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Abstract
We are in the midst of a pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease 2019 (COVID-19). SARS-CoV-2 has caused more than two million deaths after one year of the pandemic. The world is experiencing a deep economic recession. Safe and effective vaccines are needed to prevent further morbidity and mortality. Vaccine candidates against COVID-19 have been developed at an unprecedented speed, with more than 200 vaccine candidates currently under investigation. Among those, 20 candidates have entered the clinical Phase 3 to evaluate efficacy, and three have been approved by the European Medicines Agency. The aim of immunization is to act against infection, disease and/or transmission. However, the measurement of vaccine efficacy is challenging, as efficacy trials need to include large cohorts with verum and placebo cohorts. In the future, this will be even more challenging as further vaccine candidates will receive approval, an increasing number of humans will receive vaccinations and incidence might decrease. To evaluate novel and second-generation vaccine candidates, randomized placebo-controlled trials might not be appropriate anymore. Correlates of protection (CoP) could be an important tool to evaluate novel vaccine candidates, but vaccine-induced CoP have not been clearly defined for SARS-CoV-2 vaccines. In this review, we report on immunogenicity against natural SARS-CoV-2 infection, vaccine-induced immune responses and discuss immunological markers that can be linked to protection. By discussing the immunogenicity and efficacy of forerunner vaccines, we aim to give a comprehensive overview of possible efficacy measures and CoP.
Highlights
IntroductionThe ongoing coronavirus disease 2019 (COVID-19) pandemic has caused immense mortality and morbidity, and has placed huge social and economic burdens on society
The role of non-neutralizing antibodies, that mediate their function via fragment crystallizable (Fc) receptors, in SARS-CoV-2 infection, needs to be further investigated, analyzing complement-dependent cytotoxicity (CDC), ADCC or antibody-dependent phagocytosis (ADP) (Figure 3D)
Immunological correlates are critical to facilitate the evaluation on vaccine efficacy
Summary
The ongoing coronavirus disease 2019 (COVID-19) pandemic has caused immense mortality and morbidity, and has placed huge social and economic burdens on society. At the beginning of 2021, the global case count of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has passed 110 million, with more than 2.5 million confirmed deaths due to the infection [1]. Vaccines can be a key element to limit viral spread. The search for an efficient vaccine has started in January 2020 and progressed at an unprecedented scope, both in the variety 4.0/). Of vaccine platforms and in number of candidate vaccines under investigation. There are more than 250 vaccine candidates in development with 58 having progressed to clinical stages. Detailed lists can be found on various websites, e.g., by the World Health
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