CHAPTER 2: Vaccination and Vaccines for COVID-19

This chapter discusses vaccination and vaccine development historically and in the context of the coronavirus disease 2019 (COVID-19) pandemic. It describes the process of traditional vaccine development, summarizes the biology and immune response demonstrated from previous coronavirus infections and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It outlines the challenges associated with vaccine production in a pandemic and examines the various platforms being utilized for COVID-19 vaccine candidates. In addition, the question of whether mutations in the spike protein might affect the efficacy of a vaccine is addressed as are potential problems that may arise by fast-tracking vaccine production. Vaccine development has typically taken up to 15 years, but with fast-tracking it is hoped to reduce this to 1.5 years or less, thus potentially raising concerns over public acceptance as well as concerns regarding challenges from anti-vaxxers. While there are more than 100 vaccines currently in clinical trials, this chapter focuses on the vaccines that have gained approval by the drug regulators for emergency usage. Although production capacity may not be able to meet the global demand for vaccines in the very near future, it would be beneficial to have a limited number of vaccines available for emergency use and the more vulnerable population as soon as possible, with the ultimate aim of distributing vaccines globally to the rest of the population by the end of 2021.