Immunological characteristics govern the transition of COVID-19 to endemicity

Abstract

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