Prospects for a safe COVID-19 vaccine
Top Cited Papers
Open Access
- 4 November 2020
- journal article
- review article
- Published by American Association for the Advancement of Science (AAAS) in Science Translational Medicine
- Vol. 12 (568)
- https://doi.org/10.1126/scitranslmed.abe0948
Abstract
Rapid development of an efficacious vaccine against the viral pathogen SARS-CoV-2, the cause of the coronavirus disease-2019 (COVID-19) pandemic, is essential, but rigorous studies are required to determine the safety of candidate vaccines. Here, on behalf of the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Working Group, we evaluate research on the potential risk of immune enhancement of disease by vaccines and viral infections, including coronavirus infections, together with emerging data about COVID-19 disease. Vaccine-associated enhanced disease has been rarely encountered with existing vaccines or viral infections. Although animal models of SARS-CoV-2 infection may elucidate mechanisms of immune protection, we need observations of enhanced disease in people receiving candidate COVID-19 vaccines to understand the risk of immune enhancement of disease. Neither principles of immunity nor preclinical studies provide a basis for prioritizing among the COVID-19 vaccine candidates with respect to safety at this time. Rigorous clinical trial design and post-licensure surveillance should provide a reliable strategy to identify adverse events, including the potential for enhanced severity of COVID-19 disease, following vaccination.This publication has 109 references indexed in Scilit:
- Primary Severe Acute Respiratory Syndrome Coronavirus Infection Limits Replication but Not Lung Inflammation upon Homologous RechallengeJournal of Virology, 2012
- Molecular Determinants of Severe Acute Respiratory Syndrome Coronavirus Pathogenesis and Virulence in Young and Aged Mouse Models of Human DiseaseJournal of Virology, 2012
- Anti-Severe Acute Respiratory Syndrome Coronavirus Spike Antibodies Trigger Infection of Human Immune Cells via a pH- and Cysteine Protease-Independent FcγR PathwayJournal of Virology, 2011
- Severe pandemic 2009 H1N1 influenza disease due to pathogenic immune complexesNature Medicine, 2010
- T Cell Responses Are Required for Protection from Clinical Disease and for Virus Clearance in Severe Acute Respiratory Syndrome Coronavirus-Infected MiceJournal of Virology, 2010
- Lack of antibody affinity maturation due to poor Toll-like receptor stimulation leads to enhanced respiratory syncytial virus diseaseNature Medicine, 2008
- Development of a Nucleocapsid-Based Human Coronavirus Immunoassay and Estimates of Individuals Exposed to Coronavirus in a U.S. Metropolitan PopulationClinical and Vaccine Immunology, 2008
- A SARS DNA vaccine induces neutralizing antibody and cellular immune responses in healthy adults in a Phase I clinical trialVaccine, 2008
- The SARS-CoV ferret model in an infection–challenge studyVirology, 2008
- The time course of the immune response to experimental coronavirus infection of manEpidemiology and Infection, 1990