The specter of Manaus: the risks of a rapid return to pre-pandemic conditions after COVID-19 vaccine rollout

Egeren, Debra Van; Stoddard, Madison; Novokhodko, Alexander; Rogers, Michael S.; Joseph‐McCarthy, Diane; Zetter, Bruce R.; Chakravarty, Arijit

doi:10.1101/2021.05.14.21257250

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Our team has used model-based approaches to predict the rapid pace of evolutionary immune evasion [68], the inability of vaccines to enable a return to pre-pandemic conditions [69], the tendency of noncompliance with mitigation measures to incentivize further noncompliance [70], and the rapid variantdriven rebound observed upon premature relaxation of mitigation measures [71]. In each of these cases, our predictions were made months in advance [72][73][74][75].…”

Section: Discussionmentioning

confidence: 99%

The impact of vaccination frequency on COVID-19 public health outcomes: A model-based analysis

Stoddard¹,

Yuan²,

Sarkar

et al. 2023

Preprint

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While the rapid deployment of SARS-CoV-2 vaccines had a significant impact on the ongoing COVID-19 pandemic, rapid viral immune evasion and waning neutralizing antibody titers have degraded vaccine efficacy. Nevertheless, vaccine manufacturers and public health authorities have a number of levers at their disposal to maximize the benefits of vaccination. Here, we use an agent-based modeling framework coupled with the outputs of a population pharmacokinetic model to examine the impact of boosting frequency and durability of vaccinal response on vaccine efficacy. Our work suggests that repeated dosing at frequent intervals (multiple times a year) may offset the degradation of vaccine efficacy, preserving their utility in managing the ongoing pandemic. Our work relies on assumptions about antibody accumulation and the tolerability of repeated vaccine doses. Given the practical significance of potential improvements in vaccinal utility, clinical research to better understand the effects of repeated vaccination would be highly impactful. These findings are particularly relevant as public health authorities worldwide seek to reduce the frequency of boosters to once a year or less. Our work suggests practical recommendations for vaccine manufacturers and public health authorities and draws attention to the possibility that better outcomes for SARS-CoV-2 public health remain within reach.

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Section: Discussionmentioning

confidence: 99%

The impact of vaccination frequency on COVID-19 public health outcomes: A model-based analysis

Stoddard¹,

Yuan²,

Sarkar

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, the pandemic is now entering its fourth year despite a vast burden of prior infection, over 13 billion vaccination doses globally [5] and high prevalence of anti-SARS-CoV-2 antibodies [6,7]. Consistent with early-pandemic warnings [8][9][10][11][12][13], the pace of immune evasion has proven rapid [14,15], and transmission has continued robustly in the post-vaccine era [16]. Warnings about insufficient vaccine acceptance [17], rapid waning of vaccine and post-infection immune protection [18,19], and antibody evasion [8][9][10]20] have all materialized at this point [21][22][23], leading to the high levels of SARS-CoV-2 transmission.…”

Section: Introductionmentioning

confidence: 99%

Antibody escape, the risk of serotype formation, and rapid immune waning: modeling the implications of SARS-CoV-2 immune evasion

Albright

Egeren

Thakur

et al. 2023

Preprint

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As the COVID-19 pandemic progresses, widespread community transmission of SARS-CoV-2 has ushered in a volatile era of viral immune evasion rather than the much-heralded stability of "endemicity" or "herd immunity." At this point, an array of viral variants has rendered essentially all monoclonal antibody therapeutics obsolete and strongly undermined the impact of vaccinal immunity on SARS-CoV-2 transmission. In this work, we demonstrate that antigenic drift resulting in evasion of pre-existing immunity is highly evolutionarily favored and likely to cause waves of short-term transmission. In the long-term, invading variants that induce weak cross-immunity against pre-existing strains may co-circulate with those pre-existing strains. This would result in the formation of serotypes that increase disease burden, complicate SARS-CoV-2 control and raise the potential for increases in viral virulence. Less durable immunity does not drive positive selection as a trait, but such strains may transmit at high levels if they establish. Overall, our results draw attention to the importance of inter-strain cross-immunity as a driver of transmission trends and the importance of early immune evasion data to predict the trajectory of the pandemic.

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Section: Introductionmentioning

confidence: 99%

Antibody escape, the risk of serotype formation, and rapid immune waning: Modeling the implications of SARS-CoV-2 immune evasion

Albright,

Van Egeren,

Thakur

et al. 2023

PLoS ONE

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As the COVID-19 pandemic progresses, widespread community transmission of SARS-CoV-2 has ushered in a volatile era of viral immune evasion rather than the much-heralded stability of “endemicity” or “herd immunity.” At this point, an array of viral strains has rendered essentially all monoclonal antibody therapeutics obsolete and strongly undermined the impact of vaccinal immunity on SARS-CoV-2 transmission. In this work, we demonstrate that antibody escape resulting in evasion of pre-existing immunity is highly evolutionarily favored and likely to cause waves of short-term transmission. In the long-term, invading strains that induce weak cross-immunity against pre-existing strains may co-circulate with those pre-existing strains. This would result in the formation of serotypes that increase disease burden, complicate SARS-CoV-2 control, and raise the potential for increases in viral virulence. Less durable immunity does not drive positive selection as a trait, but such strains may transmit at high levels if they establish. Overall, our results draw attention to the importance of inter-strain cross-immunity as a driver of transmission trends and the importance of early immune evasion data to predict the trajectory of the pandemic.

show abstract

The specter of Manaus: the risks of a rapid return to pre-pandemic conditions after COVID-19 vaccine rollout

Cited by 4 publications

References 20 publications

The impact of vaccination frequency on COVID-19 public health outcomes: A model-based analysis

The impact of vaccination frequency on COVID-19 public health outcomes: A model-based analysis

Antibody escape, the risk of serotype formation, and rapid immune waning: modeling the implications of SARS-CoV-2 immune evasion

Antibody escape, the risk of serotype formation, and rapid immune waning: Modeling the implications of SARS-CoV-2 immune evasion

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