Immunosenescence and Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine Development

Le résumé fourni par la source

TO THE EDITOR—In the excellent summary by Graepel et al [1] regarding the need to balance expediency and scientific rigor in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine development, there is one additional aspect that merits urgent research attention and funding, namely, the problem of immunosenescence. The multifactorial reduction of immune function in the elderly may prove to be the Achilles heel of SARS-CoV-2 vaccine development, because such vaccines, if they do not adequately protect the population at highest risk of coronavirus 2019 (COVID)-related death, are likely to have little effect on COVID-related mortality, stress on intensive care unit capacity, and economic impact. The over-65 age group responds poorly to most vaccines, and, to date, efforts to overcome this by increasing dosage or adding adjuvants have had only limited success. The likelihood of protecting the elderly by raising herd immunity through vaccination of the younger age groups is low, because the necessary vaccine coverage rate would probably need to reach >90%, similar to the measles vaccine. This rate is difficult to achieve given current vaccine hesitancy and antivaccination attitudes prevalent in the United States and Europe. Immunosenescence characterizes both cellular and humoral immune responses, and when billions of dollars are being spent on risk-based vaccine candidates, it would be appropriate and essential that research targeting immunosenescence and ways to overcome it also be generously funded. Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

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