Mathematical assessment of the role of waning and boosting immunity against the BA.1 Omicron variant in the United States.

Three safe and effective vaccines against SARS-CoV-2 have played a major role in combating COVID-19 in the United States. However, the effectiveness of these vaccines and vaccination programs has been challenged by the emergence of new SARS-CoV-2 variants of concern. A new mathematical model is formulated to assess the impact of waning and boosting of immunity against the Omicron variant in the United States. To account for gradual waning of vaccine-derived immunity, we considered three vaccination classes that represent high, moderate and low levels of immunity. We showed that the disease-free equilibrium of the model is globally-asymptotically, for two special cases, if the associated reproduction number is less than unity. Simulations of the model showed that vaccine-derived herd immunity can be achieved in the United States via a vaccination-boosting strategy which entails fully vaccinating at least 59% of the susceptible populace followed by the boosting of about 72% of the fully-vaccinated individuals whose vaccine-derived immunity has waned to moderate or low level. In the absence of boosting, waning of immunity only causes a marginal increase in the average number of new cases at the peak of the pandemic, while boosting at baseline could result in a dramatic reduction in the average number of new daily cases at the peak. Specifically, for the fast immunity waning scenario (where both vaccine-derived and natural immunity are assumed to wane within three months), boosting vaccine-derived immunity at baseline reduces the average number of daily cases at the peak by about 90% (in comparison to the corresponding scenario without boosting of the vaccine-derived immunity), whereas boosting of natural immunity (at baseline) only reduced the corresponding peak daily cases (in comparison to the corresponding scenario without boosting of natural immunity) by approximately 62%. Furthermore, boosting of vaccine-derived immunity is more beneficial (in reducing the burden of the pandemic) than boosting of natural immunity. Finally, boosting vaccine-derived immunity increased the prospects of altering the trajectory of COVID-19 from persistence to possible elimination.