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Covid Vaccine

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Review

COVID-19: Mechanisms of Vaccination


and Immunity
Daniel E. Speiser 1, * and Martin F. Bachmann 2,3,4, *
1 Department of Oncology, University Hospital and University of Lausanne, 1066 Lausanne, Switzerland
2 International Immunology Centre, Anhui Agricultural University, Hefei 230036, China
3 Department of Rheumatology, Immunology and Allergology, Inselspital, University of Bern,
3010 Bern, Switzerland
4 Department of BioMedical Research, University of Bern, 3008 Bern, Switzerland
* Correspondence: daniel.speiser@unil.ch (D.E.S.); martin.bachmann@me.com (M.F.B.)

Received: 2 July 2020; Accepted: 20 July 2020; Published: 22 July 2020 

Abstract: Vaccines are needed to protect from SARS-CoV-2, the virus causing COVID-19. Vaccines
that induce large quantities of high affinity virus-neutralizing antibodies may optimally prevent
infection and avoid unfavorable effects. Vaccination trials require precise clinical management,
complemented with detailed evaluation of safety and immune responses. Here, we review the pros
and cons of available vaccine platforms and options to accelerate vaccine development towards
the safe immunization of the world’s population against SARS-CoV-2. Favorable vaccines, used in
well-designed vaccination strategies, may be critical for limiting harm and promoting trust and a
long-term return to normal public life and economy.

Keywords: SARS-CoV-2; COVID-19; nucleic acid tests; serology; vaccination; immunity

1. Introduction
The COVID-19 pandemic holds great challenges for which the world is only partially prepared [1].
SARS-CoV-2 combines serious pathogenicity with high infectivity. The latter is enhanced by the fact
that asymptomatic and pre-symptomatic individuals can transmit the virus, in contrast to SARS-CoV-1
and MERS-CoV, which were transmitted by symptomatic patients and could be contained more
efficiently [2,3]. To limit the damage of COVID-19, primary efforts focus on confinement, with physical
distancing and multiple further measures preventing infection [4,5]. At present, many investigations
aim at defining optimal strategies to limit viral transmission while simultaneously permitting business
and social activities [6]. Scientific insights and understanding of the biological mechanisms of the
virus and its capability to spread are primordial. Built on this knowledge, the practical strategies may
have at least three priorities: firstly, to continue hygiene measures and physical distancing; secondly, to
maximize the viral monitoring, both geographically and in time, to focus viral containment locally and
limit transmission wherever and whenever possible; thirdly, to rapidly increase the immunity of the
world’s population.
The diagnosis of SARS-CoV-2 infection is achieved through detection of viral RNA from a nasal
pharyngeal swab or saliva, by nucleic acid tests (NATs) or tests that detect viral protein antigens [5,7].
In infected individuals, the results are only positive for a relatively short time window, on average until
the 14th day after symptom onset [8]. Furthermore, a positive NAT result does not allow scientists
to conclude whether the affected person is or will become immune. Therefore, serological tests are
needed, as they can detect the various types of antibodies in the blood that persist for months or
even years.

Vaccines 2020, 8, 404; doi:10.3390/vaccines8030404 www.mdpi.com/journal/vaccines

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