Current Insights into Covid-19 Vaccination


Almost a year after the worldwide appearance of the coronavirus (SARS-CoV-2), several novel vaccines of diverse platforms have been successfully developed and administered. Two mRNA vaccines represented a new type of vaccine that comprised of synthetic mRNA molecules containing the code sequence necessary to build the SARS-CoV-2 spike protein. These mRNA vaccines almost single handedly carried the brunt of the US COVID-19 immunization strategy during the past three years. The known and potential benefits of COVID-19 vaccination outweigh the risks and adverse complications. The ongoing COVID-19 pandemic has stimulated unprecedented research on aspects of the vaccines’ ability to reduce the risk of severe infection and death. Likewise, basic immunological studies are pivotal to unraveling the potential and long-term effects of the vaccines as well as to be able to make adjustments to new vaccine development. As the circulating virus strain continues to evolve, updated vaccines will be critical to protecting the population, particularly the elderly and immune compromised.

  1. Lewis NM, Murray N, Adams K, Surie D, Gaglani M, Ginde AA, et al. Absolute and relative vaccine effectiveness of primary and booster series of COVID-19 vaccines (mRNA and Adenovirus vector) against COVID-19 hospitalizations in the United States, December 2021–April 2022. Open Forum Infect Dis [Internet]. 2023;10(1). Available from: 

  2. Classification of Omicron (B.1.1.529): SARS-CoV-2 variant of Concern [Internet]. [cited 2023 Oct 7]. Available from: 

  3. Chalkias S, Harper C, Vrbicky K, Walsh SR, Essink B, Brosz A, et al. A bivalent omicron-containing booster vaccine against covid-19. N Engl J Med [Internet]. 2022;387(14):1279–91. Available from: .

  4. Offit PA. Bivalent covid-19 vaccines - A cautionary tale. N Engl J Med [Internet]. 2023;388(6):481–3. Available from: .

  5. Wang Q, Bowen A, Valdez R, Gherasim C, Gordon A, Liu L, et al. Antibody response to omicron BA.4–BA.5 bivalent booster. N Engl J Med [Internet]. 2023;388(6):567–9. Available from:

  6. Collier A-RY, Miller J, Hachmann NP, McMahan K, Liu J, Bondzie EA, et al. Immunogenicity of BA.5 bivalent mRNA vaccine boosters. N Engl J Med [Internet]. 2023;388(6):565–7. Available from: 

  7. Koutsakos M, Ellebedy AH. Immunological imprinting: Understanding COVID-19. Immunity [Internet]. 2023;56(5):909–13. Available from: .

  8. Shrestha NK, Burke PC, Nowacki AS, Simon JF, Hagen A, Gordon SM. Effectiveness of the Coronavirus disease 2019 bivalent vaccine. Open Forum Infect Dis [Internet]. 2023;10(6). Available from: 

  9. Zhou Z, Barrett J, He X. Immune imprinting and implications for COVID-19. Vaccines (Basel) [Internet]. 2023;11(4):875. Available from: 

  10. Byambasuren O, Stehlik P, Clark J, Alcorn K, Glasziou P. Effect of covid-19 vaccination on long covid: systematic review. BMJ Med [Internet]. 2023;2(1):e000385. Available from: 

  11. Tsampasian V, Elghazaly H, Chattopadhyay R, Debski M, Naing TKP, Garg P, et al. Risk factors associated with Post−COVID-19 condition: A systematic review and meta-analysis. JAMA Intern Med [Internet]. 2023;183(6):566. Available from: 

  12. Notarte KI, Catahay JA, Velasco JV, Pastrana A, Ver AT, Pangilinan FC, et al. Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: A systematic review. EClinicalMedicine [Internet]. 2022;53(101624):101624. Available from: 

  13. Watanabe A, Iwagami M, Yasuhara J, Takagi H, Kuno T. Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis. Vaccine [Internet]. 2023;41(11):1783–90. Available from: 

  14. Brannock MD, Chew RF, Preiss AJ, Hadley EC, Redfield S, McMurry JA, et al. Long COVID risk and pre-COVID vaccination in an EHR-based cohort study from the RECOVER program. Nat Commun [Internet]. 2023;14(1). Available from: 

  15. Mevorach D, Anis E, Cedar N, Bromberg M, Haas EJ, Nadir E, et al. Myocarditis after BNT162b2 mRNA vaccine against Covid-19 in Israel. N Engl J Med [Internet]. 2021;385(23):2140–9. Available from: 

  16. Zhao Y, Kuang M, Li J, Zhu L, Jia Z, Guo X, et al. SARS-CoV-2 spike protein interacts with and activates TLR41. Cell Res [Internet]. 2021;31(7):818–20. Available from: .

  17. Hromić-Jahjefendić A, Sezer A, Aljabali AAA, Serrano-Aroca Á, Tambuwala MM, Uversky VN, et al. COVID-19 vaccines and myocarditis: An overview of current evidence. Biomedicines [Internet]. 2023;11(5). Available from: 

  18. Bozkurt B, Kamat I, Hotez PJ. Myocarditis with COVID-19 mRNA vaccines. Circulation [Internet]. 2021;144(6):471–84. Available from: 

  19. Voleti N, Reddy SP, Ssentongo P. Myocarditis in SARS-CoV-2 infection vs. COVID-19 vaccination: A systematic review and meta-analysis. Front Cardiovasc Med [Internet]. 2022;9:951314. Available from: .

  20. Chen C, Fu F, Ding L, Fang J, Xiao J. Booster dose of COVID-19 mRNA vaccine does not increase risks of myocarditis and pericarditis compared with primary vaccination: New insights from the vaccine adverse event reporting system. Front Immunol [Internet]. 2022;13:938322. Available from: 

  21. Irrgang P, Gerling J, Kocher K, Lapuente D, Steininger P, Habenicht K, et al. Class switch toward noninflammatory, spike-specific IgG4 antibodies after repeated SARS-CoV-2 mRNA vaccination. Sci Immunol [Internet]. 2023;8(79). Available from: 

  22. Kiszel P, Sík P, Miklós J, Kajdácsi E, Sinkovits G, Cervenak L, et al. Class switch towards spike protein-specific IgG4 antibodies after SARS-CoV-2 mRNA vaccination depends on prior infection history. Sci Rep [Internet]. 2023;13(1). Available from: 

  23. Uversky VN, Redwan EM, Makis W, Rubio-Casillas A. IgG4 antibodies induced by repeated vaccination may generate immune tolerance to the SARS-CoV-2 spike protein. Vaccines (Basel) [Internet]. 2023;11(5):991. Available from: 

  24. Moderna clinical trial data confirm its updated COVID-19 vaccine generates robust immune response in humans against widely circulating variants. 2023 Aug 17: News Release.

  25. Novavax’s updated protein-based XBB COVID vaccine induced neutralizing responses against emerging subvariants, including EG.5.1 and XBB.1.16.6. 2023 Aug 22: News Release.

  26. Wallace M. Evidence to recommendations framework: 2023–2024 monovalent, XBB containing COVID-19 vaccine. ACIP Meeting News Release ; CDC: National Center for Immunization and Respiratory Diseases. 2023 Sep 12.

  27. Boulware DR, Murray TA, Proper JL, Tignanelli CJ, Buse JB, Liebovitz DM, et al. Impact of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) vaccination and booster on Coronavirus disease 2019 (COVID-19) symptom severity over time in the COVID-OUT trial. Clin Infect Dis [Internet]. 2023;76(3):e1–9. Available from: 

  28. Poll: Nearly half of adults expect to get the new COVID-19 vaccine. KFF Health News . 2023 Sept 27: News Release.

  29. Boyle P. The new COVID boosters: What doctors and patients need to know. AAMC News. 2023 Sept 14.

Articles related to the one you are viewing

There are currently no results to show, please try again later

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit