Challenges to the Effectiveness and Immunogenicity of COVID-19 Vaccines: A Narrative Review with a Systematic Approach
- PMID: 40872876
- PMCID: PMC12390424
- DOI: 10.3390/vaccines13080789
Challenges to the Effectiveness and Immunogenicity of COVID-19 Vaccines: A Narrative Review with a Systematic Approach
Abstract
The COVID-19 pandemic accelerated the rapid development and distribution of various vaccine platforms, resulting in a significant reduction in disease severity, hospitalizations, and mortality. However, persistent challenges remain concerning the durability and breadth of vaccine-induced protection, especially in the face of emerging SARS-CoV-2 variants. This review aimed to evaluate the factors influencing the immunogenicity and effectiveness of COVID-19 vaccines to inform future vaccine advancement strategies. A narrative review with systematic approach was conducted following PRISMA guidelines for narrative review. Literature was sourced from databases including PubMed, Embase, and Web of Science for studies published between December 2019 and May 2025. Encompassed studies assessed vaccine efficacy, immunogenicity, and safety across various populations and vaccine platforms. Data were collected qualitatively, with quantitative data from reviews highlighted where available. We have uncovered a decline in vaccine efficacy over time and weakened protection against novel variants such as Delta and Omicron. Booster doses, specifically heterologous regimens, improved immunogenicity and increased protection. Vaccine-induced neutralizing antibody titers have been found to correlate with clinical protection, although the long-term correlates of immunity remain poorly defined. The induction of IgG4 antibodies after repeated mRNA vaccinations raised concerns about potential modulation of the immune response. COVID-19 vaccines have contributed significantly to pandemic control; however, their efficacy is limited by the evolution of the virus and declining immunity. Forthcoming vaccine strategies should focus on broad-spectrum, variant-adapted formulations and defining robust comparisons of protection. Recognizing the immunological basis of vaccine response, including the role of specific antibody subclasses, is fundamental for optimizing long-term protection.
Keywords: COVID-19; SARS-CoV-2; immunization; vaccination; vaccine efficacy; vaccine immunogenicity; vaccines.
Conflict of interest statement
Author Nickolay A. Kryuchkov was employed by the company CEG PharmDev DOO. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Similar articles
-
Safety and immunogenicity of a modified mRNA-lipid nanoparticle vaccine candidate against COVID-19: Results from a phase 1, dose-escalation study.Hum Vaccin Immunother. 2024 Dec 31;20(1):2408863. doi: 10.1080/21645515.2024.2408863. Epub 2024 Oct 18. Hum Vaccin Immunother. 2024. PMID: 39422261 Free PMC article. Clinical Trial.
-
Prescription of Controlled Substances: Benefits and Risks.2025 Jul 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. 2025 Jul 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30726003 Free Books & Documents.
-
Immunogenicity and seroefficacy of pneumococcal conjugate vaccines: a systematic review and network meta-analysis.Health Technol Assess. 2024 Jul;28(34):1-109. doi: 10.3310/YWHA3079. Health Technol Assess. 2024. PMID: 39046101 Free PMC article.
-
Immunogenicity of monovalent and multivalent subunit vaccines against SARS-CoV-2 variants in mice with divergent vaccination history.Microbiol Spectr. 2025 Aug 5;13(8):e0290724. doi: 10.1128/spectrum.02907-24. Epub 2025 Jul 17. Microbiol Spectr. 2025. PMID: 40673708 Free PMC article.
-
COVID-19 Vaccines.2025 Aug 15. Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006–. 2025 Aug 15. Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006–. PMID: 33355732 Free Books & Documents. Review.
References
-
- Voysey M., Clemens S.A.C., Madhi S.A., Kotloff K., Frey S., Novak R., Diemert D., Spector S.A., Rouphael N.C., Creech B., et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021;397:99–111. doi: 10.1016/S0140-6736(20)32661-1. - DOI - PMC - PubMed
-
- El Sahly H.M., Baden L.R., Essink B., Doblecki-Lewis S., Martin J.M., Anderson E.J., Campbell T.B., Clark J., Jackson L.A., Fichtenbaum C.J., et al. Efficacy of the mRNA-1273 SARS-CoV-2 vaccine at completion of blinded phase. N. Engl. J. Med. 2021;385:1774–1785. doi: 10.1056/NEJMoa2113017. - DOI - PMC - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Miscellaneous