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Increased vaccine sensitivity of an emerging SARS-CoV-2 variant

Author

Listed:
  • Joseph A. Lewnard

    (, University of California, Berkeley
    University of California, Berkeley
    University of California, Berkeley)

  • Vennis Hong

    (Kaiser Permanente Southern California)

  • Jeniffer S. Kim

    (Kaiser Permanente Southern California)

  • Sally F. Shaw

    (Kaiser Permanente Southern California)

  • Bruno Lewin

    (Kaiser Permanente Southern California
    Kaiser Permanente Bernard J. Tyson School of Medicine)

  • Harpreet Takhar

    (Kaiser Permanente Southern California)

  • Marc Lipsitch

    (COVID-19 Response Team, Centers for Disease Control and Prevention)

  • Sara Y. Tartof

    (Kaiser Permanente Southern California
    Kaiser Permanente Bernard J. Tyson School of Medicine)

Abstract

Host immune responses are a key source of selective pressure driving pathogen evolution. Emergence of many SARS-CoV-2 lineages has been associated with enhancements in their ability to evade population immunity resulting from both vaccination and infection. Here we show diverging trends of escape from vaccine-derived and infection-derived immunity for the emerging XBB/XBB.1.5 Omicron lineage. Among 31,739 patients tested in ambulatory settings in Southern California from December, 2022 to February, 2023, adjusted odds of prior receipt of 2, 3, 4, and ≥5 COVID-19 vaccine doses were 10% (95% confidence interval: 1–18%), 11% (3–19%), 13% (3–21%), and 25% (15–34%) lower, respectively, among cases infected with XBB/XBB.1.5 than among cases infected with other co-circulating lineages. Similarly, prior vaccination was associated with greater point estimates of protection against progression to hospitalization among cases with XBB/XBB.1.5 than among non-XBB/XBB.1.5 cases (70% [30–87%] and 48% [7–71%], respectively, for recipients of ≥4 doses). In contrast, cases infected with XBB/XBB.1.5 had 17% (11–24%) and 40% (19–65%) higher adjusted odds of having experienced 1 and ≥2 prior documented infections, respectively, including with pre-Omicron variants. As immunity acquired from SARS-CoV-2 infection becomes increasingly widespread, fitness costs associated with enhanced vaccine sensitivity in XBB/XBB.1.5 may be offset by increased ability to evade infection-derived host responses.

Suggested Citation

  • Joseph A. Lewnard & Vennis Hong & Jeniffer S. Kim & Sally F. Shaw & Bruno Lewin & Harpreet Takhar & Marc Lipsitch & Sara Y. Tartof, 2023. "Increased vaccine sensitivity of an emerging SARS-CoV-2 variant," Nature Communications, Nature, vol. 14(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-39567-2
    DOI: 10.1038/s41467-023-39567-2
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    References listed on IDEAS

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