Accademia Nazionale dei Lincei, Via della Lungara 10, 00165, Rome, Italy.
Istituto Clinico Humanitas IRCCS, Humanitas University, via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy.
Cell Death Differ. 2021 Feb;28(2):626-639. doi: 10.1038/s41418-020-00720-9. Epub 2021 Jan 21.
In the eleven months elapsed since the identification of the SARS-CoV-2 virus and its genome, an exceptional effort by the scientific community has led to the development of over 300 vaccine projects. Over 40 are now undergoing clinical evaluation, ten of these are in Phase III clinical trials, three of them have ended Phase III with positive results. A few of these new vaccines are being approved for emergency use. Existing data suggest that new vaccine candidates may be instrumental in protecting individuals and reducing the spread of pandemic. The conceptual and technological platforms exploited are diverse, and it is likely that different vaccines will show to be better suited to distinct groups of the human population. Moreover, it remains to be elucidated whether and to what extent the capacity of vaccines under evaluation and of unrelated vaccines such as BCG can increase immunological fitness by training innate immunity to SARS-CoV-2 and pathogen-agnostic protection. Due to the short development time and the novelty of the technologies adopted, these vaccines will be deployed with several unresolved issues that only the passage of time will permit to clarify. Technical problems connected with the production of billions of doses and ethical ones connected with the availably of these vaccines also in the poorest countries, are imminent challenges facing us. It is our tenet that in the long run more than one vaccine will be needed to ensure equitable global access, protection of diverse subjects and immunity against viral variants.
自 SARS-CoV-2 病毒及其基因组被鉴定以来的十一个月里，科学界付出了非凡的努力，已经开发了 300 多个疫苗项目。目前有 40 多个正在进行临床评估，其中 10 个处于 III 期临床试验阶段，其中 3 个已经完成了 III 期临床试验并取得了积极结果。其中一些新疫苗已获准紧急使用。现有数据表明，新的候选疫苗可能有助于保护个人并减少大流行的传播。所利用的概念和技术平台多种多样，不同的疫苗可能更适合人类不同群体。此外，仍有待阐明评估中的疫苗以及卡介苗等无关疫苗是否以及在何种程度上能够通过训练先天免疫对 SARS-CoV-2 产生免疫适应性，并提供针对病原体的保护。由于开发时间短，采用的技术新颖，这些疫苗将面临一些尚未解决的问题，只有随着时间的推移才能澄清这些问题。与数十亿剂疫苗生产相关的技术问题以及在最贫穷国家提供这些疫苗的道德问题，是我们即将面临的紧迫挑战。我们的原则是，从长远来看，需要不止一种疫苗来确保公平获得全球疫苗、保护不同人群并防止病毒变异。
