Mitigating Covid-19 in the face of emerging virus variants, breakthrough infections and vaccine hesitancy

• Published in: Journal of autoimmunity Vol. 127; p. 102792
• Main Authors: Haque, Azizul, Pant, Anudeep B.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2022
• Subjects: Antibodies, Viral - biosynthesis; Antibodies, Viral - immunology; B-Lymphocyte Subsets - immunology; Breakthrough infections; COVID-19 - prevention & control; COVID-19 - transmission; COVID-19 Vaccines - immunology; Global vaccination; Host-Pathogen Interactions - immunology; Humans; Immunogenicity, Vaccine; Immunologic Memory; Mutation; Pandemics - prevention & control; RNA virus; SARS-CoV-2 - genetics; SARS-CoV-2 - immunology; Second-generation vaccines; T-Lymphocytes - immunology; Transparency; Vaccination; Vaccination Hesitancy; Vaccine Development; Vaccine hesitancy; Variants; Variants; Breakthrough infections; Transparency; Vaccine hesitancy; Global vaccination; RNA virus; Second-generation vaccines; Mutation
• ISSN: 0896-8411; 1095-9157; 1095-9157
• DOI: 10.1016/j.jaut.2021.102792

The emergence and rapid global spread of the new Delta and, more recently, Omicron variants of SARS-CoV-2 pose a daunting public health emergency. Being an RNA virus, the Covid-19 virus is continuing to mutate, resulting in the emergence of new variants with high transmissibility, such as the recently discovered Omicron variant. In this paper, we consider the conditions that may facilitate viral mutations and the emergence of variants with the ability to evade immunity. Here, we have discussed the importance of vaccination with the currently available vaccines. These vaccines are highly effective at preventing serious disease, hospitalization, and death from Covid-19. However, the antibody response induced by these vaccines is short-lasting and there are reports of breakthrough infections. A stable and persistent interaction between T follicular helper cells and germinal center B cells is needed for robust B cell memory response. We discussed the potential reasons behind the breakthrough infections and underscored the importance of developing better second-generation vaccines that may not necessitate frequent booster immunizations and are preventive in nature. This may involve the development of multivalent vaccines and creating vaccines against other viral proteins including conserved proteins. Vaccine hesitancy remains a notable hurdle for implementing vaccination. Furthermore, we recommend different approaches to increase vaccine acceptance, which is a critical translational component of a successful vaccine strategy. These perspectives on overcoming the pandemic's current challenges provide strategies to contain SARS-CoV-2 globally. •Controlling transmission is a priority for containing SARS-CoV-2 and future mutations.•Mutations may enable the virus to evade immunity induced by available vaccines.•Better vaccines inducing robust memory response need to be developed.•Different approaches to promote vaccine acceptance need to be undertaken.•Global vaccine coverage is essential to contain the Covid pandemic.