SARS-CoV-2 vaccines: A critical perspective through efficacy data and barriers to herd immunity

Respir Med. 2021 Apr-May:180:106355. doi: 10.1016/j.rmed.2021.106355. Epub 2021 Mar 6.

Abstract

Non-pharmacological interventions and tracing-testing strategy proved insufficient to reduce SARS-CoV-2 spreading worldwide. Several vaccines with different mechanisms of action are currently under development. This review describes the potential target antigens evaluated for SARS-CoV-2 vaccine in the context of both conventional and next-generation platforms. We reported experimental data from phase-3 trials with a focus on different definitions of efficacy as well as factors affecting real-life effectiveness of SARS-CoV-2 vaccination, including logistical issues associated to vaccine availability, delivery, and immunization strategies. On this background, new variants of SARS-CoV-2 are discussed. We also provided a critical view on vaccination in special populations at higher risk of infection or severe disease as elderly people, pregnant women and immunocompromised patients. A final paragraph addresses safety on the light of the unprecedented reduction of length of the vaccine development process and faster authorization.

Keywords: COVID-19; Primary prevention; SARS-CoV-2; Vaccination.

Publication types

  • Review

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / immunology
  • COVID-19 / prevention & control*
  • COVID-19 Vaccines / pharmacology*
  • Humans
  • Immunity, Herd*
  • Pandemics
  • SARS-CoV-2 / immunology*
  • Vaccination / methods*

Substances

  • COVID-19 Vaccines