POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”

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“A new and highly contagious coronavirus variant first identified in South Africa has been found in the United States for the first time, with two cases diagnosed in South Carolina, state health officials said Thursday. The two cases don’t appear to be connected, nor do the people have a history of recent travel, the South Carolina Department of Health and Environmental Control said…

Viruses are constantly mutating, with coronavirus variants circulating around the globe, but scientists are primarily concerned with the recent emergence of three of them. Other variants first detected in the United Kingdom and Brazil have also been confirmed in the U.S.  Researchers believe these three variants may spread more easily, and predicted it was only a matter of time before they appeared here.

“At this time, we have no evidence that infections by this variant cause more severe disease,” the U.S. Centers for Disease Control and Prevention said in a statement. “Like the UK and Brazilian variants, preliminary data suggests this variant may spread more easily and quickly than other variants.”

Also, scientists last week reported preliminary but troubling signs that some of the recent mutations may modestly reduce the strength of two current vaccines, although they stressed that the shots still protect against the disease. And there are signs that some of the new mutations may undermine tests for the virus and reduce the effectiveness of certain treatments…

Some tests suggest the South African and Brazilian variants may be less susceptible to antibody drugs or treatment with antibody-rich blood plasma from COVID-19 survivors, both of which help people fight off the virus.” (A)

“Several coronavirus variants have emerged in recent weeks that spread from person to person more easily than the dominant strain that’s driven the Covid-19 pandemic thus far. The variants were first identified in the United Kingdom, South Africa and Brazil, Andrew Joseph reports for STAT. New research suggests yet another variant has emerged in California as well.

The presence of coronavirus variants raises several questions about how the pandemic will play out in the coming months. Even countries that have taken strict precautions to prevent the virus’ spread, like Denmark, have seen a rise in variant infections.

Currently accessible Covid-19 vaccines still appear to protect people against the emerging variants, and officials emphasize the importance of following through on vaccine distribution plans, reports National Geographic’s Michael Greshko.

“There is a very slight, modest diminution in the efficacy of a vaccine against it, but there’s enough cushion with the vaccines that we have that we still consider them to be effective,” Anthony Fauci, the nation’s leading infectious diseases official, said Monday on the “Today” show.

The virus, called SARS-CoV-2, has a genetic code written with RNA instead of DNA. Sometimes, as the virus is making copies of itself, it makes a mistake when re-writing its RNA. Coronaviruses are usually able to catch and correct their mistakes, but sometimes a genetic typo makes its way into a new generation of viruses.

Sometimes those typos have no effect on the virus, and sometimes they actually hurt the virus. But the recently-identified variants, through some combination of several typos, got an advantage: increased transmission….

In the U.S., the CDC warned that the U.K. variant of the coronavirus may become the most common form of the virus by March, Erin Garcia de Jesus reports for Science News. It has already been identified in 22 states, per CNN, and it is particularly common in Florida and California.

The variant is about 30 to 70 percent more contagious than versions of the virus that have circulated for the past year, per the Washington Post, and early data suggests it may be more deadly as well…”  (B)

“Goldstein has a simpler explanation, one that’s beginning to get more traction in the scientific community. The convergent evolution of wilier versions of the virus might just be a consequence of so many poorly managed government pandemic responses, which didn’t marshal sufficient resources or inspire the kind of collective action required to not just crush the initial curve, but keep it crushed. “The fact that we lost control in so many places in the fall allowed for the ballooning of this incredibly huge viral population size,” says Goldstein. That created the opportunity for that many more mutations to happen, and in some places, the right circumstances for some particularly insidious ones to get selected.

Hanage put it this way to reporters last week: “The strategy here and elsewhere has been to try and control the level of transmission that doesn’t require very severe restrictions, but also doesn’t allow the virus to go exponential and overload health care systems.” But the problem with that approach is that it still gives the virus plenty of opportunities to mutate, and in so doing, change its behavior. If those changes make it spread faster or give it an edge against treatments and vaccines, that balancing act falls apart. “It tips you from a point where you’re capable of dealing with it to a point where you’re not,” he continued…

Scientists may never get a clear answer to exactly where and under what conditions these new variants emerged. But de Oliveira isn’t so sure it matters. “The one thing we know for sure is that if you keep the virus circulating long enough, it will develop escape mutations,” he says.

The much more pressing question, then, is to what degree will such mutations affect efforts to vaccinate our way out of the pandemic?..

In a statement, Moderna CEO Stéphane Bancel said that he is confident the company’s vaccine should still be protective against the newly detected variants, but that “it is imperative to be proactive as the virus evolves.” To that end, Moderna’s scientists are retooling the company’s mRNA sequence to more closely mimic the most significant mutations and plan to test it as an additional booster shot in clinical studies later this year.

“We shouldn’t panic yet, but we should be careful. This is a warning,” says Hatziioannou. “If the virus continues to accumulate mutations in its spike protein, we run the risk of the efficacy of vaccines diminishing further.”..

With these new variants showing signs of being better at spreading and eluding both natural immune defenses and treatments like monoclonal antibodies and convalescent serum, the race is on to vaccinate as many people as possible in the shortest time frame. At least in the US, the last mile challenges with getting ultra-cold, two-shot vaccines into people’s arms are proving so problematic that the Biden administration has proposed creating 100 new mass vaccination sites across the country.

That’s good. But scientists like Hanage are still worried that if governments and societies don’t do enough to slow the speed of infections soon, more dangerous mutations will almost certainly emerge. “The fact that it’s happened three times already means we can expect it to continue happening,” he said during last week’s press briefing.” (C)

“Experts still don’t know what metrics, such as antibody levels in the blood, signal if a person is protected from the coronavirus. That makes it hard to tell from experiments done with lab-grown cells whether low levels of neutralizing antibodies are enough to stop an infection in a person or protect them from developing severe COVID-19, says Stuart Ray, a virologist and infectious disease physician at Johns Hopkins University School of Medicine.

While the preliminary results hint at some trouble for vaccines, there’s not yet enough evidence to push scientists to begin giving people updated shots. For that, “I think we’d need to see evidence of reinfections in people who had well demonstrated immune responses” to the coronavirus, Ray says.

If it did come to that point, some types of vaccines could be easier to update than others. A new version of mRNA vaccines like Pfizer’s and Moderna’s could be made in the lab in a few days, says John Mascola, director of the Dale and Betty Bumpers Vaccine Research Center at NIAID. Moderna announced January 25 that the company plans to run clinical trials to test whether vaccinated people could get a third dose of its vaccine. Moderna is also planning to test a booster shot that uses a protein from the coronavirus variant in South Africa. Pfizer has said that the company is laying the groundwork to tweak its vaccine.

Other vaccines, like AstraZeneca’s or Johnson & Johnson’s, need to be produced in lab-grown cells, which could take a few weeks (SN: 11/23/20). Companies would then need to ramp up manufacturing for millions of doses, which takes time.

But one complication is how regulatory agencies like the FDA might want to test updated vaccines tweaked to target new coronavirus variants. So far, that is unclear. If experts learn what immune system signals correlate with immunity in ongoing clinical trials, new vaccines might be tested in tens or hundreds of people — as agencies already do for updated influenza vaccines — rather than tens of thousands. But for now, Mascola says, “it is uncharted territory.” “ (D)

“Novavax, a little-known company supported by the U.S. federal government’s Operation Warp Speed, said for the first time on Thursday that its Covid-19 vaccine offered robust protection against the virus. But it also found that the vaccine is not as effective against the fast-spreading variant first discovered in South Africa, another setback in the global race to end a pandemic that has already killed more than 2.1 million people.

That could be a problem for the United States, which hours earlier reported its first known cases of the contagious variant in two unrelated people in South Carolina. And it came just days after Moderna and Pfizer said that their vaccines were also less effective against the same variant.

Novavax, which makes one of six vaccine candidates supported by Operation Warp Speed last summer, has been running trials in Britain, South Africa, the United States and Mexico. It said Thursday that an early analysis of its 15,000-person trial in Britain revealed that the two-dose vaccine had an efficacy rate of nearly 90 percent there. But in a small trial in South Africa, the efficacy rate dropped to just under 50 percent.

Almost all the cases that scientists have analyzed there so far were caused by the variant, known as B.1.351. The data also showed that many trial participants were infected with the variant even after they had already had Covid.” (E)

“Johnson & Johnson announced on Friday that its one-dose coronavirus vaccine provided strong protection against Covid-19, potentially offering the United States a third powerful tool in a desperate race against a worldwide rise in virus mutations.

But the results came with a significant cautionary note: The vaccine’s efficacy rate dropped from 72 percent in the United States to 57 percent in South Africa, where a highly contagious variant is driving most cases. Studies suggest that this variant also blunts the effectiveness of Covid vaccines made by Pfizer-BioNTech, Moderna and Novavax. The variant has spread to at least 31 countries, including the United States, where two cases were documented this week.

Johnson & Johnson said that it planned to apply for emergency authorization of the vaccine from the Food and Drug Administration as soon as next week, putting it on track to receive clearance later in February.

“This is the pandemic vaccine that can make a difference with a single dose,” said Dr. Paul Stoffels, the chief scientific officer of Johnson & Johnson.

While less effective than the Moderna and Pfizer vaccines, Johnson & Johnson’s is still considered a strong vaccine by scientists. Annual flu vaccines, for example, are typically 40 to 60 percent effective.

The company’s announcement comes as the Biden administration is pushing to immunize Americans faster even with a tight vaccine supply. White House officials have been counting on Johnson & Johnson’s vaccine to ease the shortfall. But the company may only have about seven million doses ready when the F.D.A. decides whether to authorize it, according to federal health officials familiar with its production, and about 30 million doses by early April.

The variant from South Africa, known as B.1.351, could make things even worse for the vaccine push. Given the speed at which the variant swept through that country, it is conceivable that by April it could make up a large fraction of infections in the United States. That would undermine the effectiveness of available vaccines.

The fact that four vaccines backed by the federal government seem to be less effective against the B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.” (F)


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