Governance is key to controlling SARS-CoV-2’s vaccine resistance

Little attention has been paid to governance’s impacts on the evolution of SARS-CoV-2, the virus that causes COVID-19. To evaluate such impacts on the evolution of vaccine resistance, we analyzed a stochastic compartmental model to quantify the risk a mutant strain capable of evading immunity emerges post-vaccine rollout. We calibrated the model with publicly available data for four territories in the Western Hemisphere qualitatively differing in pandemic interventions. The model shows an immune-evading strain to be readily selected over all infectivities in Texas. In Panama, only a high level of transmission permits immune evasion to evolve. No invasion appears likely in Costa Rica and Uruguay. Programs combining pharmaceutical and nonpharmaceutical interventions are best positioned to remove the epidemiological space SARS-CoV-2 needs to evolve vaccine resistance.