Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-OC43, and HCoV-229E): Results from the Flu Watch cohort study

Andrew C. Hayward*, Robert W. Aldridge, Dan Lewer, Sarah Beale, Anne M. Johnson, Maria Zambon, Ellen B. Fragaszy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)
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Background: There is currently a pandemic caused by the novel coronavirus SARS-CoV-2. The intensity and duration of this first and second waves in the UK may be dependent on whether SARS-CoV-2 transmits more effectively in the winter than the summer and the UK Government response is partially built upon the assumption that those infected will develop immunity to reinfection in the short term. In this paper we examine evidence for seasonality and immunity to laboratory-confirmed seasonal coronavirus (HCoV) from a prospective cohort study in England.

Methods: In this analysis of the Flu Watch cohort, we examine seasonal trends for PCR-confirmed coronavirus infections (HCoV-NL63, HCoV-OC43, and HCoV-229E) in all participants during winter seasons (2006-2007, 2007-2008, 2008-2009) and during the first wave of the 2009 H1N1 influenza pandemic (May-Sep 2009). We also included data from the pandemic and 'post-pandemic' winter seasons (2009-2010 and 2010-2011) to identify individuals with two confirmed HCoV infections and examine evidence for immunity against homologous reinfection.

Results: We tested 1,104 swabs taken during respiratory illness and detected HCoV in 199 during the first four seasons. The rate of confirmed HCoV infection across all seasons was 390 (95% CI 338-448) per 100,000 person-weeks; highest in the Nov-Mar 2008/9 season at 674 (95%CI 537-835) per 100,000 person-weeks. The highest rate was in February at 759 (95% CI 580-975) per 100,000 person-weeks. Data collected during May-Sep 2009 showed there was small amounts of ongoing transmission, with four cases detected during this period. Eight participants had two confirmed infections, of which none had the same strain twice.

Conclusion: Our results provide evidence that HCoV infection in England is most intense in winter, but that there is a small amount of ongoing transmission during summer periods. We found some evidence of immunity against homologous reinfection.

Original languageEnglish
Article number52
JournalWellcome Open Research
Early online date30 Mar 2020
Publication statusPublished - 10 Dec 2020

Bibliographical note

Funding Information: This study was supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to RA [206602] and funding to The Flu Watch Study.
The Flu Watch study received funding from the Medical Research Council (MRC) and the Wellcome Trust [G0600511, G0800767 and MC_U122785833]. S.B. is supported by an MRC doctoral studentship [MR/N013867/1].
DL is funded by the National Institute for Health Research [DRF-2018-11-ST2-016]. This paper presents independent research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © 2020 Aldridge RW et al.

Citation: Aldridge RW, Lewer D, Beale S et al. Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-OC43, and HCoV-229E): results from the Flu Watch cohort study [version 2; peer review: 2 approved]. Wellcome Open Res 2020, 5:52.



  • Epidemiology
  • HCoV-229E
  • HCoV-NL63
  • HCoV-OC43
  • Pandemic
  • Public health
  • SARS-CoV-2


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