How long might immunity to the coronavirus last? Years, maybe even decades, according to a new study — the most hopeful answer yet to a question that has shadowed plans for widespread vaccination.
Eight months after infection, most people who have recovered still have enough immune cells to fend off the virus and prevent illness, the new data show. A slow rate of decline in the short term suggests, happily, that these cells may persist in the body for a very, very long time to come.
The research, published online, has not been peer-reviewed nor published in a scientific journal. But it is the most comprehensive and long-ranging study of immune memory to the coronavirus to date.
“That amount of memory would likely prevent the vast majority of people from getting hospitalized disease, severe disease, for many years,” said Shane Crotty, a virologist at the La Jolla Institute of Immunology who co-led the new study.
The findings are likely to come as a relief to experts worried that immunity to the virus might be short-lived, and that vaccines might have to be administered repeatedly to keep the pandemic under control.
And the research squares with another recent finding: that survivors of SARS, caused by another coronavirus, still carry certain important immune cells 17 years after recovering.
The findings are consistent with encouraging evidence emerging from other labs. Researchers at the University of Washington, led by the immunologist Marion Pepper, had earlier shown that certain “memory” cells that were produced following infection with the coronavirus persist for at least three months in the body.
A study published last week also found that people who have recovered from Covid-19 have powerful and protective killer immune cells even when antibodies are not detectable.
These studies “are all by and large painting the same picture, which is that once you get past those first few critical weeks, the rest of the response looks pretty conventional,” said Deepta Bhattacharya, an immunologist at the University of Arizona.
Akiko Iwasaki, an immunologist at Yale University, said she was not surprised that the body mounts a long-lasting response because “that’s what is supposed to happen.” Still, she was heartened by the research: “This is exciting news.”
A small number of infected people in the new study did not have long-lasting immunity after recovery, perhaps because of differences in the amounts of coronavirus they were exposed to. But vaccines can overcome that individual variability, said Jennifer Gommerman, an immunologist at the University of Toronto.
“That will help in focusing the response, so you don’t get the same kind of heterogeneity that you would see in an infected population,” she said.
In recent months, reports of waning antibody levels have created worry that immunity to the coronavirus may disappear in a few months, leaving people vulnerable to the virus again.
But many immunologists have noted that it is natural for antibody levels to drop. Besides, antibodies are just one arm of the immune system.
Although antibodies in the blood are needed to block the virus and forestall a second infection — a condition known as sterilizing immunity — immune cells that “remember” the virus more often are responsible for preventing serious illness.
“Sterilizing immunity doesn’t happen very often — that is not the norm,” said Alessandro Sette, an immunologist at the La Jolla Institute of Immunology and co-leader of the study.
More often, people become infected a second time with a particular pathogen, and the immune system recognizes the invader and quickly extinguishes the infection. The coronavirus in particular is slow to do harm, giving the immune system plenty of time to kick into gear.
“It may be terminated fast enough that not only are you not experiencing any symptoms but you are not infectious,” Dr. Sette said.
Confused by the all technical terms used to describe how vaccines work and are investigated? Let us help:
- Adverse event: A health problem that crops up in volunteers in a clinical trial of a vaccine or a drug. An adverse event isn’t always caused by the treatment tested in the trial.
- Antibody: A protein produced by the immune system that can attach to a pathogen such as the coronavirus and stop it from infecting cells.
- Approval, licensure and emergency use authorization: Drugs, vaccines and medical devices cannot be sold in the United States without gaining approval from the Food and Drug Administration, also known as licensure. After a company submits the results of clinical trials to the F.D.A. for consideration, the agency decides whether the product is safe and effective, a process that generally takes many months. If the country is facing an emergency — like a pandemic — a company may apply instead for an emergency use authorization, which can be granted considerably faster.
- Background rate: How often a health problem, known as an adverse event, arises in the general population. To determine if a vaccine or a drug is safe, researchers compare the rate of adverse events in a trial to the background rate.
- Efficacy: A measurement of how effective a treatment was in a clinical trial. To test a coronavirus vaccine, for instance, researchers compare how many people in the vaccinated and placebo groups get Covid-19. The real-world effectiveness of a vaccine may turn out to be different from its efficacy in a trial.
- Phase 1, 2, and 3 trials: Clinical trials typically take place in three stages. Phase 1 trials usually involve a few dozen people and are designed to observe whether a vaccine or drug is safe. Phase 2 trials, involving hundreds of people, allow researchers to try out different doses and gather more measurements about the vaccine’s effects on the immune system. Phase 3 trials, involving thousands or tens of thousands of volunteers, determine the safety and efficacy of the vaccine or drug by waiting to see how many people are protected from the disease it’s designed to fight.
- Placebo: A substance that has no therapeutic effect, often used in a clinical trial. To see if a vaccine can prevent Covid-19, for example, researchers may inject the vaccine into half of their volunteers, while the other half get a placebo of salt water. They can then compare how many people in each group get infected.
- Post-market surveillance: The monitoring that takes place after a vaccine or drug has been approved and is regularly prescribed by doctors. This surveillance typically confirms that the treatment is safe. On rare occasions, it detects side effects in certain groups of people that were missed during clinical trials.
- Preclinical research: Studies that take place before the start of a clinical trial, typically involving experiments where a treatment is tested on cells or in animals.
- Viral vector vaccines: A type of vaccine that uses a harmless virus to chauffeur immune-system-stimulating ingredients into the human body. Viral vectors are used in several experimental Covid-19 vaccines, including those developed by AstraZeneca and Johnson & Johnson. Both of these companies are using a common cold virus called an adenovirus as their vector. The adenovirus carries coronavirus genes.
- Trial protocol: A series of procedures to be carried out during a clinical trial.
Dr. Sette and his colleagues recruited 185 men and women, aged 19 to 81, who had recovered from Covid-19. The majority had mild symptoms not requiring hospitalization; most provided just one blood sample, but 38 provided multiple samples over many months.
The team tracked four components of the immune system: antibodies, B cells that make more antibodies as needed; and two types of T cells that kill other infected cells. The idea was to build a picture of the immune response over time by looking at its constituents.
“If you just look at only one, you can really be missing the full picture,” Dr. Crotty said.
He and his colleagues found that antibodies were durable, with modest declines at six to eight months after infection, although there was a 200-fold difference in the levels among the participants. T cells showed only a slight, slow decay in the body, while B cells grew in number — an unexpected finding the researchers can’t quite explain.
The study is the first to chart the immune response to a virus in such granular detail, experts said. “For sure, we have no priors here,” Dr. Gommerman said. “We’re learning, I think for the first time, about some of the dynamics of these populations through time.”
Worries over how long immunity to the coronavirus persists were sparked mainly by research into those viruses causing common colds. One frequently cited study, led by Jeffrey Shaman of Columbia University, suggested that immunity might fade quickly and that reinfections could occur within a year.
“What we need to be very mindful of is whether or not reinfection is going to be a concern,” Dr. Shaman said. “And so seeing evidence that we have this kind of persistent, robust response, at least to these time scales, is very encouraging.” So far, at least, he noted, reinfections with the coronavirus seem to be rare.
Exactly how long immunity lasts is hard to predict, because scientists don’t yet know what levels of various immune cells are needed to protect from the virus. But studies so far have suggested that even small numbers of antibodies or T and B cells may be enough to shield those who have recovered.
The participants in the study have been making those cells in robust amounts — so far. “There’s no sign that memory cells are suddenly going to plummet, which would be kind of unusual,” Dr. Iwasaki said. “Usually, there’s a slow decay over years.”
There is some emerging evidence that reinfections with common cold coronaviruses are a result of viral genetic variations, Dr. Bhattacharya noted, and so those concerns may not be relevant to the new coronavirus.
“I don’t think it’s an unreasonable prediction to think that these immune memory components would last for years,” he said.