Modelling immunity gaps to quantify infection resurgences

When COVID-19 restrictions were removed, many countries observed infection surges in respiratory pathogens like respiratory syncytial virus (RSV) and influenza. This has been postulated to have been caused by reduced immunity in populations due to non-pharmaceutical interventions that reduced transm...

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Main Authors: Alex James, Reuben McGregor, Natalie Lorenz, Nicole J. Moreland, Miguel Moyers-Gonzalez
Format: Article
Language:English
Published: The Royal Society 2025-07-01
Series:Royal Society Open Science
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Online Access:https://royalsocietypublishing.org/doi/10.1098/rsos.250030
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author Alex James
Reuben McGregor
Natalie Lorenz
Nicole J. Moreland
Miguel Moyers-Gonzalez
author_facet Alex James
Reuben McGregor
Natalie Lorenz
Nicole J. Moreland
Miguel Moyers-Gonzalez
author_sort Alex James
collection DOAJ
description When COVID-19 restrictions were removed, many countries observed infection surges in respiratory pathogens like respiratory syncytial virus (RSV) and influenza. This has been postulated to have been caused by reduced immunity in populations due to non-pharmaceutical interventions that reduced transmission of these pathogens. This pandemic-related phenomenon has been termed ‘immunity debt’ or ‘immunity gap’. We propose a simple extension of the classic susceptible–immune–susceptible model to explore this phenomenon. The model is parametrized using RSV antibody data derived from healthy adults in Aotearoa, New Zealand. We consider a case study based on the prolonged stringent public health measures during the border closure years of 2020–2022 and compare these findings to observed hospitalization trends in Aotearoa, New Zealand. Our model predicts that diseases with very fast waning immunity are less likely to see increased infection rates after prolonged periods of stringent public health measures. However, diseases that wane moderately fast, such as RSV, are more likely to see a strong resurgence of cases when restrictions ease. Our results can be used to predict disease characteristics most likely to lead to strong resurgences after periods of prolonged restrictions and thus inform future public health responses.
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spelling doaj-art-8c74f488b6d846928435cb2a9d7b314e2025-08-20T03:58:40ZengThe Royal SocietyRoyal Society Open Science2054-57032025-07-0112710.1098/rsos.250030Modelling immunity gaps to quantify infection resurgencesAlex James0Reuben McGregor1Natalie Lorenz2Nicole J. Moreland3Miguel Moyers-Gonzalez4University of Canterbury, Christchurch, Canterbury, New ZealandDepartment of Molecular Medicine and Pathology, The University of Auckland, Auckland, New ZealandDepartment of Molecular Medicine and Pathology, The University of Auckland, Auckland, New ZealandDepartment of Molecular Medicine and Pathology, The University of Auckland, Auckland, New ZealandUniversity of Canterbury, Christchurch, Canterbury, New ZealandWhen COVID-19 restrictions were removed, many countries observed infection surges in respiratory pathogens like respiratory syncytial virus (RSV) and influenza. This has been postulated to have been caused by reduced immunity in populations due to non-pharmaceutical interventions that reduced transmission of these pathogens. This pandemic-related phenomenon has been termed ‘immunity debt’ or ‘immunity gap’. We propose a simple extension of the classic susceptible–immune–susceptible model to explore this phenomenon. The model is parametrized using RSV antibody data derived from healthy adults in Aotearoa, New Zealand. We consider a case study based on the prolonged stringent public health measures during the border closure years of 2020–2022 and compare these findings to observed hospitalization trends in Aotearoa, New Zealand. Our model predicts that diseases with very fast waning immunity are less likely to see increased infection rates after prolonged periods of stringent public health measures. However, diseases that wane moderately fast, such as RSV, are more likely to see a strong resurgence of cases when restrictions ease. Our results can be used to predict disease characteristics most likely to lead to strong resurgences after periods of prolonged restrictions and thus inform future public health responses.https://royalsocietypublishing.org/doi/10.1098/rsos.250030disease resurgencepartial differential equation modelmathematical epidemiology
spellingShingle Alex James
Reuben McGregor
Natalie Lorenz
Nicole J. Moreland
Miguel Moyers-Gonzalez
Modelling immunity gaps to quantify infection resurgences
Royal Society Open Science
disease resurgence
partial differential equation model
mathematical epidemiology
title Modelling immunity gaps to quantify infection resurgences
title_full Modelling immunity gaps to quantify infection resurgences
title_fullStr Modelling immunity gaps to quantify infection resurgences
title_full_unstemmed Modelling immunity gaps to quantify infection resurgences
title_short Modelling immunity gaps to quantify infection resurgences
title_sort modelling immunity gaps to quantify infection resurgences
topic disease resurgence
partial differential equation model
mathematical epidemiology
url https://royalsocietypublishing.org/doi/10.1098/rsos.250030
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