Sterilizing immunity after vaccination is desirable to prevent the spread of infection from vaccinees, which can be especially dangerous in hospital settings while managing frail patients. Sterilizing immunity requires neutralizing antibodies at the site of infection, which for respiratory viruses such as SARS-CoV-2 implies the occurrence of neutralizing IgA in mucosal secretions. Systemic vaccination by intramuscular delivery induces no or low-titer neutralizing IgA against vaccine antigens. Mucosal priming or boosting, is needed to provide sterilizing immunity. On the other side of the coin, sterilizing immunity, by zeroing interhuman transmission, could confine SARS-CoV-2 in animal reservoirs, preventing spontaneous attenuation of virulence in humans as presumably happened with the endemic coronaviruses. We review here the pros and cons of each vaccination strategy, the current mucosal SARS-CoV-2 vaccines under development, and their implications for public health.

Mucosal Vaccines, Sterilizing Immunity, and the Future of SARS-CoV-2 Virulence

Maggi F.
Secondo
;
2022-01-01

Abstract

Sterilizing immunity after vaccination is desirable to prevent the spread of infection from vaccinees, which can be especially dangerous in hospital settings while managing frail patients. Sterilizing immunity requires neutralizing antibodies at the site of infection, which for respiratory viruses such as SARS-CoV-2 implies the occurrence of neutralizing IgA in mucosal secretions. Systemic vaccination by intramuscular delivery induces no or low-titer neutralizing IgA against vaccine antigens. Mucosal priming or boosting, is needed to provide sterilizing immunity. On the other side of the coin, sterilizing immunity, by zeroing interhuman transmission, could confine SARS-CoV-2 in animal reservoirs, preventing spontaneous attenuation of virulence in humans as presumably happened with the endemic coronaviruses. We review here the pros and cons of each vaccination strategy, the current mucosal SARS-CoV-2 vaccines under development, and their implications for public health.
BNT162b2; COVID-19; IgA; IgG; Intranasal vaccine; MRNA-1273; Mucosal vaccines; Neutralizing antibody; Oral vaccines; SARS-CoV-2; Sterilizing immunity; Animals; Antibodies, Neutralizing; Antibodies, Viral; COVID-19; COVID-19 Vaccines; Disease Models, Animal; Humans; Immunity, Mucosal; Immunoglobulin G; Mice; Mucous Membrane; SARS-CoV-2; Spike Glycoprotein, Coronavirus; Virulence
Focosi, D.; Maggi, F.; Casadevall, A.
File in questo prodotto:
File Dimensione Formato  
Focosi viruses-14-00187 2022.pdf

accesso aperto

Tipologia: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 517.81 kB
Formato Adobe PDF
517.81 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2131896
Citazioni
  • ???jsp.display-item.citation.pmc??? 18
  • Scopus 17
  • ???jsp.display-item.citation.isi??? 17
social impact