Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity?
Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity?
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DOI：
10.1016/s2213-2600(21)00407-0
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发表时间：
2021-12
期刊：
影响因子：
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通讯作者：
Ward T
中科院分区：
文献类型：
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作者：
Milne G;Hames T;Scotton C;Gent N;Johnsen A;Anderson RM;Ward T
许多国家都在推出SARS-CoV-2疫苗，作为退出史无前例的新冠肺炎相关限制的战略。然而，这一战略的成功关键取决于自然感染和疫苗接种所产生的保护性免疫的持续时间。SARS-CoV-2感染引起针对大量病毒表位的获得性免疫反应，尽管这种反应的持续时间因年龄和疾病严重程度而异。病例研究和大型观察性研究的最新证据表明，与对其他常见呼吸道病毒的研究一致，保护性免疫反应从初次感染开始持续约5-12个月，再次感染更有可能是由于初次体液反应不够强劲。体液和细胞介导的免疫记忆的标记可以持续数月，并可能有助于缓解再次感染时的严重疾病。新出现的数据，包括突破性感染的证据，表明疫苗对新出现的令人担忧的变种的有效性可能会显著降低，因此需要开发二次疫苗以维持人群水平的保护性免疫。尽管如此，还需要其他干预措施，由于抗原漂移、对新变种的选择压力以及全球人口流动，可能会发生进一步的疫情。
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.