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新型冠状病毒肺炎:疫苗、效力及对变异毒株的影响

COVID-19: vaccines, efficacy and effects on variants.

作者信息

Rudan Igor, Adeloye Davies, Sheikh Aziz

机构信息

Usher Institute, University of Edinburgh, Edinburgh, UK.

出版信息

Curr Opin Pulm Med. 2022 May 1;28(3):180-191. doi: 10.1097/MCP.0000000000000868. Epub 2022 Feb 23.

Abstract

PURPOSE OF REVIEW

We reviewed three leading strategies of vaccine development against coronavirus disease 2019 (COVID- 19): mRNA vaccines, adenoviral vector vaccines and recombinant nanoparticles. We also considered the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and their impact on the effectiveness of the most widely implemented vaccines.

RECENT FINDINGS

General properties, efficacy, safety and global uptake of Pfizer/BioNTech's Comirnaty (BNT162b2), Moderna's Spikevax (mRNA-1273), Oxford/AstraZeneca's ChAdOx1 nCoV-19, J&J/Janssen's Ad26.COV2.S and Novavax's NVX-CoV2373 vaccines at the end of the year 2021 were presented. We summarized the information on the effectiveness against COVID-19 infection, severe disease and death. We then focused on important missense mutations in the five variants of concern (VoC): Alpha, Beta, Gamma, Delta and Omicron. We explored the evidence for the effectiveness of the vaccines against those five VoC.

SUMMARY

It is difficult to predict the further development of the COVID-19 pandemic. The development of vaccines of an increasingly broad spectrum against coronaviruses, more easily deliverable and conferring more durable immune protection is likely. However, the very large number of infections may lead to new mutations with unpredictable impacts. Interventions that would control COVID-19 more effectively and enable a safer coexistence with the SARS-CoV-2 virus and its emerging variants are still needed in early 2022.

摘要

综述目的

我们回顾了针对2019冠状病毒病(COVID-19)的三种主要疫苗研发策略:信使核糖核酸(mRNA)疫苗、腺病毒载体疫苗和重组纳米颗粒。我们还考虑了严重急性呼吸综合征冠状病毒2(SARS-CoV-2)变体的出现及其对最广泛使用的疫苗有效性的影响。

最新发现

介绍了辉瑞/生物科技公司的Comirnaty(BNT162b2)、莫德纳公司的Spikevax(mRNA-1273)、牛津大学/阿斯利康公司的ChAdOx1 nCoV-19、强生公司的Ad26.COV2.S和诺瓦瓦克斯公司的NVX-CoV2373疫苗在2021年底的一般特性、疗效、安全性和全球接种情况。我们总结了这些疫苗在预防COVID-19感染、重症疾病和死亡方面有效性的相关信息。然后,我们重点关注了五个值得关注的变体(VoC):阿尔法、贝塔、伽马、德尔塔和奥密克戎中的重要错义突变。我们探讨了这些疫苗针对这五个VoC有效性的证据。

总结

很难预测COVID-19大流行的进一步发展。研发针对冠状病毒的广谱性不断增强、更易于递送且能提供更持久免疫保护的疫苗是有可能的。然而,大量的感染可能会导致产生具有不可预测影响的新突变。在2022年初,仍然需要能够更有效地控制COVID-19并实现与SARS-CoV-2病毒及其新出现变体更安全共存的干预措施。

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