Kosinski Robert J
Independent Researcher, 303 Tamassee Drive, Clemson, SC 29631, USA.
Vaccines (Basel). 2024 May 13;12(5):532. doi: 10.3390/vaccines12050532.
This paper simulates a hypothetical pan-coronavirus vaccine that confers immediate sterilizing immunity against all SARS-CoV-2 variants. Simulations used a SEIIS (susceptible, exposed, infective, immune, susceptible) spreadsheet model that ran two parallel subpopulations: one that accepted vaccination and another that refused it. The two subpopulations could transmit infections to one another. Using data from the United States (US), the simulated vaccine was tested against limiting factors such as vaccine hesitancy, slow vaccination distribution, and the development of high-transmission variants. The vaccine was often successful at reducing cases, but high-transmission variants and discontinuation of non-pharmaceutical interventions (NPIs) such as masking greatly elevated cases. A puzzling outcome was that if NPIs were discontinued and high-transmission variants became common, the model predicted consistently higher rates of disease than are actually observed in the US in 2024. However, if cumulative exposure to virus antigens increased the duration of immunity or decreased the infectivity of the virus, the model predictions were brought back into a more realistic range. The major finding was that even when a COVID-19 vaccine always produces sterilizing immunity against every SARS-CoV-2 variant, its ability to control the epidemic can be compromised by multiple common conditions.
本文模拟了一种假设的泛冠状病毒疫苗，该疫苗能对所有新冠病毒变异株立即产生绝育免疫。模拟使用了一个SEIIS（易感、暴露、感染、免疫、易感）电子表格模型，该模型运行两个平行的亚群体：一个接受疫苗接种，另一个拒绝接种。这两个亚群体可以相互传播感染。利用来自美国的数据，对模拟疫苗进行了针对疫苗犹豫、疫苗接种分布缓慢以及高传播变异株出现等限制因素的测试。该疫苗在减少病例方面通常很成功，但高传播变异株以及诸如戴口罩等非药物干预措施（NPIs）的停止实施极大地增加了病例数。一个令人困惑的结果是，如果停止实施非药物干预措施且高传播变异株变得普遍，该模型预测的疾病发生率始终高于2024年美国实际观察到的发生率。然而，如果累积接触病毒抗原增加了免疫持续时间或降低了病毒的传染性，模型预测结果就会回到更现实的范围。主要发现是，即使一种新冠疫苗始终能对每一种新冠病毒变异株产生绝育免疫，其控制疫情的能力仍可能受到多种常见情况的影响。
