SARS vaccines: where are we?

Rachel L. Roper; Kristina E. Rehm

Disclosures

Expert Rev Vaccines. 2009;8(7):887-898. 

In This Article

Expert Commentary & Five-year View

Since protection from disease has not been demonstrated for any vaccine tested in an animal model that mimics human SARS disease, further vaccine development to improve vaccine efficacy is needed. While it is clear that antibodies to S protein offer some protection against SARS, it is equally apparent that high neutralizing antibody titers are not sufficient to protect animals from serious tissue damage after SARS-CoV challenge. Thus, it will likely be necessary to generate protective T-lymphocyte responses or antibodies to other SARS proteins, or to improve protection. Data collected thus far suggest that strategies including mucosal immunizations coupled with a heterologous systemic route of vaccination may improve efficacy. Alternatively, the development of safe attenuated SARS vaccines may be able to offer both the quality and quantity of immune response required to stop serious SARS-CoV-induced tissue damage. It will be necessary to conduct more trials with direct comparison of vaccines (and combinations of prime-boost) in appropriate animal models that more closely mimic human disease course. It will also be important to pursue an understanding of the role of T-cell immunity against SARS, since little is known at this time. Development of improved T-cell analysis reagents for ferrets will aid in this endeavor. The rate of SARS vaccine progress in the next 5 years likely depends on the perceived disease threat from SARS. If another epidemic or pandemic occurs, funding and research for vaccine development will be a priority. Likewise, efficacy in humans can only be demonstrated if there is another SARS outbreak among a population of vaccinated and control subjects.

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