Barrier gesture relaxation during vaccination campaign in France: modelling impact of waning immunity

Abstract Non-pharmaceutical interventions have been implemented intermittently for more than a year in most countries of the world to mitigate COVID-19 epidemic. In France, while the vaccination campaign is progressing, the French government has decided to remove many public health restrictions such as business closure, lockdowns and curfews. Nonetheless, social distancing, mask wearing, and hand washing (also called barrier gestures) are still recommended. We utilize an age-structured compartmental SEIR model that takes into account SARS-CoV-2 waning immunity, vaccination, and increased transmissibility from variants of concern, to estimate if barrier gestures can be relaxed without causing a resurgence of severe infections. This model assumes that susceptibility to infection is a function of immunity status, which depends on initial infection severity and vaccination status. It is calibrated on confirmed COVID-19 cases from the French surveillance database, and accounts for changes in contact behaviors due to implementation of nation-wide public health policies. We study partial and full relaxation of barrier gestures occurring from August to December 2021 under various immunity duration assumptions. Maintaining application of barrier gestures appears essential to avoid a resurgence of severe infections that would exceed health care capacities, while surmounting vaccine hesitancy represents the key to consider their relaxation. Immunity duration assumptions significantly influence the short-term dynamic of the epidemic which should be considered for further modelling.