Abstract: This review takes into consideration the principal vaccines developed against the SARS-CoV-2 in this unprecedented period of Covid-19 pandemic. We evaluated the mechanism of action of each vaccine as well as the efficacy, the safety and the storage temperature. In addition, the problem of the dose units, the vaccinal strategy, the activity of alternative compounds such as the monoclonal antibodies and especially the issue of the virus variants were also described in detail. Four vaccines are currently used in Italy: Pfizer-BioNTech mRNA BNT162b2 (Comirnaty) (USA), Moderna mRNA 1273 (USA), Astra-Zeneca ChAdOx1-S (recombinant) viral vector adenovirus belonging to Oxford (UK) and Pomezia (Italy), Janssen (two recombinant viral vector adenoviruses) belonging to Johnson & Johnson (USA). The efficacy of Pfizer and Moderna for preventing disease or severe disease results 95– 87.5% and 94.5– 100%, respectively. The efficacy of Astra-Zeneca and Janssen is about 70% and 65%, respectively; in the case of Janssen, it depends on the geographical area ranging from 72% to 57%. The problem of the administrated doses (one dose, two doses from the same vaccine or from different vaccines, half dose) is also discussed. The vaccination strategy based on the age group remains the simplest, most transparent and fair criterion. This strategy is also based on accelerating the administration of the vaccines, so that as many subjects as possible can be vaccinated quickly for achieving the “herd immunity”. The monoclonal antibodies appeared to be a valid solution for the treatment of Covid-19 disease. Two antibodies (bamlanivimab and etesevimab) have just been approved by the FDA. They could also be used for the infection by virus variants which represent a big problem due to their higher transmissibility and virulence and to their lower response to the vaccines.

Keywords: Covid-19 vaccines, vaccinal strategy, dose units, monoclonal antibodies, virus variants, vaccinal platforms

中文翻译：

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主要抗 SARS-CoV-2 疫苗概述：作用机制、有效性和安全性

摘要：本综述考虑了在 Covid-19 大流行这一前所未有的时期针对 SARS-CoV-2 开发的主要疫苗。我们评估了每种疫苗的作用机制以及功效、安全性和储存温度。此外，还详细描述了剂量单位问题、疫苗策略、单克隆抗体等替代化合物的活性，特别是病毒变种的问题。意大利目前使用四种疫苗：辉瑞-BioNTech mRNA BNT162b2 (Comirnaty)（美国）、Moderna mRNA 1273（美国）、阿斯利康 ChAdOx1-S（重组）病毒载体腺病毒（属于牛津（英国）和波梅齐亚（意大利）） 、Janssen（两种重组病毒载体腺病毒），属于Johnson & Johnson（美国）公司。辉瑞和 Moderna 预防疾病或严重疾病的功效分别为 95-87.5% 和 94.5-100%。阿斯利康和杨森的疗效分别约为70%和65%；就杨森而言，这取决于地理区域，范围从 72% 到 57%。还讨论了给药剂量（一剂、同一疫苗的两剂或不同疫苗的两剂、一半剂量）的问题。基于年龄组的疫苗接种策略仍然是最简单、最透明、最公平的标准。这一策略也是基于加快疫苗接种速度，让尽可能多的受试者快速接种疫苗，实现“群体免疫”。单克隆抗体似乎是治疗 Covid-19 疾病的有效解决方案。两种抗体（bamlanivimab 和 etesevimab）刚刚获得 FDA 批准。它们还可以用于病毒变种的感染，由于它们具有较高的传播性和毒力以及对疫苗的较低反应，因此这是一个大问题。

关键词： Covid-19疫苗、疫苗策略、剂量单位、单克隆抗体、病毒变体、疫苗平台