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      Oral and intranasal vaccines against SARS‐CoV‐2: Current progress, prospects, advantages, and challenges

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          Abstract

          Background

          The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has caused a deadly pandemic in the 21st century, resulting in many deaths, economic loss, and international immobility. Vaccination represents the only mechanism to defeat this virus. Several intramuscular vaccines have been approved and are currently used worldwide.

          Main body

          However, global mass vaccination has not been achieved owing to several limitations, including the need for expertise to administer the injection‐based vaccine, improper distribution of the vaccine, and lack of cold chain facilities, particularly in resource‐poor, low‐income countries. Mucosal vaccines are typically administered either orally or nasally, and several studies have shown promising results for developing these vaccines against SARS‐CoV‐2 that might serve as viable alternatives to current vaccines. SARS‐CoV‐2 invades the human body via oral and nasal mucosal surfaces; thus, an oral or nasal vaccine can trigger the immune system to inhibit the virus at the mucosal level, preventing further transmission via a strong mucosal and systematic immune response. Although several approaches toward developing a mucosal vaccine are currently being tested, additional attention is required.

          Conclusion

          In this article, the current approaches used to develop effective oral and nasal mucosal vaccines against SARS‐CoV‐2 and their benefits, prospects, and challenges have been summarized.

          Abstract

          Mucosal vaccines are typically administered either orally or nasally, and several studies have shown promising results for developing these vaccines against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that might serve as a viable alternative to current vaccines. SARS‐CoV‐2 invades the human body via oral and nasal mucosal surfaces; thus, an oral or nasal vaccine can trigger the immune system to inhibit the virus at the mucosal level, preventing further transmission via a strong mucosal and systematic immune response.

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          Most cited references103

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          SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor

          Summary The recent emergence of the novel, pathogenic SARS-coronavirus 2 (SARS-CoV-2) in China and its rapid national and international spread pose a global health emergency. Cell entry of coronaviruses depends on binding of the viral spike (S) proteins to cellular receptors and on S protein priming by host cell proteases. Unravelling which cellular factors are used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal therapeutic targets. Here, we demonstrate that SARS-CoV-2 uses the SARS-CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option. Finally, we show that the sera from convalescent SARS patients cross-neutralized SARS-2-S-driven entry. Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.
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            Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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              Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

              Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently. Methods In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety. Results A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups. Conclusions A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)
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                Author and article information

                Contributors
                talhabmb@bgctub.ac.bd
                kdhama@rediffmail.com
                Journal
                Immun Inflamm Dis
                Immun Inflamm Dis
                10.1002/(ISSN)2050-4527
                IID3
                Immunity, Inflammation and Disease
                John Wiley and Sons Inc. (Hoboken )
                2050-4527
                10 March 2022
                April 2022
                : 10
                : 4 ( doiID: 10.1002/iid3.v10.4 )
                : e604
                Affiliations
                [ 1 ] Department of Infectious Disease Institute of Developing Science and Health Initiatives, ECB Chattar Dhaka Bangladesh
                [ 2 ] Department of Microbiology University of Chittagong Chittagong Bangladesh
                [ 3 ] Department of Microbiology Noakhali Science and Technology University Noakhali Bangladesh
                [ 4 ] Department of Pharmacy BGC Trust University Bangladesh Chittagong Bangladesh
                [ 5 ] Department of Biology, Faculty of Mathematics and Natural Sciences Sam Ratulangi University Manado North Sulawesi Indonesia
                [ 6 ] Division of Sustainable Use of Wallacea Area The University Centre of Excellence for Biotechnology and Conservation of Wallacea, Institute for Research and Community Services, Sam Ratulangi University Manado North Sulawesi Indonesia
                [ 7 ] Department of Pharmacy, Faculty of Pharmacy University of Dhaka Dhaka Bangladesh
                [ 8 ] Division of Pathology ICAR‐Indian Veterinary Research Institute, Izatnagar Bareilly Uttar Pradesh India
                Author notes
                [*] [* ] Correspondence: Talha B. Emran, Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh.

                Email: talhabmb@ 123456bgctub.ac.bd

                Kuldeep Dhama, Division of Pathology, ICAR–Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh 243122, India.

                Email: kdhama@ 123456rediffmail.com

                Author information
                http://orcid.org/0000-0003-3188-2272
                Article
                IID3604
                10.1002/iid3.604
                8959423
                35349752
                5ba876c6-29d1-445f-84d5-8c19953cd972
                © 2022 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 February 2022
                : 20 January 2022
                : 15 February 2022
                Page count
                Figures: 1, Tables: 1, Pages: 13, Words: 7466
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                April 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.2 mode:remove_FC converted:28.03.2022

                covid‐19,intranasal vaccines,mass vaccination,mucosal vaccines,oral vaccines,sars‐cov‐2

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