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Lethal Human Coronavirus Infections and the Role of Vaccines in Their Prevention

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Human Viruses: Diseases, Treatments and Vaccines

Abstract

The Severe Acute Respiratory Syndrome coronavirus (SARS CoV) was first identified in 2002 when it caused an epidemic of fatal human pneumonia cases that from an epicenter in Hong Kong rapidly spread to multiple countries. SARS caused approximately 774 deaths before it was eradicated from the human population by quarantine control measures. Repeated outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred since 2012 with 858 reported human deaths to date. Most recently, in late 2019 a new respiratory virus infection now known as COVID-19 due to infections by the SARS-CoV-2 virus started in China before spreading rapidly to the rest of the world, resulting in approximately 1.5 million deaths to date. All these coronaviruses (CoV) causing fatal human respiratory infections originally had zoonotic origins, with SARS-like and MERS-like coronaviruses circulating in bats. Immunity in humans induced by most CoV infections is rapidly waning; presenting the problem those convalescent patients can become reinfected. Vaccines present the best strategy to protect the human population against CoV infection but face several challenges. One concern is that CoV vaccines, particularly those containing Th2-biased alum adjuvants, may cause problems of disease enhancement such as eosinophilic lung immunopathology upon virus exposure. This problem was seen with SARS vaccines in animal testing. Another concern is that vaccine protection, like natural immunity to CoV infection, may be short-lived. There is also a concern that like influenza, SARS-CoV-2 might mutate its spike protein receptor to circumvent existing human immunity including that induced by vaccines. This could slow or prevent the development of human herd immunity. Ideally CoV vaccines should provide robust long-lived immunity providing broad protection against mutated strains. This chapter describes the current state of development of CoV vaccines including against COVID-19, the issue of CoV-associated lung immunopathology and the form those current and future CoV pandemic vaccines might take.

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  1. Vaxine Pty Ltd, 11 Walkley Avenue, Warradale, 5046, Australia

    Jeremy Baldwin & Nikolai Petrovsky

  2. College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia

    Nikolai Petrovsky

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    Shamim I. Ahmad

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Baldwin, J., Petrovsky, N. (2021). Lethal Human Coronavirus Infections and the Role of Vaccines in Their Prevention. In: Ahmad, S.I. (eds) Human Viruses: Diseases, Treatments and Vaccines . Springer, Cham. https://doi.org/10.1007/978-3-030-71165-8_24

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