key: cord-0873010-n1fsb911
authors: Nalin, David
title: Immunosenescence and SARS-CoV-2 Vaccine Development
date: 2020-09-05
journal: J Infect Dis
DOI: 10.1093/infdis/jiaa564
sha: 441d5a1f9d8c134a26c0dd241f3df4fa0f3392ff
doc_id: 873010
cord_uid: n1fsb911

nan

To the excellent summary by Graepel et al. . of the need to balance expediency and scientific rigor in SARS-CoV-2 vaccine development (1) there is one additional aspect which merits urgent research attention and funding, namely the problem of immunosenescence.

The multifactorial reduction of immune function in the elderly may well prove to be the Achilles heel of SARS-CoV-2 vaccine development, since such vaccines, if they do not adequately protect the population at highest risk of Covid-related death, are likely to have little impact on COVID-related mortality, stress on ICU 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, since the necessary vaccine coverage rate would probably need to reach >90% as with measles, a rate difficult to achieve given current vaccine hesitancy and antivaccination attitudes prevalent in the United States and Europe. 

Balancing Expediency and Scientific Rigor in Severe Acute Respiratory Syndrom Coronovirus 2 Vaccine Development

M a n u s c r i p t 3 A c c e p t e d M a n u s c r i p t