Infection by SARS‐CoV‐2 with alternate frequencies of mRNA vaccine boosting

Abstract

One of the most consequential unknowns of the COVID‐19 pandemic is the frequency at which vaccine boosting provides sufficient protection from infection. We quantified the statistical likelihood of breakthrough infections over time following different boosting schedules with messenger RNA (mRNA)‐1273 (Moderna) and BNT162b2 (Pfizer‐BioNTech). We integrated anti‐Spike IgG antibody optical densities with profiles of the waning of antibodies and corresponding probabilities of infection associated with coronavirus endemic transmission. Projecting antibody levels over time given boosting every 6 months, 1, 1.5, 2, or 3 years yielded respective probabilities of fending off infection over a 6‐year span of >93%, 75%, 55%, 40%, and 24% (mRNA‐1273) and >89%, 69%, 49%, 36%, and 23% (BNT162b2). Delaying the administration of updated boosters has bleak repercussions. It increases the probability of individual infection by SARS‐CoV‐2, and correspondingly, ongoing disease spread, prevalence, morbidity, hospitalization, and mortality. Instituting regular, population‐wide booster vaccination updated to predominant variants has the potential to substantially forestall—and with global, widespread uptake, eliminate—COVID‐19.

Key Considerations during the Transition from the Acute Phase of the COVID-19 Pandemic: A Narrative Review

“…Given that COVID-19 vaccines will remain a primary strategy to decrease the health burden caused by SARS-CoV-2, it is essential to simplify the vaccination protocols, particularly regarding booster administration. Various observations demonstrate a significant decline in vaccination-induced antibodies within six months from the previous dose and indicate that biannual boosting with mRNA vaccines (most frequently used for this purpose) will induce the highest level of protection against infection [ 167 , 168 , 169 , 170 ]. Under such an approach, the risk of breakthrough infection over six years was estimated at 7–11%.…”

“…In comparison, annual boosting would also substantially reduce the 6-year risk to 25–31%. In turn, delaying boosting beyond two years yielded cumulative risks of future infection nearly as high as foregoing boosting entirely [ 170 ].…”

Long-term vaccination strategies to mitigate the impact of SARS-CoV-2 transmission: A modelling study

“…Our analyses illustrate the importance of continued booster doses as part of the wider public health response to ongoing endemic transmission of SARS-CoV-2 [ 23 , 60 ]. Prioritising boosters to high-risk and older populations is an efficient strategy in terms of reducing hospitalisations and death, while managing finite healthcare resources, but further data are required to understand the cost-effectiveness of vaccinating a wider age group to protect against the consequences of long COVID.…”

Infection by SARS-CoV-2 with alternate frequencies of mRNA vaccine boosting for patients undergoing antineoplastic treatment for cancer

“…To project antibody waning based on initial responses for each patient cohort in ongoing therapy, we applied an established comparative evolutionary framework (2-4) for inference of infection probability given antibody level to mRNA boosting with the BNT162b2 vaccine. We integrated longitudinal anti-N and anti-S IgG antibody waning data for six human-infecting coronaviruses (HCoV-OC43, HCoV-NL63, and HCoV-229E, SARS-CoV-1, SARS-CoV-2, and MERS; 3) into an ancestral and descendent states analysis, fitting logistic regression models of endemic daily probabilities of infection without (2,4). From ensuing daily probabilities of infection given antibody level, cumulative probabilities of breakthrough infection were calculated for alternate, variant-updated booster schedules for members of the general population, patients with untreated cancer and undergoing continuous treatment over two years, scheduled every month, three months, six months, one year, or two years.…”