Progress and Pitfalls in the Quest for Effective SARS-CoV-2 (COVID-19) Vaccines.
Progress and Pitfalls in the Quest for Effective SARS-CoV-2 (COVID-19) Vaccines.
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DOI：
10.3389/fimmu.2020.579250
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发表时间：
2020
影响因子：
7.3
通讯作者：
Wen SC
中科院分区：
文献类型：
--
作者：
Flanagan KL;Best E;Crawford NW;Giles M;Koirala A;Macartney K;Russell F;Teh BW;Wen SC
目前，全世界约有200种SARS-CoV-2候选疫苗正在进行临床前和临床试验。各种候选疫苗采用了一系列疫苗策略，包括一些新的方法。目前，目标是证明它们在人类中是安全和免疫原性的（1/2期研究），其中几项正在进入2期和3期试验，以证明疗效并收集有关安全性的全面数据。很有可能许多疫苗将被证明能刺激健康个体的抗体和T细胞反应，并具有可接受的安全性，但关键是要确认它们能预防COVID-19。SARS-CoV-2疫苗很有希望在全世界推广，以遏制这一流行病，避免其最具破坏性的影响。然而，这很可能首先需要对关键的弱势群体采取有针对性的办法。目前正在进行合作，以确保生产能够以前所未有的规模和速度进行，以使数十亿人免疫。确保在地球仪范围内公平地进行部署至关重要。需要仔细评估和持续监测安全性，以解决在以前的情况下看到的免疫增强的理论问题。在此，我们回顾了目前的知识，这种新的病毒的免疫反应，因为它涉及到有效和安全的SARS-CoV-2疫苗的设计和范围的新的和既定的疫苗开发方法正在采取。我们提供了一些领先疫苗的细节，并讨论了潜在的问题，包括不良反应，扩大规模和交付。
There are currently around 200 SARS-CoV-2 candidate vaccines in preclinical and clinical trials throughout the world. The various candidates employ a range of vaccine strategies including some novel approaches. Currently, the goal is to prove that they are safe and immunogenic in humans (phase 1/2 studies) with several now advancing into phase 2 and 3 trials to demonstrate efficacy and gather comprehensive data on safety. It is highly likely that many vaccines will be shown to stimulate antibody and T cell responses in healthy individuals and have an acceptable safety profile, but the key will be to confirm that they protect against COVID-19. There is much hope that SARS-CoV-2 vaccines will be rolled out to the entire world to contain the pandemic and avert its most damaging impacts. However, in all likelihood this will initially require a targeted approach toward key vulnerable groups. Collaborative efforts are underway to ensure manufacturing can occur at the unprecedented scale and speed required to immunize billions of people. Ensuring deployment also occurs equitably across the globe will be critical. Careful evaluation and ongoing surveillance for safety will be required to address theoretical concerns regarding immune enhancement seen in previous contexts. Herein, we review the current knowledge about the immune response to this novel virus as it pertains to the design of effective and safe SARS-CoV-2 vaccines and the range of novel and established approaches to vaccine development being taken. We provide details of some of the frontrunner vaccines and discuss potential issues including adverse effects, scale-up and delivery.
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