Taming a pandemic One year after its emergence, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become so widespread that there is little hope of elimination. There are, however, several other human coronaviruses that are endemic and cause multiple reinfections that engender sufficient immunity to protect against severe adult disease. By making assumptions about acquired immunity from its already endemic relatives, Lavine et al. developed a model with which to analyze the trajectory of SARS-CoV-2 into endemicity. The model accounts for SARS-CoV-2’s age-structured disease profile and assesses the impact of vaccination. The transition from epidemic to endemic dynamics is associated with a shift in the age distribution of primary infections to younger age groups, which in turn depends on how fast the virus spreads. Longer-lasting sterilizing immunity will slow the transition to endemicity. Depending on the type of immune response it engenders, a vaccine could accelerate establishment of a state of mild disease endemicity. Science , this issue p. 741 The transition from epidemic to endemic dynamics of SARS-CoV-2 is associated with a shift in the age distribution of primary infections to younger age groups. 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.
【초록키워드】 SARS-CoV-2, Vaccine, coronavirus, immune response, vaccination, pandemic, Immunity, SARS-COV-2 infection, children, severity, outcome, severe acute respiratory syndrome Coronavirus, virus, Elimination, Reinfection, Epidemic, sterilizing immunity, Mild, trajectory, age, epidemiological data, childhood, common cold, acquired immunity, respiratory, distribution, disease, predict, Primary infection, Endemic, Analysis, endemicity, severe disease, age distribution, Science, acute respiratory syndrome, adult disease, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, transition, shift, Severity of infection, assumption, component, HCoVs, virulent, endemic human coronaviruses, widespread, immunological, PROTECT, human coronavirus, evaluate, question, cause, reached, groups, turn, accelerate, endemic human coronavirus, spreads, 【제목키워드】 COVID-19, Characteristics,