Coronavirus vaccine development: from SARS and MERS to COVID-19
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REVIEW
Coronavirus vaccine development: from SARS and MERS to COVID‑19 Yen‑Der Li1†, Wei‑Yu Chi2†, Jun‑Han Su1, Louise Ferrall2, Chien‑Fu Hung2 and T.‑C. Wu2,3*
Abstract Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new type of coronavirus that causes the Corona‑ virus Disease 2019 (COVID-19), which has been the most challenging pandemic in this century. Considering its high mortality and rapid spread, an effective vaccine is urgently needed to control this pandemic. As a result, the academia, industry, and government sectors are working tightly together to develop and test a variety of vaccines at an unprec‑ edented pace. In this review, we outline the essential coronavirus biological characteristics that are important for vac‑ cine design. In addition, we summarize key takeaways from previous vaccination studies of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV), highlighting the pros and cons of each immunization strategy. Finally, based on these prior vaccination experiences, we discuss recent progress and potential challenges of COVID-19 vaccine development. Keywords: SARS-CoV-2, Coronaviruses, Vaccine, Vaccine development Introduction Coronaviruses (CoVs) are a group of related viruses that can cause respiratory tract infection in humans ranging from mild symptoms to lethal outcomes. Until now, there are seven genera of CoVs that are known to infect humans [1]. Four of these genera, including Human Coronavirus 229E (HCoV-229E), Human Coronavirus OC43 (HCoV-OC43), Human Coronavirus NL63 (HCoVNL63), and Human Coronavirus HKU1 (HCoV-HKU1), only cause relatively mild and self-limiting respiratory symptoms [2]. Alternatively, the other three CoVs, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome Coronavirus (MERSCoV), and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), are highly pathogenic and can lead to severe respiratory diseases and fatal outcome in infected patients. The first lethal coronavirus SARS-CoV *Correspondence: [email protected] † Yen-Der Li and Wei-Yu Chi have contributed equally to this work 2 Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA Full list of author information is available at the end of the article
emerged in 2002 in Guangdong Province, China. During the 2002–2004 outbreak, SARS-CoV had infected 8,098 people and resulted in 774 SARS-associated deaths (~ 10% mortality rate) across 29 countries before it disappeared [3]. In 2012, MERS-CoV emerged in Saudi Arabia. It caused two outbreaks in South Korea in 2015 and in Saudi Arabia in 2018, and still has ongoing reports of sporadic cases nowadays. As of January 2020, there are 2,519 confirmed MERS cases and 866 deaths (~ 35% mortality rate) across 27 countries [4]. In December 2019, a new type of CoV that can cause severe respiratory illness emerged in Wuhan, China. The World Health Organization named this novel virus SARS-CoV-2 and the diseas
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