Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity?

Gregory Milne*, Thomas Hames, Chris Scotton, Nick Gent, Alexander Johnsen, Roy M. Anderson, Tom Ward

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)

Abstract

Many nations are pursuing the rollout of SARS-CoV-2 vaccines as an exit strategy from unprecedented COVID-19-related restrictions. However, the success of this strategy relies critically on the duration of protective immunity resulting from both natural infection and vaccination. SARS-CoV-2 infection elicits an adaptive immune response against a large breadth of viral epitopes, although the duration of the response varies with age and disease severity. Current evidence from case studies and large observational studies suggests that, consistent with research on other common respiratory viruses, a protective immunological response lasts for approximately 5–12 months from primary infection, with reinfection being more likely given an insufficiently robust primary humoral response. Markers of humoral and cell-mediated immune memory can persist over many months, and might help to mitigate against severe disease upon reinfection. Emerging data, including evidence of breakthrough infections, suggest that vaccine effectiveness might be reduced significantly against emerging variants of concern, and hence secondary vaccines will need to be developed to maintain population-level protective immunity. Nonetheless, other interventions will also be required, with further outbreaks likely to occur due to antigenic drift, selective pressures for novel variants, and global population mobility.

Original languageEnglish
Pages (from-to)1450-1466
Number of pages17
JournalThe Lancet Respiratory Medicine
Volume9
Issue number12
Early online date21 Oct 2021
DOIs
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information: GM is supported by the Biotechnology and Biological Sciences Research Council (London Interdisciplinary Doctoral Training Programme funding; grant number BB/M009513/1), and was, at the time of writing, supported by the UK Department of Health and Social Care. The funders had no involvement in the writing, analysis, or interpretation of results, or the decision to submit for publication. No payment was received from a pharmaceutical company or other agency directly related to the writing of this manuscript.

Open Access: Free to read, but no Open Access licence.

Publisher Copyright: © 2021 Elsevier Ltd. All rights reserved.

Citation: Gregory Milne, Thomas Hames, Chris Scotton, Nick Gent, Alexander Johnsen, Roy M Anderson, Tom Ward, Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity?, The Lancet Respiratory Medicine, Volume 9, Issue 12, 2021, Pages 1450-1466, ISSN 2213-2600,

DOI: https://doi.org/10.1016/S2213-2600(21)00407-0.

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