Department of Clinical Immunology, Medical Faculty, University Hospital "Lozenetz", Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407, Sofia, Bulgaria.
First Department of Internal Medicine, Faculty of Medicine, Medical University-Varna, 55 Marin Drinov Str., Varna, 9002, Bulgaria.
Rheumatol Int. 2021 Mar;41(3):509-518. doi: 10.1007/s00296-021-04792-9. Epub 2021 Jan 30.
Coronavirus disease 2019 (COVID-19) pandemic has become challenging even for the most durable healthcare systems. It seems that vaccination, one of the most effective public-health interventions, presents a ray of hope to end the pandemic by achieving herd immunity. In this review, we aimed to cover aspects of the current knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and vaccine candidates in the light of autoimmune inflammatory diseases (AIIDs) and to analyze their potential in terms of safety and effectiveness in patients with AIIDs. Therefore, a focused narrative review was carried out to predict the possible implications of different types of SARS-CoV-2 vaccines which confer distinct immune mechanisms to establish immune response and protection against COVID-19: whole virus (inactivated or weakened), viral vector (replicating and non-replicating), nucleic acid (RNA, DNA), and protein-based (protein subunit, virus-like particle). Still, there is uncertainty among patients with AIIDs and clinicians about the effectiveness and safety of the new vaccines. There are a variety of approaches towards building a protective immunity against SARS-CoV-2. Only high-quality clinical trials would clarify the underlying immunological mechanisms of the newly implemented vaccines/adjuvants in patients living with AIIDs.
2019 年冠状病毒病（COVID-19）大流行即使对于最耐用的医疗保健系统来说也极具挑战性。接种疫苗似乎是最有效的公共卫生干预措施之一，通过实现群体免疫为结束大流行带来了一线希望。在这篇综述中，我们旨在根据自身免疫性炎症性疾病（AIID）来涵盖严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗和候选疫苗的现有知识的各个方面，并分析其在 AIID 患者中的安全性和有效性方面的潜力。因此，我们进行了一项重点叙述性综述，以预测不同类型的 SARS-CoV-2 疫苗对建立针对 COVID-19 的免疫反应和保护的可能影响：全病毒（灭活或减毒）、病毒载体（复制型和非复制型）、核酸（RNA、DNA）和基于蛋白质的（蛋白质亚单位、病毒样颗粒）。然而，AIID 患者和临床医生对新型疫苗的有效性和安全性仍存在不确定性。有多种方法可以建立针对 SARS-CoV-2 的保护性免疫。只有高质量的临床试验才能阐明针对 AIID 患者新实施的疫苗/佐剂的潜在免疫机制。
