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About 20 states across the country have so far detected the more transmissible variant B.1.1.7 SARS-CoV-2. Given the unknowns of the emerging situation, experts from the Society of Infectious Diseases of America (IDSA) addressed the effectiveness of the vaccine, how well equipped the United States is to track new mutations, and shared their impressions of President Joe Biden’s executive orders. 19.
Dr. Mirella Salvatore
One of the major concerns remains the ability of COVID-19 vaccines to work on new strains. “All of our vaccines target spike protein and try to get neutralizing antibodies that bind to that protein,” Mirella Salvatore, MD, assistant professor of medicine and public health sciences at Weill Cornell Medicine in New York City, said in a briefing. IDSA release Thursday.
The B.1.1.7 mutation occurs in the “very important” spike protein, a component of the SARS-CoV-2 virus needed for binding, which allows the virus to enter cells, added Salvatore, an IDSA colleague.
Evidence suggests that SARS-CoV-2 should be able to produce one or two mutations per month. However, variant B.1.1.7 surprised investigators in the United Kingdom when they first discovered that the strain had 17 mutations, Salvatore said.
It is not yet known why this strain is more transmissible, but Salvatore speculated that the mutation gives the virus an advantage and increases binding, allowing it to enter cells more easily. She added that the mutations could have occurred among immunocompromised people infected with SARS-CoV-2, but “this is just a hypothesis.”
Dr. Kathryn Edwards
On a positive note, Kathryn M. Edwards, MD, another IDSA colleague, explained at the briefing that existing vaccines target more than one location on the virus’s spike protein. Therefore, “if there is a mutation that changes the structure of the spike protein, there will be other areas where binding can occur.”
This polyclonal response “is why the vaccine may still be effective against this virus,” added Edwards, scientific director of the Vanderbilt Vaccine Research Program and professor of pediatrics at Vanderbilt University School of Medicine in Nashville, Tennessee.
Salvatore pointed out that although the new variant is more transmissible, it does not seem to be more lethal. This could affect overall mortality, but not the person who becomes infected.
Standing one step ahead
When asked to be assured that COVID-19 vaccines will work against emerging variants, Edwards said: “We may need to change the vaccine to be more receptive to new variants, but this does not seem to be the case at this time. “
If vaccines need updating, mRNA vaccines have an advantage – researchers can review them quickly. “All you have to do is put all the little nucleotides together,” Edwards said.
“Some of us are looking at how this will work and we are looking at the flu,” she added. Edwards drew an analogy with choosing – and sometimes updating – flu strains each year for the annual flu vaccine. With adequate funding, the same system could be replicated to address any evolving changes in SARS-CoV-2, she said.
In terms of funding, Salvatore said more money will be needed to optimize the surveillance system for emerging strains in the United States.
“Actually, we have this system – there’s a wonderful network that sequences the flu strains,” she said. “The structure exists, we just need funding.”
“The CDC is making the system instrumented to get more viruses to be sequenced,” Edwards said.
Both experts praised the CDC for its website, with up-to-date surveillance information for emerging SARS-CoV-2 strains.
Supporting Biden’s science
A reporter asked each infectious disease expert to share his impression of Biden’s newly signed COVID-19 executive orders.
“The biggest food to eat is the role of science and the lessons we’ve learned from masks, hand washing and distance,” Edwards said. “We have to take into account the advice …[especially] with a more contagious variant.
“It is encouraging that science will be heard – that is the general message,” she added.
Salvatore agreed, saying that the orders give “the feeling that now we can act following science.”
“We have a lot of papers that show the effectiveness of masking,” she said, for example. Salvatore acknowledged that there are “a lot of contrasting ideas about masking” in the United States, but stressed their importance.
“We should follow measures that we know work,” she said.
Both experts said more research is needed to stay ahead of this evolving scenario. “We still need a lot of basic science to show how this virus reproduces in the cell,” Salvatore said. “We really need to characterize all these mutations and their functions.”
“We need to be concerned, to do follow-up studies,” she added, “but we don’t have to panic.”
This article was based on a media report from the Society of Infectious Diseases of America on January 21, 2021. Salvatore revealed that it is a PI site of a study by Verily life sciences LLC / Brin Foundation on predictors of severe COVID- 19 (PRESCO) and PI for a study initiated by a Genentech-sponsored investigator on combination influenza therapy. Edwards disclosed NIH and CDC grants; consulting for Bionet and IBM; and being a member of the safety and data monitoring committees for Sanofi, X-4 Pharma, Seqirus, Moderna, Pfizer and Merck.
Damian McNamara is a Miami-based journalist. It covers a wide range of medical specialties, including infectious diseases, gastroenterology and critical care. Follow Damian on Twitter: @MedReporter.
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