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In this commentary in The Lancet, the authors highlight the challenges of mass vaccination against COVID-19. They include issues with who to vaccinate first, vaccine hesitancy, and the unknowns about immunity duration.
This is a helpful article that clarifies some of the issues with vaccination beyond vaccine development; it is particularly helpful for counseling patients and answering their questions.
– Morgan Soffler, MD
This abstract is available on the publisher's site.
Vaccines to protect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have risen up the agenda of most policy makers and individuals as the second wave of COVID-19 in northern hemisphere countries grows and there is increasing pressure on health-care systems. For any licensed vaccine, efficacy and duration of protection are key issues. Vaccine efficacies to protect against infection above 80% are desirable,1 but duration of protection will remain uncertain for a number of years post licensure of COVID-19 vaccines. Preliminary evidence suggests waning antibody titres in those who have recovered from SARS-CoV-2 infection,2 but antibodies are only one part of the human immune response and acquired immunity to reinfection or the prevention of disease when reinfected.3, 4, 5 Data on immunity to other coronaviruses suggest that immunity to SARS-CoV-2 might be short lived, perhaps 12–18 months in duration.6 Whether past infection will prevent severe COVID-19 on re-exposure to SARS-CoV-2 is not known at present.