Immune life history, vaccination, and the dynamics of SARS-CoV-2 over the next 5 years.
Immune life history, vaccination, and the dynamics of SARS-CoV-2 over the next 5 years.
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在未来5年中，免疫生活史，疫苗接种和SARS-COV-2的动态。
DOI：
10.1126/science.abd7343
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发表时间：
2020-11-13
期刊：
影响因子：
--
通讯作者：
Grenfell BT
中科院分区：
文献类型：
--
作者：
Saad-Roy CM;Wagner CE;Baker RE;Morris SE;Farrar J;Graham AL;Levin SA;Mina MJ;Metcalf CJE;Grenfell BT
人类感染了几种季节性和交叉反应的冠状病毒。没有一种能激发完全的保护性免疫力，重复感染是常态。疫苗在激发免疫力方面往往不如自然感染有效，而且存在不良交叉反应的风险。Saad-Roy等人使用了一系列简单的模型，用于各种免疫场景，以设想有和没有疫苗的严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的免疫学未来。模型结果表明，我们对不完美的冠状病毒免疫格局的不完善的了解可能会导致从反复出现严重流行病到消除的不同情况。我们准确地描述对SARS-CoV-2的免疫反应，以便将其转化为疾病控制管理，这一点至关重要。《科学》，本期第811页，建模表明，提高对SARS-CoV-2免疫反应的精确理解是多么重要。2019冠状病毒病（COVID-19）大流行的未来轨迹取决于针对严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的适应性免疫动态;然而，自然感染或疫苗接种引发的免疫反应的显著特征仍不确定。我们使用简单的流行病学模型来探索对未来COVID-19病例的规模和时间的估计，考虑到对SARS-CoV-2的适应性免疫反应的保护效力和持续时间的不同假设，以及其与疫苗和非药物干预的相互作用。我们发现，对原发性SARS-CoV-2感染和潜在疫苗的免疫反应的变化可以导致明显不同的免疫景观和严重病例的负担，从持续流行到接近消除。我们的研究结果说明了未来COVID-19动态的可能复杂性，并强调了免疫学表征在测量活动性感染之外的重要性，以充分预测SARS-CoV-2感染产生的免疫景观。
Humans are infected by several seasonal and cross-reacting coronaviruses. None provokes fully protective immunity, and repeat infections are the norm. Vaccines tend to be less efficient than natural infections at provoking immunity, and there are risks of adverse cross-reactions. Saad-Roy et al. used a series of simple models for a variety of immune scenarios to envisage immunological futures for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with and without vaccines. The model outcomes show that our imperfect knowledge about the imperfect coronavirus immune landscape can give rise to diverging scenarios ranging from recurring severe epidemics to elimination. It is critical that we accurately characterize immune responses to SARS-CoV-2 for translation into managing disease control. Science, this issue p. 811 Modeling shows how essential it is to improve precise understanding of immune responses to SARS-CoV-2. The future trajectory of the coronavirus disease 2019 (COVID-19) pandemic hinges on the dynamics of adaptive immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, salient features of the immune response elicited by natural infection or vaccination are still uncertain. We use simple epidemiological models to explore estimates for the magnitude and timing of future COVID-19 cases, given different assumptions regarding the protective efficacy and duration of the adaptive immune response to SARS-CoV-2, as well as its interaction with vaccines and nonpharmaceutical interventions. We find that variations in the immune response to primary SARS-CoV-2 infections and a potential vaccine can lead to markedly different immune landscapes and burdens of critically severe cases, ranging from sustained epidemics to near elimination. Our findings illustrate likely complexities in future COVID-19 dynamics and highlight the importance of immunological characterization beyond the measurement of active infections for adequately projecting the immune landscape generated by SARS-CoV-2 infections.
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