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Hum Vaccin Immunother . Waning immunity and the future of booster vaccination strategies in global vaccine programs post COVID-19

tetano

Editor, Senior Moderator
Hum Vaccin Immunother


. 2026 Dec;22(1):2626088.
doi: 10.1080/21645515.2026.2626088. Epub 2026 Feb 8.
Waning immunity and the future of booster vaccination strategies in global vaccine programs post COVID-19

Rhitam Biswas[SUP] 1 2 [/SUP], Aditi Roy[SUP] 1 2 [/SUP], Titirsha Kayal[SUP] 3 [/SUP], Soumya Basu[SUP] 4 [/SUP], Soumyadip Ghosh[SUP] 1 5 [/SUP], Sudha Ramaiah[SUP] 1 5 [/SUP], Anand Anbarasu[SUP] 1 2 [/SUP]


Affiliations
Abstract

The problem of waning immunity is a major global concern of vaccine programs, with immunity against diseases such as COVID-19 (reduction in efficacy by ~25% in six months), pertussis (waning in 4-12 y), and influenza (annual updates needed) expected to decrease with time. While boosters reduce serious results in high-risk categories, these effects are short-term (4-6 months) and encourage global imbalances, where low-income areas lag in primary vaccination (<2%). Computational models have shown that primary vaccination in underserved regions prevents ~60% of hospitalizations worldwide, surpassing booster-focused measures (~47%). To maintain protection, variant-responsive boosters, rapid booster-design pipelines, universal vaccine platforms (including pan-coronavirus vaccines), and equity-based solutions (decentralized production) need to be integrated. Aligning with frameworks like the Immunization Agenda 2030 of the World Health Organization, plans should balance the expansion of high-risk groups while broadening primary access, providing infrastructure investment, and real-time surveillance to address evolving pathogens and systemic disparities.

Keywords: Vaccine; equitable distribution; global health; immunity.

 
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