A Different Perspective of COVID-19 Pandemic: Efficacy and Safety of mRNA Vaccines in Immunocompetent and Immunocompromised Individuals (Part 3)

Exp Clin Transplant. 2024 Jan;22(Suppl 2):33-62. doi: 10.6002/ect.2023.0132.ABSTRACTShortly after the declaration of the pandemic, several anti-SARS-CoV-2 vaccines entered phase 3 clinical trials. One year later, Pfizer-BioNTech and Moderna published their initial trial results, encompassing a 2-month follow-up. The studies were only designed to test whether the vaccines were effective and safe on the short-term.The vaccine's efficacy in the 2 trials was defined as relative risk reduction instead of absolute risk reduction, a more accurate determinant of vaccine effectiveness in the real world. These studies were not designed to assess viraltransmission, disease severity, and death as primary outcomes.Vulnerable subgroups of individuals were excluded from the studies. No correlate of immunity against the SARS-CoV2 was identified.Vaccine-induced immunity declined shortly after vaccination and was not protective against new variants. Vaccination and boosting effectiveness were suboptimal in immunocompromised patients. In contrast, in recovered COVID-19 patients, natural immunity was shown to be protective, lasting longer and being more effective against new variants. Findings from subsequent scientific reports questioned the effectiveness of these vaccines in providing protective immunity despite boosting in infection-naïve and infection-experienced individuals. Reports also raised concerns on their safety in relation to cardiovascular pathology, sudden death, and acquired aut...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Source Type: research