Volume 39 Issue 12, December 2021
Editorial | 06 December 2021
Technologies to advance COVID-19 vaccine equity
Poor countries need vaccine formats with low barriers to manufacture, distribution and administration.
…The massive global effort over the past two years to develop, make, and administer vaccines against a novel, fast-spreading pathogen is unprecedented in the history of vaccines. The results are still unfolding and will have much to teach us about both the immunology of viral infection and the strengths and weaknesses of emerging COVID-19 vaccine technologies. With international cooperation and open data sharing, they may shed light on some of the most intractable problems in vaccinology: how best to make mucosal vaccines, how to induce robust immunity in the immunocompromised or aged people with immunosenescence, how best to increase the longevity of protection, and how to elicit broadly neutralizing antibodies against diverse viral lineages or a rapidly mutating virus.
The knowledge gained could lead to more-effective COVID-19 vaccines. Current vaccines greatly diminish the risks of infection, transmission, serious illness, and death but do not entirely prevent them, with immunocompromised and elderly people the most vulnerable. Efficacy wanes in a matter of months (in the age cohorts for which data are available — 16 and up). Improvements that can be envisaged include intranasal or oral vaccines for stronger mucosal immunity to reduce infection and transmission, and pan-sarbecovirus vaccines to protect against all SARS coronavirus strains.
No single vaccine will be best for every country and every pandemic condition. But we need to ensure that all people, including those in poor, rural, or remote communities, have access to highly effective and safe COVID-19 vaccines. Vaccine technologies that are validated for COVID-19 may also aid the development of vaccines for other infectious diseases, such as tuberculosis, pandemic influenza, malaria, and respiratory syncytial virus infection, and strengthen our preparedness to fight future pathogens.