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Dear Colleagues,

The COVID-19 pandemic has been largely contained thanks to massive deployment of anti-spike vaccines. Different technologies have been in place, but none of them has been convincingly able to induce sterilizing mucosal immunity. Transmission of infection from vaccines to nonresponding immunosuppressed patients at risk for severe COVID-19 demands the development of next-generation mucosal vaccines able to induce sterilizing immunity. Mucosal vaccines come with additional benefits, such as oral route, home self-administration, and no need for needles or refrigeration chains. These manufacturing efforts are nevertheless halted by the ongoing evolution of the spike protein. Clinical experiences with neutralizing antibody-based therapeutics (i.e., anti-RBD monoclonal antibodies and convalescent plasma) have largely contributed to identifying the critical residues within the spike proteins which should be monitored for vaccine resistance. In this Special Issue, we will collect original research on immune escape after antibody therapies, vaccine efficacy against SARS-CoV-2 variants, preclinical and clinical research with candidate mucosal vaccines, and statistical modeling of the impact of sterilizing immunity for the achievement of herd immunity

Prof. Dr. Fabrizio Maggi
Guest Editor

Manuscript Submission Information

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Keywords

SARS-CoV-2
immune escape
mAbs
vaccines
variants
sterilizing immunity

Published Papers (2 papers)

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Research

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12 pages, 2863 KiB

Open AccessArticle

Waning of Anti-SARS-CoV-2 Spike Antibody Levels 100 to 200 Days after the Second Dose of the BNT162b2 Vaccine

by Hidenori Matsunaga, Hidefumi Takeuchi, Yuichiro Oba, Satoshi Fujimi, Tomoyuki Honda and Keizo Tomonaga

Vaccines 2022, 10(2), 177; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines10020177 - 24 Jan 2022

Cited by 2 | Viewed by 5521

Abstract

Anti-SARS-CoV-2 antibodies of 444 vaccinated hospital employees in Japan were measured 94–109 days and 199–212 days after receiving the second BNT162b2 vaccine dose to evaluate the intensity and duration of antibody response in our own cohort. Among uninfected participants, anti-S antibody levels were greatly decreased 199–212 days after the second vaccination compared to the levels measured 94–109 days after the second vaccination (median levels: 830 AU/mL and 2425 AU/mL, respectively; p < 0.001). The rate of decrease between the two testing periods was lower in infected participants than in uninfected participants (median: 47.7% and 33.9%, respectively; p < 0.001). Anti-S antibody levels were significantly higher in females (median: females, 2546 AU/mL; males, 2041 AU/mL; p = 0.002 during the first test period). The peak body temperature after vaccination was higher in females than in males (median: females, 37.4 °C; males: 37.1 °C; p = 0.044). Older males tended to have lower antibody levels. In conclusion, the duration of the anti-S antibody response to the BNT162b2 vaccine was short-lived, particularly in males. Anti-S antibody levels of 1000 AU/mL or lower according to SARS-CoV-2 IgG II Quant (Abbott) might indicate insufficient prevention against the delta variant, and the majority of participants appeared to have lost their protection 200 days after vaccination. Full article

(This article belongs to the Special Issue COVID-19 Vaccines: From Immune Escape to Neutralizing Antibody-Based Therapeutics to Sterilizing Immunity)

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12 pages, 903 KiB

Open AccessSystematic Review

Efficacy of High-Dose Polyclonal Intravenous Immunoglobulin in COVID-19: A Systematic Review

by Daniele Focosi, Massimo Franchini, Marco Tuccori and Mario Cruciani

Vaccines 2022, 10(1), 94; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines10010094 - 09 Jan 2022

Cited by 12 | Viewed by 2410

Abstract

Background: Although several therapeutic strategies have been investigated, the optimal treatment approach for patients with coronavirus disease (COVID-19) remains to be elucidated. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of polyclonal intravenous immunoglobulin (IVIG) therapy in COVID-19. Methods: A systematic literature search using appropriate medical subject heading (MeSH) terms was performed through Medline (PubMed), EMBASE, SCOPUS, OVID and Cochrane Library electronic databases. The main outcomes considered were mortality and safety of IVIG versus placebo/standard of care. This review was carried out in accordance with Cochrane methodology including the risk bias assessment and grading of the quality of evidence. Measures of treatment effect were mean differences (MD) together with 95% confidence intervals (CIs) for continuous outcome measures and risk ratio (RR) or MD for binary outcomes. Two reviewers independently extracted data from individual studies, and disagreements were resolved by a third reviewer. Results: A total of 2401 COVID-19 patients from 10 studies (four randomized controlled trials (RCT) and six non-randomized controlled trials (non-RCTs)) were included in the analysis. Participants received IVIG or placebo/standard of care. The use of IVIG was not associated with a significantly reduced risk of death (RR 0.50, 95% CIs 0.18–1.36, p = 0.17 for RCTs; RR 0.95, 95% CIs 0.61–1.58, p = 0.94 for non-RCTs; low certainty of evidence). IVIG significantly reduced the length of hospital stay (MD −2.24, 95% CIs −3.20/−1.27; p = 0.00001; low certainty of evidence), although this difference was significant only for studies evaluating moderate COVID-19 patients. No significant difference was observed in the incidence of overall and serious adverse events between IVIG recipients and controls (very low certainty of evidence). Conclusions: The current evidence from the literature does not support the use of IVIG in COVID-19 patients. Full article

(This article belongs to the Special Issue COVID-19 Vaccines: From Immune Escape to Neutralizing Antibody-Based Therapeutics to Sterilizing Immunity)

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