Impact of waning immunity against SARS-CoV-2 severity exacerbated by vaccine hesitancy
Author summary While the SARS-CoV-2 outbreak continues, the deployment of vaccines in many regions has blunted the severity of SARS-CoV-2 infections and decreased hospitalizations. However, the medium-term impacts of the duration of severity-blocking immunity, and its potential interactions with heterogeneous vaccine uptake (e.g. from vaccine hesitancy) or more robust vaccines, remain unknown. To titrate these effects, we use immuno-epidemiological models to examine potential future scenarios. We find that sufficient vaccine hesitancy (and correspondingly higher vaccination rates among adopters) can rapidly increase the fraction of individuals infected after waned severity-blocking immunity even when robust vaccines are deployed. This result underlines that pharmaceutical developments for broadly protective vaccines should be combined with campaigns to increase vaccine uptake globally. We also show that this fraction is highly dependent on underlying immune uncertainties, which illustrates the importance of accurately measuring immune parameters for proper prediction based on hospitalization data.