Learning from the past: development of safe and effective COVID-19 vaccines

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has elicited an equally rapid response aiming to develop a COVID-19 vaccine. These efforts are encouraging; however, comprehensive efficacy and safety evaluations are essential in the development of a vaccine, and we can learn from previous vaccine development campaigns. In this Perspective, we summarize examples of vaccine-associated disease enhancement in the history of developing vaccines against respiratory syncytial virus, dengue virus, SARS-CoV and Middle East respiratory syndrome coronavirus, which highlight the importance of a robust safety and efficacy profile, and present recommendations for preclinical and clinical evaluation of COVID-19 vaccine candidates as well as for vaccine design and optimization. In this Perspective, Su, Du and Jiang discuss lessons from previous vaccine development efforts for other viruses and how the mechanisms of vaccine-associated disease enhancement seen in some viral infections can inform the development of a safe and efficacious COVID-19 vaccine.

Automated summary

In the development of a COVID-19 vaccine, it is crucial to prioritize safety and efficacy evaluations, drawing lessons from past vaccine development efforts. Su, Du, and Jiang summarize the lessons from previous vaccine development for other viruses, highlighting how mechanisms of vaccine-associated disease enhancement can inform the development of a safe and effective COVID-19 vaccine.