ReviewNature reviews. Immunology2021
Concerns about SARS-CoV-2 evolution should not hold back efforts to expand vaccination.
Review in Nature reviews. Immunology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 1 synthesis or guideline pooled it, 133 citations in OpenAlex.
- A systematic review of Vaccine Breakthrough Infections by SARS-CoV-2 Delta Variant.International journal of biological sciences · 2022Pooled it
- Article
- Global disparities in COVID-19 vaccine coverage associated with trajectories of SARS-CoV-2 adaptation.BMC infectious diseases · 2026Article
- Breakthrough infections and incomplete vaccine efficacy drive pathogen immune escape.PloS one · 2026Article
- Pregnancy reduces COVID-19 vaccine immunity against novel variants.NPJ vaccines · 2025Article
- The speed of vaccination rollout and the risk of pathogen adaptation.Journal of the Royal Society, Interface · 2025Article
- Review
- Early mutational signatures and transmissibility of SARS-CoV-2 Gamma and Lambda variants in Chile.Scientific reports · 2024Article
- Assessing the impacts of vaccination and viral evolution in contact networks.Scientific reports · 2024Article
- Within-host evolutionary dynamics and tissue compartmentalization during acute SARS-CoV-2 infection.Journal of virology · 2024Article
- Article
- Complex Interplay between Population Immunity and Viral Dynamics.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Selection for immune evasion in SARS-CoV-2 revealed by high-resolution epitope mapping and sequence analysis.iScience · 2023Article
- Association of vaccination, international travel, public health and social measures with lineage dynamics of SARS-CoV-2.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Evolutionary implications of SARS-CoV-2 vaccination for the future design of vaccination strategies.Communications medicine · 2023Review
- Evolution of SARS-CoV-2-specific CD4Immunogenetics · 2023Review
- SARS-CoV-2 infection of airway organoids reveals conserved use of Tetraspanin-8 by Ancestral, Delta, and Omicron variants.Stem cell reports · 2023Article
- Which vaccination strategy against COVID-19?International health · 2023Article
- Interplay of Digital Proximity App Use and SARS-CoV-2 Vaccine Uptake in Switzerland: Analysis of Two Population-Based Cohort Studies.International journal of public health · 2023Article
- Towards evolutionary predictions: Current promises and challenges.Evolutionary applications · 2023Review
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
When vaccines are in limited supply, expanding the number of people who receive some vaccine, such as by halving doses or increasing the interval between doses, can reduce disease and mortality compared with concentrating available vaccine doses in a subset of the population. A corollary of such dose-sparing strategies is that the vaccinated individuals may have less protective immunity. Concerns have been raised that expanding the fraction of the population with partial immunity to SARS-CoV-2 could increase selection for vaccine-escape variants, ultimately undermining vaccine effectiveness. We argue that, although this is possible, preliminary evidence instead suggests such strategies should slow the rate of viral escape from vaccine or naturally induced immunity. As long as vaccination provides some protection against escape variants, the corresponding reduction in prevalence and incidence should reduce the rate at which new variants are generated and the speed of adaptation. Because there is little evidence of efficient immune selection of SARS-CoV-2 during typical infections, these population-level effects are likely to dominate vaccine-induced evolution.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.