The BSI’s Immunology and COVID-19 taskforce has produced a report on immunity and COVID-19. The rapid review-style document lays out what we do and don't currently know about immunity to SARS-CoV-2 and outlines four research recommendations to help increase our knowledge of the immune system's response following COVID-19 vaccination and natural infection. In this article, our Policy & Public Affairs Manager, Matthew Gibbard, discusses the findings of this report and explains its importance, both for the BSI’s policy work and mission, and to ensure the UK comes out from the pandemic swiftly while minimising risks.
The BSI’s Immunology and COVID-19 taskforce has continued its successful run of reports addressing the key questions that are facing policymakers in the UK by bringing together the latest science to form answers on what we do and don't know about immunity and COVID-19 and issuing a set of research recommendations. After publication, we send a copy to civil servants and legislators across the country, in the UK Parliament in Westminster, in the Scottish Parliament, in the Senedd, and in the Stormont to ensure that every government and scrutinising body has access to high level immunology in looking at the decision making in the weeks and months to come.
And as usual, we received excellent feedback from many parliamentarians, officials, and others working in the science and research policy arena, with many spurred into action. This has included Peers and MPs asking questions to Ministers in the Houses of Lords and Commons, respectively, and the BSI being asked to send a representative to give oral evidence at the All Party Parliamentary Group on Coronavirus’s evidence session on ‘vaccination and vaccine rollout’.
With many of the questions being addressed also being of great interest and relevance to the general public, we have also produced a briefer and more accessible Q&A blog for those without a research background. Much of the uncertainty that people have around taking a COVID-19 vaccine or what generating immunity means to them comes, not from misinformation necessarily, but from a lack of good quality information which is accessible, so we hope that this will, in part, address that and we urge you to share it with non-scientific family and friends.
Unravelling the immune response to SARS-CoV-2
Understanding immunity to COVID-19, induced by both natural infection and through vaccination, is key to our ability to exit the current pandemic. In this report, we explored the answers to key questions around immunity, including the effectiveness of the immune response, how to measure and track immunity, the benefits of vaccine-mediated immunity, and the longevity of any immunity conferred.
It is important to say that there are differing degrees of immunity. Different individuals will create different immune responses to invasive pathogens, and the case of the SARS-CoV-2 virus is no exception. Some people create a very effective immune response, so they will not get sick again from SARS-CoV-2 and will not pass the virus to anyone else (so-called ‘sterilising’ immunity), while others will make antibodies and be protected from the disease COVID-19, but may still be infected with the SARS-CoV-2 virus and transmit it to others (‘protective’ immunity).
Immunity can be difficult to measure. The best marker currently is neutralising antibodies, which have been shown to persist in some individuals up to 8 months after original infection. While immunity can also be measured by looking at memory immune cells, methods for doing this at scale are not currently available. Immunity can wane over time and this can lead to the small chance of reinfection. Exactly how long immunity following COVID-19 lasts will need a longer time to determine.
Vaccine-mediated immunity is preferable and safer than naturally acquired immunity. While clinical trials recorded the ability of the vaccines to protect from COVID-19 disease, questions remain around whether the vaccines being administered currently will prevent people from being able to carry and transmit the SARS-CoV-2 virus. Currently not enough time has elapsed between the vaccines first being administered in humans and the present time for durability of vaccine-induced immunity to be determined, but this is the subject of ongoing Phase 3 vaccine studies.
To establish detailed studies of the immune response following COVID-19 vaccination and natural infection to identify how long immunity conferred by vaccination might last, how often booster vaccinations might be needed and to support the development of future vaccines.
To use structural biology modelling to build our understanding of how potential mutations in the virus may affect infectiousness. If we can predict these, we can proactively develop vaccines to combat them before they arise.
To implement ongoing, detailed monitoring of new SARS-CoV-2 variants that might emerge on a global scale and assess the level of protection that current COVID-19 vaccines might provide against these variants.
To monitor how well the differentCOVID-19 vaccines work in different age groups to make sure that the right vaccines are given to the right patients.
The research recommendations in this British Society for Immunology report clearly outline the next steps we need to take to uncover vital questions about the long-term protection from COVID-19 conferred by vaccines. It is only through detailed studies of how immunity is generated and a strong monitoring programme of vaccine-mediated immunity that we will be able to control the virus and exit the current pandemic.
–Professor Deborah Dunn-Walters, Chair of BSI Immunology & COVID-19 taskforce
Monitoring COVID-19 immunity
The answers to all the questions in the report will have a profound impact on the policy decisions that the Government makes. Questions over how immunity can be measured, how long immunity lasts and the reliability of such tests can undermine the usefulness of ‘vaccine passports’, and whether the vaccine stops the spread of the SARS-CoV-2 virus to others or simply stops the person who has been vaccinated from contracting the disease, COVID-19, will be vital to looking at how we end lockdown. The longevity of immunity conferred by a vaccine will determine whether there will be need for an annual COVID-19 vaccination programme, like that currently carried out for flu.
With so many key policy issues resting on issues of COVID-19 immunity, it is integral to the country’s future that we immediately implement a robust and widespread immune monitoring programme to understand in detail the immunity conferred through vaccination in different individuals.
It is also crucial that we ensure proper surveillance of viral variance at a global scale and through this the ability of any variants to escape vaccine-mediated immunity.
With the UK being an international leader in the rollout of COVID-19 vaccines, we can lead the world in immune monitoring protocols that will allow us to emerge from this pandemic more safely and quickly. This is an opportunity that we should seize with both hands.
BSI Policy & Public Affairs Manager
Making research accessible
The project has also been condensed into a question and answer blog, which is more accessible for those without a research background.
Our huge thanks to all members of our Immunology and COVID-19 taskforce who gave their time to contribute to this work. Our expert advisory group aims to identify the immunology research priorities to guide future studies and treatments and inform public health measures to control the Coronavirus spread.