The genetic sequence of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) was published approximately a year ago in January 2020, triggering an intense global competition to develop a vaccine against the lethal infection it causes, the coronavirus disease 2019 (COVID-19). Vaccine developers the world over are currently using next-generation vaccine platforms and novel paradigms to accelerate their production. Some of these, such as the mRNA vaccines, have been highly successful, reaching the arms of millions of recipients, at the time of writing. Indeed, the first COVID-19 vaccine, which entered the first human, clinical (Phase I) trials in March 2020, was approved in the US for emergency use in December 2020. This unprecedented rapidity of conducting vaccine trials, and approval by authorities, is a singular tribute to new technology as well as human ingenuity in the face of adversity.1 A number of other vaccines in the pipeline should see the light of day in 2021 once they complete their, final (Phase II/III) human trials, and their proven safety and efficacy approved by the regulatory authorities. The account below is a sketch of the ideal properties essential for a vaccine, and the major COVID-19 vaccine platforms (highly simplified) used for their production.In brief, the aim of a vaccine is to stimulate the body’s own protective immune responses so that, if an individual encounters the specific viral pathogen, then the immune system can quickly recognize the foe, jump into action, and prevent the spread of infection and terminate the disease process. 2 In the case of vaccines against SARS-CoV-2,the basic premise, in essence, is to produce antibodies against the spike protein or the proteins on the receptor binding domain (RBD) on the viral surface. 3 It is well recognized that the numerous spikes on the virus surface initiate its attachment to susceptible human cells, allowing viral entry to the cell and causing infection. Hence, blocking this all-important critical step with the help of either the naturally produced (infection) or the artificially produced (vaccine) antibody prevents the infection.

In general, there are a number of critical parameters to be fulfilled by an ideal vaccine. 4, 5 Hence a vaccine targeting SARS- CoV-2 should fit the following profile of an ideal vaccine:

Clearly, none of the vaccines available today, for any disease, possesses all of the above characteristics, nor is 100% efficacious. In reality, the goal of vaccine manufacturers is to produce a vaccine that has most of these attributes. This said, the top two attributes of a good vaccine are its safety and efficacy. Hence, a successful COVID-19 vaccine should be safe, with long-lasting immunity developing shortly after vaccination, and protect the overwhelming majority, if not all, of vaccinees against moderate to severe disease, particularly those in the most vulnerable groups.

The next section, outlines the principles, advantages and disadvantages of five major vaccine platforms. Some of these vaccines have already undergone appropriate clinical trials and received approval, while others are in the pipeline and are currently undergoing Phase I/II/III trials.

The dental team is exposed to an incessant array of emerging and re-emerging microbial threats throughout a lifetime of clinical practice. SARS-CoV-2 is the latest addition to this list, and it is likely that this pervasive disease will be entrenched in the global community for many a decade, probably in many guises. Indeed, barely a year has passed since the first signs of infection, and we are already witnessing a more infectious variant of SARS-CoV-2 (variant VUI 202012/01) in the UK and elsewhere.

The bulwark against such viral threats is the stringent, standard infection control measures routinely enforced in dentistry, and incorporated therein is the vaccination routine for the team members. In addition, it is obligatory that the principal employer considers measures to reduce risks to employees from all workplace biological hazards, including infections, as per the Control of Substances Hazardous to Health Regulations (COSHH) regulations in the UK.6 Further, the UK Department of Health stipulates that all healthcare workers in general practice, including dental practice staff, be immunized against a range of preventable, occupationally acquired infections including hepatitis B, influenza, varicella and rubella. 7 Clearly, it is a matter of time until COVID-19 is incorporated into this extensive list (Table 1).

In these circumstances, the principal employer in a dental practice setting will have to face COVID-19 infection as a lasting threat, and be prepared to overcome the various logistical issues arising from such a new provision that will benefit all stakeholders. These include dentists, paradental personnel, such as dental assistants and hygienists, dental technicians and administrative staff working in the premises, and above all, the patients attending the clinic.

So, what are the provisional, logistical issues that may be entailed in a newly mandated provision of COVID-19 vaccination for all healthcare workers? Although not an exhaustive list, these provisions are likely to include the following:

If the vaccine recipient does not seroconvert even after a third dose, then it may be obligatory for the dentist to discontinue the unresponsive vaccinee from the practice. Whether a different type of COVID-19 vaccine (ie manufactured on a different platform) could be given for an unresponsive vaccinee needs to be resolved in due course, when more information is available. Alternatively, the principal employer needs to obtain a written, and signed, non-liability statement from the unresponsive vaccine, in the rare event that they develop COVID-19 through exposure to a patient/attendee at the clinic. Such written records must be properly stored and retained for retrieval and future use, if necessary.

Clearly, some of the above are conjectural scenarios owing to the sparsity of data on the subject, and the rapidly shifting landscape of COVID-19. The eventual impact of this dreaded disease on dentistry is incomprehensible, as yet. Nevertheless, the foregoing should serve as a preparatory primer for the profession on COVID-19 vaccines. Finally, Table 2 provides detailed attributes of the vaccines that are currently approved in the UK and USA, which should be helpful in decision- making when choosing a vaccine.

Conflict of Interest: The authors declare that they have no conflict of interest.Informed Consent: Informed consent was obtained from all individual participants included in the article.