Rapid relaxation of pandemic restrictions after vaccine rollout favors growth of SARS-CoV-2 variants: A model-based analysis

  1. Debra Van Egeren
  2. Madison Stoddard
  3. Alexander Novokhodko
  4. Michael S. Rogers
  5. Diane Joseph-McCarthy
  6. Bruce Zetter
  7. Arijit Chakravarty

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Abstract

The development and deployment of several SARS-CoV-2 vaccines in a little over a year is an unprecedented achievement of modern medicine. The high levels of efficacy against transmission for some of these vaccines makes it feasible to use them to suppress SARS-CoV-2 altogether in regions with high vaccine acceptance. However, viral variants with reduced susceptibility to vaccinal and natural immunity threaten the utility of vaccines, particularly in scenarios where a return to pre-pandemic conditions occurs before the suppression of SARS-CoV-2 transmission. In this work we model the situation in the United States in May-June 2021, to demonstrate how pre-existing variants of SARS-CoV-2 may cause a rebound wave of COVID-19 in a matter of months under a certain set of conditions. A high burden of morbidity (and likely mortality) remains possible, even if the vaccines are partially effective against new variants and widely accepted. Our modeling suggests that variants that are already present within the population may be capable of quickly defeating the vaccines as a public health intervention, a serious potential limitation for strategies that emphasize rapid reopening before achieving control of SARS-CoV-2.

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  1. Version published to 10.1371/journal.pone.0258997
  2. ScreenIT

    SciScore for 10.1101/2021.05.14.21257250: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our work has a few important limitations. First, the simulations of the United States shown here are examples based on the currently available estimates for viral parameters such as transmissibility and vaccine evasion. Those estimates are preliminary and may change as more information becomes available. The results here depend heavily on the estimates for transmissibility for the immune-evading strains (P.1 and B.1.351), and these estimates are vulnerable to experimental error38. Thus, while our work suggests, for example, that P.1 is likely to pose a public health threat in the coming months within the United States if contact rates return to pre-pandemic levels, uncertainty around viral parameters for P.1 prevents us from making a definitive prediction. Second, a number of key parameter values in our system are currently unknown: for example, vaccine impact on the transmission of viral variants, the degree of cross-protection against reinfection conferred by infection with viral variants, and the variant-specific risk of death if infected after vaccination. The estimates used in our simulations were chosen to be conservative with respect to these parameters, but emerging experimental data may change these results. Third, we do not consider the generation of new, possibly more transmissible or immune-evading variants. New variants, such as B.1.617, which recently appeared in India, could overtake existing variants and possibly lead to more infections. Finally, our modeling ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.05.14.21257250v1 on medRxiv