Abstract
The first quarter of the 21st century has remarkably been characterized by a multitude of challenges confronting human society as a whole in terms of several outbreaks of infectious viral diseases, such as the 2003 severe acute respiratory syndrome (SARS), China; the 2009 influenza H1N1, Mexico; the 2012 Middle East respiratory syndrome (MERS), Saudi Arabia; and the ongoing coronavirus disease 19 (COVID-19), China. COVID-19, caused by SARS-CoV-2, reportedly broke out in December 2019, Wuhan, the capital of China’s Hubei province, and continues unabated, leading to considerable devastation and death worldwide. The most common target organ of SARS-CoV-2 is the lungs, especially the bronchial and alveolar epithelial cells, culminating in acute respiratory distress syndrome (ARDS) in severe patients. Nevertheless, other tissues and organs are also known to be critically affected following infection, thereby complicating the overall aetiology and prognosis. Excluding H1N1, the SARS-CoV (also referred as SARS-CoV-1), MERS, and SARS-CoV-2 are collectively referred to as coronaviruses, and taxonomically placed under the realm Riboviria, order Nidovirales, suborder Cornidovirineae, family Coronaviridae, subfamily Orthocoronavirinae, genus Betacoronavirus, and subgenus Sarbecovirus. As of 23 September 2021, the ongoing SARS-CoV-2 pandemic has globally resulted in around 229 million and 4.7 million reported infections and deaths, respectively, apart from causing huge psychosomatic debilitation, academic loss, and deep economic recession. Such an unprecedented pandemic has compelled researchers, especially epidemiologists and immunologists, to search for SARS-CoV-2-associated potential immunogenic molecules to develop a vaccine as an immediate prophylactic measure. Amongst multiple structural and non-structural proteins, the homotrimeric spike (S) glycoprotein has been empirically found as the most suitable candidate for vaccine development owing to its immense immunogenic potential, which makes it capable of eliciting both humoral and cell-mediated immune responses. As a consequence, it has become possible to design appropriate, safe, and effective vaccines, apart from related therapeutic agents, to reduce both morbidity and mortality. As of 23 September 2021, four vaccines, namely, Comirnaty, COVID-19 vaccine Janssen, Spikevax, and Vaxzevria, have received the European Medicines Agency’s (EMA) approval, and around thirty are under the phase three clinical trial with emergency authorization by the vaccine-developing country-specific National Regulatory Authority (NRA). In addition, 100–150 vaccines are under various phases of pre-clinical and clinical trials. The mainstay of global vaccination is to introduce herd immunity, which would protect the majority of the population, including immunocompromised individuals, from infection and disease. Here, we primarily discuss category-wise vaccine development, their respective advantages and disadvantages, associated efficiency and potential safety aspects, antigenicity of SARS-CoV-2 structural proteins and immune responses to them along with the emergence of SARS-CoV-2 VOC, and the urgent need of achieving herd immunity to contain the pandemic.
Highlights
The positive, single-stranded RNA genome-containing SARS-CoV-2 is the causative virus of coronavirus disease 19 (COVID-19), which belongs to the species severe acute respiratory syndrome-related coronavirus and the genus Betacoronavirus
The continuance of the current pandemic must be attributed to several variables, such as a high transmissibility and an intrinsically inbuilt immune evasiveness of the virus, the presence of a huge proportion of asymptomatic carriers among infected individuals, a global emergence of variants of concern (VOC), inappropriate COVID-19 behaviour owing to the prevalence of callousness and medical/health illiteracy in the general population, virus-induced cytokine storm, a lack of specific anti-SARS-CoV-2 medicines, and standard treatment modality [10,11,12,13,14]
This has compelled researchers and clinicians to hurriedly repurpose the FDA-approved drugs intended against non-related infections [15,16,17,18,19], develop novel therapeutic molecules/drugs, cell-based therapy, convalescent plasma therapy, antibody cocktails, and vaccines to combat the current pandemic as many researchers have reviewed previously [20,21,22,23,24]
Summary
The positive, single-stranded RNA genome-containing SARS-CoV-2 is the causative virus of coronavirus disease 19 (COVID-19), which belongs to the species severe acute respiratory syndrome-related coronavirus and the genus Betacoronavirus. The continuance of the current pandemic must be attributed to several variables, such as a high transmissibility and an intrinsically inbuilt immune evasiveness of the virus, the presence of a huge proportion of asymptomatic carriers among infected individuals, a global emergence of variants of concern (VOC), inappropriate COVID-19 behaviour owing to the prevalence of callousness and medical/health illiteracy in the general population, virus-induced cytokine storm, a lack of specific anti-SARS-CoV-2 medicines, and standard treatment modality [10,11,12,13,14] This has compelled researchers and clinicians to hurriedly repurpose the FDA-approved drugs intended against non-related infections [15,16,17,18,19], develop novel therapeutic molecules/drugs, cell-based therapy, convalescent plasma therapy, antibody cocktails, and vaccines to combat the current pandemic as many researchers have reviewed previously [20,21,22,23,24]. We discuss various immunogenic epitopes on SARS-CoV-2 structural (S, M, E, and N) and non-structural proteins (various ORF-encoded proteins), the development of vaccines based on such epitopes, innate and adaptive immune responses, as well as vaccines’ nature, efficacy, doses along with gap and the routes of administration, and known side effects and limitations, especially with regard to SARS-CoV-2 VOC
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