COVID-19 vaccine strategies must focus on severe disease and global equity

McIntyre, Peter; Aggarwal, Rakesh; Jani, Ilesh; Jawad, Jaleela; Kochhar, Sonali; MacDonald, Noni E.; Madhi, Shabir А.; Mohsni, Ezzeddine; Mulholland, Kim; Neuzil, Kathleen M.; Nohynek, Hanna; Olayinka, Folake; Pitisuttithum, Punnee; Pollard, Andrew J.; Cravioto, Alejandro

doi:10.1016/s0140-6736(21)02835-x

Cited by 71 publications

(77 citation statements)

References 52 publications

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“…Decisions on measures against SARS-CoV-2 infections are challenging and require scientific knowledge on their efficacy and their potential benefits and harms ( Ioannidis, 2020a ; Kampf and Kulldorff, 2021 ; Pilz, 2021 ). Vaccination against SARS-CoV-2 proved to be highly efficacious in short-term randomized controlled trials (RCTs) and effective in real-life settings ( Khandker et al, 2021 ; McIntyre et al, 2022 ; Polack et al, 2020 ; Sharif et al, 2021 ). Reports on waning immunity as early as a few months after vaccination pose a challenge to public health strategies ( Chemaitelly et al, 2021b ; Goldberg et al, 2021b ; Levin et al, 2021 ; Rosenberg et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, with new emerging variants like Omicron the ability to achieve sufficient protection against infection and transmission is contested ( Buchan et al, 2022 ). In the context of increasingly complex vaccination strategies and general measures against COVID-19, natural immunity acquired after SARS-CoV-2 infections may be a crucial, yet often less considered, factor ( Ioannidis, 2020b ; McIntyre et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

“…Detailed knowledge on the efficacy and duration of natural immunity in terms of protection against reinfections and related morbidity and mortality may be key for the COVID-19 pandemic as more than a third and possibly more than half of the global population may have already been infected (at least once) with SARS-CoV-2 at the beginning of 2022, with the majority of the cases not being officially detected and reported ( Bergeri et al, 2021 ; Hotez et al, 2021 ; McIntyre et al, 2022 ). This estimate is based on seroprevalence data suggesting that almost a quarter of the global population had been infected by spring 2021 with substantial further increase thereafter with the advent of the Delta variant waves since mid-2021 and then the massive surges of the Omicron variant starting in December 2021 ( Arora et al, 2021 ; Bergeri et al, 2021 ; Chen et al, 2021 ; Ioannidis, 2021c ; Jones et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity

Pilz

Theiler‐Schwetz

Trummer

et al. 2022

Environmental Research

224

191

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Seroprevalence surveys suggest that more than a third and possibly more than half of the global population has been infected with SARS-CoV-2 by early 2022. As large numbers of people continue to be infected, the efficacy and duration of natural immunity in terms of protection against SARS-CoV-2 reinfections and severe disease is of crucial significance for the future. This narrative review provides an overview on epidemiological studies addressing this issue. National surveys covering 2020–2021 documented that a previous SARS-CoV-2 infection is associated with a significantly reduced risk of reinfections with efficacy lasting for at least one year and only relatively moderate waning immunity. Importantly, natural immunity showed roughly similar effect sizes regarding protection against reinfection across different SARS-CoV-2 variants, with the exception of the Omicron variant for which data are just emerging before final conclusions can be drawn. Risk of hospitalizations and deaths was also reduced in SARS-CoV-2 reinfections versus primary infections. Observational studies indicate that natural immunity may offer equal or greater protection against SARS-CoV-2 infections compared to individuals receiving two doses of an mRNA vaccine, but data are not fully consistent. The combination of a previous SARS-CoV-2 infection and a respective vaccination, termed hybrid immunity, seems to confer the greatest protection against SARS-CoV-2 infections, but several knowledge gaps remain regarding this issue. Natural immunity should be considered for public health policy regarding SARS-CoV-2.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity

Pilz

Theiler‐Schwetz

Trummer

et al. 2022

Environmental Research

224

191

View full text Add to dashboard Cite

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“…2 Much of the evidence related to boosters pre-Omicron is still relevant for booster policy decisions although timelines may be accelerated due to the new variant, and the primary focus must remain on vaccinating those at high risk of severe outcomes. 3 …”

mentioning

confidence: 99%

“… 9 However, these are additional benefits and the focus needs to remain on preventing severe illness in the vulnerable. 3 …”

mentioning

confidence: 99%

COVID-19 vaccine boosters in the Asia-Pacific region in the context of Omicron

Hart

Chokephaibulkit

Mayxay

et al. 2022

The Lancet Regional Health - Western Pacific

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COVID‐19 in a common woolly monkey (Lagothrix lagothricha): First evidence of fatal outcome in a nonhuman primate after natural SARS‐CoV‐2 infection

Diaz,

Sáenz,

Cabrera

et al. 2024

American J Primatol

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Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), was declared a pandemic by the World Health Organization in March 2020. Since then, viral spread from humans to animals has occurred worldwide. Nonhuman primates (NHPs) have been found to be susceptible to reverse‐zoonosis transmission of SARS‐CoV‐2, but initial research suggested that platyrrhine primates are less susceptible than catarrhine primates. Here we report the natural SARS‐CoV‐2 infection of a common woolly monkey (Lagothrix lagothricha) from a wildlife rehabilitation center in Ecuador. The course of the disease, the eventual death of the specimen, and the pathological findings are described. Our results show the susceptibility of a new platyrrhine species to SARS‐CoV‐2 and provide evidence for the first time of a COVID‐19‐associated death in a naturally infected NHP. The putative route of transmission from humans, and implications for captive NHPs management, are also discussed. Given that common woolly monkeys are at risk of extinction in Ecuador, further understanding of the potential threat of SARS‐CoV‐2 to their health should be a conservation priority. A One Health approach is the best way to protect NHPs from a new virus in the same way that we would protect the human population.

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COVID-19 vaccine strategies must focus on severe disease and global equity

Cited by 71 publications

References 52 publications

SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity

SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity

COVID-19 vaccine boosters in the Asia-Pacific region in the context of Omicron

COVID‐19 in a common woolly monkey (Lagothrix lagothricha): First evidence of fatal outcome in a nonhuman primate after natural SARS‐CoV‐2 infection

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