text: COVID 19 vaccines concerns beyond protective efficacy and safety Several vaccine candidates have been developed using different platforms including nucleic acids DNA and RNA viral vectors replicating and non replicating virus like particles peptide based recombinant proteins live attenuated and inactivated virus modalities Although many of these vaccines are undergoing pre clinical trials several large clinical trials investigating the clinical efficacy and safety of coronavirus disease 2019 COVID 19 vaccines have produced promising findings In this review we provide a status update on COVID 19 vaccines currently undergoing clinical trials and discuss issues of concern beyond vaccine efficacy and safety including dosing regimens the mixed vaccine strategy prior severe acute respiratory syndrome coronavirus 2 infection antibody levels cellular immunity and protection variants of concern COVID 19 vaccine distribution vaccination willingness herd immunity immunity passports and vaccine indications Four vaccines have obtained emergency use authorization 87 are at the clinical development stage and 186 are in pre clinical development While the knowledge and development of COVID 19 vaccines is rapidly expanding the benefits of COVID 19 vaccines must outweigh the potential risks of adverse events To combat the COVID 19 pandemic clinicians should consistently update COVID 19 associated information and healthcare authorities and manufacturers should work together to provide adequate and appropriate vaccinations for the prevention of COVID 19 b What is the context b Severe acute respiratory syndrome coronavirus 2 SARS CoV 2 caused a global pandemic the coronavirus disease 2019 COVID 19 outbreak The development and implementation of the COVID 19 vaccine could be an important measure to control the COVID 19 pandemic b What is new b Several phase 3 clinical trials have demonstrated the effectiveness and safety of COVID 19 vaccines for the prevention of SARS CoV 2 infections Several COVID 19 vaccines have obtained emergency use authorization and been implemented in many countries Although concerns regarding unusual blood clots and low platelet counts have been raised the benefits of COVID 19 vaccines outweigh the potential risks of adverse events b What is the impact b Except for children the COVID 19 vaccine is recommended for all people including those pregnant or immunocompromised Healthcare authorities should advise people receiving the vaccine that they must seek medical attention if they have associated thromboembolism and thrombocytopenia symptoms More studies are necessary to determine the appropriate vaccine dose and regimen strategy as well as the effectiveness of COVID 19 vaccines against variants of concerns A global effort must be made to achieve widespread vaccination and herd immunity 