2. updated statement on the immunity of convalescents
05/01/2022
2. update of the statement on the immunity of convalescents
3 December 2021
At the time of publication of the GfV's updated statement on the immunity of convalescents on September 30, 2021, the data available at that time (see below) suggested that a confirmed infection still provides very good protection against reinfection and severe courses even after one year. A paper by Gazit et al.1 from Israel, which is important for this conclusion, reported that people who have undergone SARS-CoV-2 infection have better protection against infection with the delta variant than those who have been vaccinated twice. Another recently published study from France2 came to the same conclusion. In the meantime, two further articles from the USA have also been published. One comes to the conclusion that a previous SARS-CoV-2 infection in ≥ 18-year-olds provides worse protection against the disease than a double vaccination3. The other investigated ≥65-year-olds and also reported that having had the infection confers worse protection against infection, severe disease and death than full vaccination4. Due to this contradictory data situation, it cannot currently be assumed with certainty that those who have recovered will be protected for one year. It is undisputed that the COVID-19 vaccination leads to a strong increase in the antiviral immune response after a SARS-CoV-2 infection. Therefore, until further clarification of the situation, people who have had a SARS-CoV-2 infection should generally be vaccinated 6 months after having had the infection in accordance with the STIKO recommendations5 and also take into account the recommendations for booster vaccination. Due to the increasing number of infections in fully vaccinated people without a booster, the urgent recommendation for a booster vaccination after 6 months also applies to this group of people5.
Given the momentum of the knowledge gain on the durability of the immune response to SARS-CoV-2 in fully vaccinated and recovered individuals and the potential problem with the omicron variant, we also anticipate that further updates on vaccination will be necessary in the future.
The Board of Directors of the Society of Virology
Prof. Dr. Ralf Bartenschlager, Heidelberg University Hospital
Prof. Dr. Thomas Stamminger, University Hospital Ulm
Prof. Dr. Ulf Dittmer, University Hospital Essen
Prof. Dr. Sandra Ciesek, University Hospital Frankfurt
Prof. Dr. Klaus Überla, Erlangen University Hospital
References
1 Gazit et al, doi.org/10.1101/2021.08.24.21262415
2 Grant et al, doi.org/10.1016/j.lanepe.2021.100278
3 Bozio et al, doi: 10.15585/mmwr.mm7044e1
4 Young-Xu et al, doi.org/10.1101/2021.09.27.21264194
5 https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2021/Ausgaben/48_21.pdf?__blob=publicationFile
1. updated statement on the immunity of convalescents
30 September 2021
New scientific evidence on the immune response induced by SARS-CoV-2 infection or COVID-19 vaccination and observational studies on the incidence of second infections with SARS-CoV-2 allow a reassessment of the duration of immunity after having undergone SARS-CoV-2 infection.
In the first months of the pandemic, it was assumed that an infection with SARS-CoV2 would only result in short-lived protective immunity. This was mainly based on the observation that certain antibody types were no longer measurable just a few months after infection. However, this assessment is now outdated. A large number of studies have shown that SARS-CoV-2 infection in humans leads to the formation of immunological memory cells, which are the actual protective mechanism of the immune system against recurrence of the disease[1],[2],[3]. They ensure, for example, that antibodies are produced very quickly upon renewed contact with the pathogen, which are much more effective than the antibodies that were present directly after the first infection. In particular, they are able to efficiently neutralize variants of SARS-CoV-2. This has been demonstrated in recovered patients who came into contact with parts of SARS-CoV-2 again via vaccination[4],[5]. Even if the antibody levels still present upon renewed contact with the virus are not sufficiently high to completely prevent infection with SARS-CoV-2, the rapid memory response of our immune system can at least ensure that severe courses of the disease are prevented.
There are now also some observational studies on the protection of recovered people against re-infection. Data from several countries show that people who have undergone SARS-CoV-2 infection are very well protected against reinfection or illness, and that this protection also extends to virus variants, including the delta variant[6],[7],[8],[9]. In the first six months after the infection, the protection against renewed SARS-CoV-2 infection is at least as good as the protection of fully vaccinated people6,8. In addition, the studies show that a completed SARS-CoV-2 infection still provides very good protection against reinfection and severe COVID-19 disease progression even after one year8,9.
Conclusions:
The proven duration of protection after a SARS-CoV-2 infection is at least one year. From an immunological point of view, a significantly longer period of protection can be assumed, but this has not yet been proven by corresponding studies due to the limited observation period.
Based on these current findings, people who have recovered should initially be treated in the same way as fully vaccinated people for at least one year in regulations to combat the pandemic (e.g. mandatory testing).
It is advisable to review the recommended timing of vaccination after surviving a SARS-CoV-2 infection.
The Board of Directors of the Society of Virology
Prof. Dr. Ralf Bartenschlager, Heidelberg University Hospital
Prof. Dr. Thomas Stamminger, University Hospital Ulm
Prof. Dr. Ulf Dittmer, University Hospital Essen
Prof. Dr. Sandra Ciesek, University Hospital Frankfurt
Prof. Dr. Klaus Überla, Erlangen University Hospital
With the participation of:
PD Dr. Sebastian Ulbert
Head of Department Vaccines and Infection Models
Fraunhofer Institute for Cell Therapy and Immunology
Perlickstr. 1, 04103 Leipzig
[1] Turner et al, doi.org/10.1038/s41586-021-03647-4
[2] Ogega et al, doi.org/10.1172/JCI145516
[3] Breton et al, doi.org/10.1084/jem.20202515
[4] Reynolds et al, doi: 10.1126/science.abh1282
[5] Stamatatos et al, doi 10.1126/science.abg9175
[6] Hall et al, doi: 10.1016/S0140-6736(21)00790-X
[7] Hansen et al,doi: 10.1016/S0140-6736(21)00575-4
[8] Gazit et al, doi.org/10.1101/2021.08.24.21262415
[9] Vitale et al, doi:10.1001/jamainternmed.2021.2959
The Board of Directors of the Society of Virology
Authors (in alphabetical order):
Prof. Dr Ralf Bartenschlager, Molecular Virology, Heidelberg University Hospital
Prof. Dr Ulf Dittmer, Institute for Virology, University Hospital Essen
Prof. Dr Isabella Eckerle, Centre for Emerging Viral Diseases, University Hospital Geneva, Switzerland
Prof. Dr. Hartmut Hengel, Institute of Virology, University Hospital Freiburg
Prof. Dr. Heidemarie Holzmann, Centre for Virology, Medical University of Vienna, Austria
Prof. Dr. Thomas Mertens, Institute for Virology, University Hospital Ulm
Prof. Dr Stephanie Pfänder, Department of Molecular and Medical Virology, Ruhr-Universität Bochum
Prof. Dr Hendrik Streeck, Institute for Virology, University Hospital Bonn
Prof. Dr. Matthias Tenbusch, Virological Institute, Clinical and Molecular Virology, University Hospital Erlangen
Prof. Dr. Klaus Überla, Virological Institute, Clinical and Molecular Virology, University Hospital Erlangen
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