical stage, followed by clinical trials when successful. Only if clinical trials show no significant evidence of safety concerns, vaccines can be manufactured, stored, and distributed to immunize the population. So far, regulatory authorities from many countries have approved nine vaccines with phase 3 results. In the current pandemic, a paradigm for the COVID-19 vaccine development has arisen, as many challenges must be overcome. Mass-production and cold-chain storage to immunize large human populations should be feasible and fast, and a combination of different vaccines may boost logistics and immunization. In silico trials is an emerging and innovative field that can be applied to predict and simulate immune, molecular, clinical, and epidemiological outcomes of vaccines to refine, reduce, and partially replace steps in vaccine development. Vaccine-resistant variants of SARS-CoV-2 might emerge, leading to the necessity of updates. A globally fair vaccine distribution system must prevail over vaccine nationalism for the world to return to its pre-pandemic status.