Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Rev Med Virol. 2023 Jan;33(1):e2359. doi: 10.1002/rmv.2359. Epub 2022 May 1.
Designing and manufacturing efficient vaccines against coronavirus disease 2019 (COVID-19) is a major objective. In this systematic review, we aimed to evaluate the most important vaccines under construction worldwide, their efficiencies and clinical results in healthy individuals and in those with specific underlying diseases. We conducted a comprehensive search in PubMed, Scopus, EMBASE, and Web of Sciences by 1 December 2021 to identify published research studies. The inclusion criteria were publications that evaluated the immune responses and safety of COVID-19 vaccines in healthy individuals and in those with pre-existing diseases. We also searched the VAERS database to estimate the incidence of adverse events of special interest (AESI) post COVID-19 vaccination. Almost all investigated vaccines were well tolerated and developed good levels of both humoural and cellular responses. A protective and efficient humoural immune response develops after the second or third dose of vaccine and a longer interval (about 28 days) between the first and second injections of vaccine could induce higher antibody responses. The vaccines were less immunogenic in immunocompromised patients, particularly those with haematological malignancies. In addition, we found that venous and arterial thrombotic events, Bell's palsy, and myocarditis/pericarditis were the most common AESI. The results showed the potency of the SARS-CoV-2 vaccines to protect subjects against disease. The provision of further effective and safe vaccines is necessary in order to reach a high coverage of immunisation programs across the globe and to provide protection against infection itself.
设计和制造针对 2019 年冠状病毒病(COVID-19)的高效疫苗是主要目标。在本系统评价中,我们旨在评估全球正在构建的最重要的疫苗,它们在健康个体和患有特定基础疾病的个体中的效率和临床结果。我们于 2021 年 12 月 1 日在 PubMed、Scopus、EMBASE 和 Web of Sciences 上进行了全面检索,以确定已发表的研究。纳入标准是评估 COVID-19 疫苗在健康个体和患有预先存在疾病的个体中的免疫反应和安全性的研究。我们还搜索了 VAERS 数据库,以估计 COVID-19 疫苗接种后特别关注的不良事件(AESI)的发生率。几乎所有研究的疫苗都具有良好的耐受性,并产生了良好的体液和细胞反应水平。在接种第二或第三剂疫苗后,会产生保护性和高效的体液免疫反应,并且在第一和第二剂疫苗之间延长间隔(约 28 天)可能会诱导更高的抗体反应。疫苗在免疫功能低下的患者中免疫原性较低,特别是那些患有血液恶性肿瘤的患者。此外,我们发现静脉和动脉血栓形成事件、贝尔氏面瘫和心肌炎/心包炎是最常见的 AESI。结果表明,SARS-CoV-2 疫苗有能力保护受试者免受疾病侵害。有必要提供进一步有效和安全的疫苗,以便在全球范围内实现高疫苗接种覆盖率,并提供针对感染本身的保护。