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      Coronavirus disease 2019 (COVID‐19) vaccines: A concise review

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          Abstract

          The development of a successful vaccine against severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), the agent of coronavirus disease 2019 (COVID‐19), in an unmatched period of ten months, is a tribute to human ingenuity in the face of a vicious pandemic. A return to pre‐pandemic “normalcy” depends on the successful delivery of the vaccine to a majority (~70%) so as to develop herd immunity critical to arrest the community spread of infection. Vaccination against COVID‐19 is particularly important for dentistry as the dental team works in an environment replete with aerosol‐generating procedures (AGP) that facilitate virus spread. Hence, a COVID‐19 vaccine is likely to be an obligatory requirement for the dental practice, and the latest addition to the extensive list of vaccines required for dental professionals for the safe delivery of dental care. Here, we review the currently available major candidate vaccines against SARS‐CoV‐2 and their benefits and risks. These include the vaccines developed on next‐generation platforms (mRNA, DNA, and viral vector vaccines), and the classic platforms (the live‐attenuated virus, and the protein subunit vaccines) The review concludes with a summary of impending issues and challenges facing the provision of COVID‐19 vaccines for all stakeholders in dentistry.

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          Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

          Fernando P Polack, Stephen J. Thomas, Nicholas R.E. Kitchin … (2023)
          Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently. Methods In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety. Results A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups. Conclusions A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)
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            An mRNA Vaccine against SARS-CoV-2 — Preliminary Report

            Lisa A Jackson, Evan J Anderson, Nadine G Rouphael … (2020)
            Abstract Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019 and spread globally, prompting an international effort to accelerate development of a vaccine. The candidate vaccine mRNA-1273 encodes the stabilized prefusion SARS-CoV-2 spike protein. Methods We conducted a phase 1, dose-escalation, open-label trial including 45 healthy adults, 18 to 55 years of age, who received two vaccinations, 28 days apart, with mRNA-1273 in a dose of 25 μg, 100 μg, or 250 μg. There were 15 participants in each dose group. Results After the first vaccination, antibody responses were higher with higher dose (day 29 enzyme-linked immunosorbent assay anti–S-2P antibody geometric mean titer [GMT], 40,227 in the 25-μg group, 109,209 in the 100-μg group, and 213,526 in the 250-μg group). After the second vaccination, the titers increased (day 57 GMT, 299,751, 782,719, and 1,192,154, respectively). After the second vaccination, serum-neutralizing activity was detected by two methods in all participants evaluated, with values generally similar to those in the upper half of the distribution of a panel of control convalescent serum specimens. Solicited adverse events that occurred in more than half the participants included fatigue, chills, headache, myalgia, and pain at the injection site. Systemic adverse events were more common after the second vaccination, particularly with the highest dose, and three participants (21%) in the 250-μg dose group reported one or more severe adverse events. Conclusions The mRNA-1273 vaccine induced anti–SARS-CoV-2 immune responses in all participants, and no trial-limiting safety concerns were identified. These findings support further development of this vaccine. (Funded by the National Institute of Allergy and Infectious Diseases and others; mRNA-1273 ClinicalTrials.gov number, NCT04283461).
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              mRNA vaccines — a new era in vaccinology

              Norbert Pardi, Michael Hogan, Frederick W. Porter … (2018)
              mRNA vaccines represent a promising alternative to conventional vaccine approaches because of their high potency, capacity for rapid development and potential for low-cost manufacture and safe administration. However, their application has until recently been restricted by the instability and inefficient in vivo delivery of mRNA. Recent technological advances have now largely overcome these issues, and multiple mRNA vaccine platforms against infectious diseases and several types of cancer have demonstrated encouraging results in both animal models and humans. This Review provides a detailed overview of mRNA vaccines and considers future directions and challenges in advancing this promising vaccine platform to widespread therapeutic use.
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                Author and article information

                Contributors
                Lakshman Perera Samaranayake:
                ORCID: https://orcid.org/0000-0002-9122-336X
                lakshman@hku.hk
                Kausar Sadia Fakhruddin:
                ORCID: https://orcid.org/0000-0003-0135-6597
                kfakhruddin@sharjah.ac.ae
                Journal
                Journal ID (nlm-ta): Oral Dis
                Journal ID (iso-abbrev): Oral Dis
                Journal ID (doi): 10.1111/(ISSN)1601-0825
                Journal ID (publisher-id): ODI
                Title: Oral Diseases
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 1354-523X
                ISSN (Electronic): 1601-0825
                Publication date (Electronic): 31 May 2021
                Electronic Location Identifier: 10.1111/odi.13916
                Affiliations
                [ 1 ] Faculty of Dentistry The University of Hong Kong Hong Kong China (SAR)
                [ 2 ] National Dental Research Institute Singapore (NDRIS) Duke NUS Medical School Singapore City Singapore
                [ 3 ] Department of Preventive and Restorative Dentistry College of Dental Medicine University of Sharjah Sharjah UAE
                Author notes
                [*] [* ] Correspondence

                Lakshman Perera Samaranayake, Faculty of Dentistry, The University of Hong Kong, Hong Kong.

                Kausar Sadia Fakhruddin, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.

                Emails: lakshman@ 123456hku.hk ; kfakhruddin@ 123456sharjah.ac.ae

                Author information
                https://orcid.org/0000-0002-9122-336X
                https://orcid.org/0000-0003-0816-538X
                https://orcid.org/0000-0003-0135-6597
                Article
                Publisher ID: ODI13916
                DOI: 10.1111/odi.13916
                PMC ID: 8242875
                PubMed ID: 33991381
                SO-VID: 94fcadee-554e-4ace-ba90-82d395d6e5f2
                Copyright © © 2021 Wiley Periodicals LLC
                License:

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                Date revision received : 05 April 2021
                Date received : 17 February 2021
                Date accepted : 06 May 2021
                Page count
                Figures: 2, Tables: 2, Pages: 11, Words: 19871
                Categories
                Subject: Invited Review
                Subject: Invited Reviews
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:30.06.2021

                ScienceOpen disciplines: Dentistry
                Keywords: challenges,coronavirus disease 2019,impact,platforms,severe acute respiratory syndrome coronavirus 2,vaccines
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: challenges, coronavirus disease 2019, impact, platforms, severe acute respiratory syndrome coronavirus 2, vaccines

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