By Daniel R. Lucey MD, MPH, FIDSA
In December, distinct SARS-CoV-2 virus variants with multiple mutations in the spike (S) protein were reported in the UK (“B.1.1.7”) and South Africa (“B.1.351”), and then, on Jan. 10, in travelers from northern Brazil arriving in Japan (“B.1.1.248”). A crucial question is whether any COVID vaccine will have a less protective effect against these variants. The answer to this question carries major public policy, as well as public health, ramifications. This answer must include how much (what %) — protection, and for how long (# months) is protection provided after only one dose, of a two-dose vaccine? To date the focus has been on protection after two doses of vaccine.
Preliminary reports in the media and in unpublished manuscripts have been optimistic that the variants found in the UK and S. Africa will be protected against by the Pfizer and Moderna vaccines.
For example, a recent not-yet-peer-reviewed manuscript reported that sera from 20 people who had received two doses of the Pfizer vaccine, administered three weeks apart, neutralized a specific N501Y mutant (only) virus as well as the virus without the N501Y mutant. Much needed more complete data would include at least two additional analyses:
- Comparing one dose with two doses of the vaccine and,
- Using the entire variant viruses with many mutations, rather than only one key mutation.
These two analyses should be part of a standard template for evaluating the predictable and certain future variants of SARS-CoV-2.
Daniel Lucey, MD, MPH, FIDSA, FACP, is a Clinical Professor of Medicine (Teaching) at Dartmouth Geisel School of Medicine, adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including patient care in Sierra Leone and Liberia (MSF) during Ebola 2014, SARS 2003, MERS 2013, Plague 2017 as well as H5N1, Zika, and Yellow Fever. Since Jan. 6 he has contributed more than 50 posts to Science Speaks on COVID-19 and traveled to China Feb. 11. With career experiences, he proposed and helped design the 2018-2022 Smithsonian Exhibition on Epidemics.