Elmer Huerta | COVID-19 vaccines | Sinopharm | The Future of COVID-19 Vaccines | Column | Second wave | TECHNOLOGY

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During the last weeks, the news revealing that the scientific community and the general public have caused much concern new variants of SARS-CoV-2 they would escape the neutralizing action of the antibodies directed at the original virus. Today we will see what is known about it and what would be the future of vaccines that have been developed against the new coronavirus.

“The Kent variant.”

I don’t think it’s an exaggeration to say that we are facing new types of viruses SARS-CoV-2, that is, new variants, viruses carrying multiple mutations that have therefore developed new behaviors.

In that sense, variant B117, or Kent variant, discovered in South London in September 2020, is a virus that carries a mutation N501Y in the protein S or spike of the virus, which helps it enter cells.

The variant also has 13 other mutations in protein SIt has been shown that it increases the contagiousness of the virus and that it could give false negatives as results in at least one molecular test to discover the virus.

The B117 variant, which is already in more than 80 countries, has the potential to increase the speed of spread of the pandemic in the countries of the world to which it has already reached. In Peru, three cases of this variant have already been found.e.

—South Africa and Manaus—

Those are the names of the most worrying variants in relation to vaccines. The B1351 variant was discovered in South Africa in October 2020 and currently represents 80 to 90% of the cases of COVID-19 in that country. This variant, like the British variant, is highly contagious, but unlike the previous one, has mutations in the area of ​​the spike against which neutralizing antibodies act. One of these mutations, E484K, is the most important, since it is responsible for the fact that the antibodies produced by natural disease or vaccination cannot neutralize the virus.

Recently, however, Public Health England (PHE) reported that they have found that the B117 variant has acquired that E484K mutation, that is, the variant of a variant has been produced, thus opening the door that the British variant cannot be neutralized either by the antibodies produced by vaccination.

In January 2021, the P1 variant was identified in 42% (13 of 31) of the PCR positive samples collected between December 15 and 23 in Manaus (Brazil), a city that at that time was experiencing an increase in cases of COVID-19. P1 has 10 mutations in the spike protein, including E484K, so it may not be neutralized by the antibodies produced by vaccination either.

-What does this mean?-

Given that the three new variants found so far show the E484K mutation, we can ask ourselves two important questions. The first is whether these –and other future variants– can escape naturally acquired immunity and cause reinfections. The second is whether these variants can escape the vaccines that are causing so much hope in the world.

—Reinfections—

Although reinfections are a scientifically proven fact, confirmed cases with comparison of the genomic sequence of the first and second viruses they are less than 50. Despite having hundreds of confirmed cases (some of them in Peru), there is no evidence that reinfections are occurring in the thousands or millions.

—Response to vaccines—

Data from phase 3 studies indicate that Johnson & Johnson’s vaccine decreased severe and severe cases of COVID-19 in 57% in South Africa, and 72% in the US, while the Novavax vaccine provided a level of protection against mild and moderate to severe COVID-19 infection of 60% in South Africa and 89.3% in the United Kingdom. Recall that variant B1.351 is the dominant one in South Africa.

—Real life data—

Israel gives us data of the vaccine’s effectiveness in the real world, and it is very encouraging to know that – despite laboratory data to the contrary – it appears that vaccines against SARS-CoV-2 They’re working. For example, infections in people over 60 years of age decreased by 41% from mid-January to early February; during the same period, hospitalizations decreased by 31%. In people under the age of 59 who received the vaccine, cases were reduced by just 12% and hospitalizations by 5%. An unpublished, non-peer-reviewed study suggests that the Pfizer-BioNTech vaccine is 66% to 85% effective in preventing infection, and 87% to 96% effective in preventing serious diseases.

-Corollary-

Since all the vaccines that are being developed are directed against the spike of the virus, and that variants with the E484K mutation are being produced very rapidly, which evades the action of neutralizing antibodies against the virus, it is feared that first-generation vaccines may become obsolete in the near future.

Already the Government of South Africa had to temporarily suspend the vaccination program with AstraZeneca / Oxford, because it was not effective against the B1351 variety, and the manufacturers have said that they are prepared to develop next-generation vaccines.

It is very probable, experts say, which –as it happens with the flu– we have to get vaccinated annually with multi-purpose vaccines containing two or three varieties of coronavirus.

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