Concerns about SARS-CoV-2 evolution should not hold back efforts to expand vaccination.
Nat Rev Immunol
; 21(5): 330-335, 2021 05.
Article
in English
| MEDLINE | ID: covidwho-1164868
ABSTRACT
When vaccines are in limited supply, expanding the number of people who receive some vaccine, such as by halving doses or increasing the interval between doses, can reduce disease and mortality compared with concentrating available vaccine doses in a subset of the population. A corollary of such dose-sparing strategies is that the vaccinated individuals may have less protective immunity. Concerns have been raised that expanding the fraction of the population with partial immunity to SARS-CoV-2 could increase selection for vaccine-escape variants, ultimately undermining vaccine effectiveness. We argue that, although this is possible, preliminary evidence instead suggests such strategies should slow the rate of viral escape from vaccine or naturally induced immunity. As long as vaccination provides some protection against escape variants, the corresponding reduction in prevalence and incidence should reduce the rate at which new variants are generated and the speed of adaptation. Because there is little evidence of efficient immune selection of SARS-CoV-2 during typical infections, these population-level effects are likely to dominate vaccine-induced evolution.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vaccines
/
Vaccination
/
Off-Label Use
/
SARS-CoV-2
/
COVID-19
Type of study:
Observational study
/
Qualitative research
Topics:
Vaccines
/
Variants
Limits:
Humans
Language:
English
Journal:
Nat Rev Immunol
Journal subject:
Allergy and Immunology
Year:
2021
Document Type:
Article
Affiliation country:
S41577-021-00544-9
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