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About 20 states across the country have so far detected the most transmissible SARS-CoV-2 variant B.1.1.7. Given the unknowns of the emerging situation, experts from the Society of Infectious Diseases of America (IDSA) discussed the effectiveness of the vaccine, the degree of readiness the United States has to track new mutations, and shared the his impressions of the executive orders of President Joe Biden COVID-19
Dra. Mirella Salvatore
One of the main concerns remains the ability of COVID-19 vaccines to work on new strains. “All of our vaccines target the ear protein and try to cause neutralizing antibodies that bind to that protein,” said Mirella Salvatore, adjunct professor of population medicine and health sciences at Weill Cornell Medicine in the city of New York, during an IDSA press conference. Thursday.
The B.1.1.7 mutation occurs in the “very important” ear protein, a component of the SARS-CoV-2 virus needed for binding, which allows the virus to enter cells, added Salvatore, a member of the IDSA.
Evidence suggests that SARS-CoV-2 should be able to produce one or two mutations a month. However, variant B.1.1.7 surprised UK researchers when they discovered that the strain had 17 mutations, Salvatore said.
It is still unknown 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. He added that the mutations could have arisen among immunocompromised people infected with SARS-CoV-2, but “this is just a hypothesis.”
Dra. Kathryn Edwards
On a positive note, Kathryn M. Edwards, MD, another IDSA member, explained in the briefing that existing vaccines are targeted at more than one location of the virus ear protein. Therefore, “if there is a mutation that changes a structure of the ear 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 stressed that while the new variant is more transmissible, it does not appear to be more lethal. “This can affect overall mortality, but not for the person who gets the infection.”
Stay one step ahead
When asked about the certainty that COVID-19 vaccines will work against emerging variants, Edwards said, “We may need to change the vaccine to make it more sensitive to new variants, but at this point that doesn’t seem to be the case. . “
If vaccines require an upgrade, 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,” he added. Edwards made an analogy with the choice of flu strains and sometimes the annual update, for the annual flu vaccine. With adequate funding, the same system could be replicated to cope with any evolutionary changes to SARS-CoV-2, he said.
As for funding, Salvatore said more money would be needed to optimize the emerging strain monitoring system in the United States.
“In fact, we have this system: there’s a wonderful network that sequences flu strains,” he said. “The structure exists, we just need funding.”
“The CDC is equipping the system to be able to sequence more viruses,” Edwards said.
Both experts praised CDC for its website with up-to-date surveillance information on emerging strains of SARS-CoV-2.
The support of Biden science
One reporter asked each infectious disease expert to share his impression of Biden’s recently signed COVID-19 executive orders.
“Takeaway food is the role of science and the lessons we’ve learned from masks, hand washing and distancing,” Edwards said. “We need to heed the advice …[especially] with a more contagious variant.
“It’s encouraging to hear science – that’s the general message,” he added.
Salvatore agreed, saying the orders give “the feeling that we can now act following science.”
“We have a lot of documents that show the effectiveness of masking,” for example, he said. Salvatore acknowledged that there are “many contrasting ideas about masking” in the United States, but stressed its importance.
“We need to follow measures that we know work,” he 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 have to really characterize all these mutations and their functions.”
“We have to worry, do follow-up studies,” he added, “but we don’t need to panic.”
This article was based on a report from the Infectious Diseases Society of America of January 21, 2021. Salvatore revealed that he is a PI of a study by the Verily life sciences LLC / Brin Foundation on Predictors of Severe COVID- 19 Outcomes (PRESCO) and PI for a study initiated by a Genentech-sponsored researcher on combination therapy for influenza. Edwards revealed the NIH and CDC grants; consulting for Bionet and IBM; and to serve on the data monitoring and security committees of 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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