Abstract
Pfizer-BioNTech and Moderna developed in record time mRNA vaccines against COVID-19 of high efficacy. The modest protection achieved with a similarly designed mRNA from CureVac underlines the importance of biotechnological details in formulation such as replacement of uridine by pseudouridine in the mRNA encoding the SARS-CoV-2 spike protein or the lipid composition of the nanoparticle coating the mRNA. Phase 3 vaccine trials and vaccine studies in special subject groups as well observational studies in whole populations confirmed the real-world vaccine efficacy against symptomatic disease, particularly against severe COVID-19 cases and to a lesser extent against mild SARS-CoV-2 infections. mRNA vaccine protection extended also to the alpha and beta variant viruses. The surge of delta variants led to an increase of infections and cases even in populations which achieved high vaccine coverage. This efficacy decline resulted to a lesser extent from a weaker neutralization of the delta variant but mostly from a waning vaccine protection over time. Data from Israel documented the efficacy of a third ‘booster’ injection 5 months after the second injection in older segments of the population. Adverse reactions consisted of transient injection site pain, headache, muscle pain, fatigue, fever and chills. Extensive surveillance studies documented a good safety profile revealing only a non-significant increase in transient facial nerve paralysis and a significant, but modest increase in myocarditis in vaccinated young males that was lower than the myocarditis risk induced by SARS-CoV-2 infection.
【초록키워드】 COVID-19, viruses, Efficacy, Vaccine, severe COVID-19, fatigue, mRNA vaccine, neutralization, SARS-COV-2 infection, variant, Infection, risk, headache, delta variant, observational studies, observational study, Population, Spike protein, mRNA vaccines, Formulation, Adverse reactions, Coverage, Surveillance, myocarditis, mRNA, SARS-CoV-2 spike protein, Fever, male, nanoparticle, Pain, Mild, Alpha, Beta variant, group, SARS-CoV-2 infections, Pfizer-BioNTech, safety profile, booster, Moderna, Delta variants, Adverse reaction, phase, muscle pain, Older, subject, injection, chills, CureVac, symptomatic disease, uridine, replacement, Facial nerve, vaccine trial, pseudouridine, facial nerve paralysis, injection site pain, lipid composition, nerve paralysis, increase in, Extensive, the SARS-CoV-2, 【제목키워드】 mRNA vaccine, microbial,