COVID-19疫苗保护效力及挑战

Protective effectiveness and challenges of COVID-19 vaccines

由严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)感染引起的2019冠状病毒病(COVID-19)为全球流行病,安全、有效的疫苗接种对结束COVID-19流行至关重要。随机临床试验被认为是评价疫苗干预效果的"金标准",但也存在明显局限性。随着全球大规模人群接种COVID-19疫苗,需要在非受控条件下跨越不同人群对疫苗保护效力进行评估。同时SARS-CoV-2变异株不断出现,变异病毒可能逃逸现有疫苗免疫保护。因此,COVID-19疫苗面临诸多挑战,如疫苗对特殊人群的免疫原性、有效性和安全性,疫苗效力持久性,病毒变异与突破感染,抗体依赖增强效应及致病性自身免疫等。本文对目前已发表文献进行综述,这对疫情防控具有重要参考价值。

Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has been a global pandemic.Safe and effective vaccination is critical to ending the epidemic of COVID-19.Although randomized clinical trials are considered the“gold standard”for evaluating intervention effects of vaccines,they have notable limitations.As mass vaccination campaigns against COVID-19 commence worldwide,vaccine effectiveness needs to be assessed for a range of outcomes across diverse populations in a noncontrolled setting.Meanwhile,SARS-CoV-2 variants continue to emerge during the global pandemic and may facilitate escape from current vaccine immune protection.Hence,COVID19 vaccines faced many challenges,such as safety,immunogenicity,and efficacy of the COVID-19 Vaccine in special populations,the duration of protective effectiveness,viral mutations and breakthrough infection,antibody-dependent enhancement effect,and pathogenic autoimmune and so on.This article summarizes these tissues studied at present,it is of great significance for public health and social measures in the ongoing pandemic response.