Immune evasion means we need a new COVID-19 social contract

Open Access – Published: February 18, 2021
DOI: https://doi.org/10.1016/S2468-2667(21)00036-0

The collective benefits of herd immunity have become similar to a mantra in mass vaccination strategies, repeated by governments and researchers. However, the prominence of herd immunity being touted as a solution to the pandemic might be about to change with the emergence of immune evasion, a virological game changer that is as important as the arrival of SARS-CoV-2 variants. Dealing with immune evasion will require a re-evaluation of public health strategies, and the creation of a new, evidence-based social contract.Studies suggest that the emergence and spread of SARS-CoV-2 variants is correlated with the absence of robust immune protection after first exposure to previous (wild-type) viruses, or even to a vaccine.12 This evolution, associated with the emergence of immune escape mutants, has not only been observed with SARS-CoV-2, but also with other viruses.3 Such evolution might be assisted by the waning of the immune response and notably the antibody response. The rapid arrival of SARS-CoV-2 variants such as the variants first identified in South Africa and Brazil suggests a so-called natural immune evasion.2 Also, the dynamics of natural or vaccinal collective immunity in the regions where these variants emerged might have placed substantial pressure on the viral ecosystem, facilitating the emergence of a variant with enhanced transmissibility.

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Published: February 18, 2021

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DOI: https://doi.org/10.1016/S2468-2667(21)00036-0

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© 2021 The Author(s). Published by Elsevier Ltd.

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