The Coming of Age of Nucleic Acid Vaccines during COVID-19

Abstract

The SARS-CoV-2 pandemic has caused untold damage globally, presenting unusual demands on but also unique opportunities for vaccine development. The development, production, and distribution of vaccines are imperative to saving lives, preventing severe illness, and reducing the economic and social burdens caused by the COVID-19 pandemic.

Application of Traditional Vaccine Development Strategies to SARS-CoV-2

“…However, public attention in the United States and elsewhere has largely focused on vaccine development platforms that use new technologies, especially mRNA vaccines. We review vaccine technologies used for SARS-CoV-2 in two parts: here, the application of established vaccine development platforms to SARS-CoV-2, and separately, novel nucleic acid-based approaches ( 5 ).…”

“…Here, we discuss a selection of programs that use well-established vaccine biotechnologies. These programs have been undertaken worldwide, in complement to the more cutting-edge approaches developed and distributed in the United States, the European Union, the United Kingdom, and Russia ( 5 ). In this review, we discuss vaccine development using two well-established technologies, whole-virus vaccination and subunit vaccination, and the role these technologies have played in the global response to the COVID-19 pandemic.…”

“…In China, the first emergency use authorization (EUA) was granted to an IWV vaccine in July 2020, with full approval following that December ( 52 , 53 ). The fact that these vaccines have not received as much public attention (at least in Western media) as nucleic acid vaccines for SARS-CoV-2 may be due at least in part to the novelty of nucleic acid vaccine technologies ( 54 ), which are more modular and immunogenic ( 5 ).…”

“…Additional support for the efficacy of Abdala and other Cuban vaccines comes from the fact that Cuba’s COVID-19 death rate has virtually flatlined since fall 2021, with fewer than 250 deaths reported during the entire year of 2022 in a population of 11.3 million ( 227 ). Therefore, in addition to developing a vaccine with an estimated VE paralleling that of vaccines developed using cutting-edge nucleic acid technologies ( 5 ), Cuba’s vaccine rollout has also been much more successful than in nearly all similar-size countries. This remarkable vaccine program underscores the continued importance of established, cost-effective vaccine development strategies ( 225 ) that make it possible for countries that have not traditionally been a leader in biotechnological innovation but have developed a solid vaccine production sector ( 228 ) to develop and produce vaccines that will serve their own population’s needs.…”

“…Additionally, the vaccine technologies available differ widely around the globe. As we review elsewhere ( 5 ), wealthier nations have invested heavily in mRNA and DNA vaccines. In contrast, as we describe above, many countries outside Europe and North America have developed highly effective vaccines using more traditional approaches.…”