Immunological characteristics govern the transition of COVID-19 to endemicity

• Type of Material: Article
• Authors: Jennie S Lavine, Emory University; Ottar N Bjornstad, Pennsylvania State University; Rustom Antia, Emory University
• Language: English
• Date: 2021-02-12
• Publisher: AAAS
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1126/science.abe6522
• Title of Journal or Parent Work: Science
• Volume: 371
• Issue: 6530
• Start Page: 741
• End Page: 745
• Grant/Funding Information: This work was funded by NIH grants U01 AI150747, U01 HL139483, and U01 AI144616.
• Keywords: Adult; Antibodies, Viral; Age Distribution; Endemic Diseases; Adolescent; Severity of Illness Index; Child; Infant; Adaptive Immunity; Humans; COVID-19; Coronavirus Infections; Epidemics; COVID-19 Vaccines; SARS-CoV-2; Coronavirus; Communicable Diseases, Emerging; Immunoglobulin M; Seroepidemiologic Studies; Immunoglobulin G; Child, Preschool; Reinfection; Severe Acute Respiratory Syndrome
• Research Categories: Health Sciences, Public Health; Biology, General; Health Sciences, Immunology

Abstract

We are currently faced with the question of how the severity of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may change in the years ahead. Our analysis of immunological and epidemiological data on endemic human coronaviruses (HCoVs) shows that infection-blocking immunity wanes rapidly but that disease-reducing immunity is long-lived. Our model, incorporating these components of immunity, recapitulates both the current severity of SARS-CoV-2 infection and the benign nature of HCoVs, suggesting that once the endemic phase is reached and primary exposure is in childhood, SARS-CoV-2 may be no more virulent than the common cold. We predict a different outcome for an emergent coronavirus that causes severe disease in children. These results reinforce the importance of behavioral containment during pandemic vaccine rollout, while prompting us to evaluate scenarios for continuing vaccination in the endemic phase.