Moderna vaccine appears to work against variants

https://www.bbc.co.uk/news/health-55797312

by pseudolus • 5 years ago

227 112 5 years ago

bbc.co.uk

r00fus• 5 years ago

I don't see any identification of the variants successfully defeated in this article.

For example the E484K variant identified in Brazil that is supposed to be antibody resistant is quite terrifying.

foolmeonce• 5 years ago

B.1.1.7(UK) and B.1.351(SA) the article links to the source. They say "variants including", but I doubt they would leave out the Brazilian one if it was tested.

contravariant• 5 years ago

The linked study names the 501.V2 / B.1.351 / South African (vulg.) variant. This variant also has the E484K found in the B.1.1.248 / Brazil (vulg.) variant.

That said based on the title you might assume the vaccine to be as effective, but that's not quite what the study says. In short it states:

A six-fold reduction in neutralizing titers was observed with the B.1.351 variant relative to prior variants. Despite this reduction, neutralizing titer levels with B.1.351 remain above levels that are expected to be protective.

ryan_j_naughton• 5 years ago

Six fold reduction is extremely concerning!

As the vaccine becomes more widespread, it will be tested more widely by exposure to the virus and this will trigger faster evolutionary cycles by the virus to defeat the vaccine.

My forecast is we will have to get much faster at releasing updated vaccines and distributing them in order to stay ahead of this virus -- and that everyone will need to be vaccinated every 6 months until we hit sufficient heard immunity of the circulating strains such that is stops circulating so rapidly and the speed of mutation consequently reduces.

adventured• 5 years ago

The headline is slightly misleading if only because it's so vague, which is why this is out today:

"Moderna says it’s working on Covid booster shot for variant in South Africa, says current vaccine provides some protection"

"The company’s researchers said its current coronavirus vaccine appears to work against the two highly transmissible strains found in the U.K. and South Africa, although it looks like it may be less effective against the latter."

https://www.cnbc.com/2021/01/25/covid-vaccine-moderna-workin...

anonuser1234562• 5 years ago

EK484K is a particular mutation, not a variant. It is common to a Brazilian variant and the SA variant referenced in the article.

hda111• 5 years ago

Variant is almost synonymous to mutation here. Do you want to say the new variants didn’t come into being via mutation?

nikolay2• 5 years ago

Can you explain what is the difference between mutation, lineage, variant, strain, please?

slumdev5• 5 years ago

No reason to be afraid of new strains. Coronaviruses become less deadly as they evolve to become better at spreading.

brianbreslin• 5 years ago

That's a mixed bag, as on one hand sure the number of dead goes down per 100, but then the number of folks infected goes up, thereby meaning the same number of dead possibly, or more people infected in hospitals.

wittyreference• 5 years ago

Viruses are believed to become less deadly over time when being less deadly offers an evolutionary advantage in ability to spread. If being more deadly and more spreadable have the same mechanism (e.g., avoiding spike protein-inhibiting antibodies), you can expect that old adage not to hold true over the short-term.

lazide5• 5 years ago

That is a dangerous misunderstanding of evolutionary pressure in viruses.

LONG TERM, less deadly viruses will tend to spread better because the more deadly a virus is, the more it raises stakes for the host population to remove it or prevent it , and the more it can make it apparent who has been infected. Ebola for instance justifies pretty almost any action you can imagine to contain it's spread, where we are still arguing if lockdowns or travel restrictions are the cost appropriate measure with COVID.

If the time of fatality is sufficiently delayed, or the time to implement other countermeasures or recognize the situation has changed is too long, it doesn't help anyone in the short, medium, or potentially even long term - you can have massive fatalities and huge spread.

The 1918 pandemic had multiple waves, with the second in particular having a much higher fatality rate than the first - 10x a typical flu season, which is what we're seeing now. This was almost certainly caused by variants, though lack of data makes it impossible to prove. [https://en.wikipedia.org/wiki/Spanish_flu]

A particularly nasty example [https://www.adn.com/alaska-news/science/2020/03/22/how-an-al...]

The more infections, the more likely we'll get more variants, and the more likely we'll get some that cause terrible, terrible problems - and may still be quite infectious.

Long term, will the most terrible ones die out? Very likely. However, smallpox was a scourage on humanity since likely 300 BCE and up until eradication by a massive global effort in 1975, it still had fatality rates around 25-35%. So don't just assume COVID will 'evolve to harmlessness', or if it does that it would happen on a timeframe convenient for society [https://www.cdc.gov/smallpox/history/history.html]

anonuser1234562• 5 years ago

A virus may become less deadly. There is no guarantee. It depends on what evolutionary options are available and what pressures are selecting mutations.

Pre-symptomatic infectiousness has about the same selection pressure as low mortality rate IMO. Low risk viruses circulate well because people don’t care about transmission very much. High risk infections cause people to take precaution and thus eliminates those stains. SARS-COV-1 and MERS were that way.

But pre-symptomatic infectiousness (SARS-COV-2) makes this calculus immaterial for most people; they transmit it without knowledge. This reduces the pressure on high mortality / morbidity strains / variants.

tsimionescu3• 5 years ago

A strain that spreads more while not being significantly less deadly is much scarier than a more deadly strain that spreads less. Do the math if you don't believe me.

CyanLite22• 5 years ago

UK's Pandemic Team says the new strain appears to be more deadly. https://www.webmd.com/lung/news/20210125/uk-variant-may-be-m...

officialchicken• 5 years ago

Unpublished, non-peer reviewed, and sample size of 8... is there a well known name for opposite of FUD?

mcc1ane• 5 years ago

hype

matthewmacleod2• 5 years ago

This seems like an unreasonable assessment. The preprint is available (https://www.biorxiv.org/content/10.1101/2021.01.25.427948v1), submitted for peer review, and the article is pretty clear from the start that this is a preliminary finding.

sambe• 5 years ago

Where was it submitted? I couldn't see that anywhere.

outlace• 5 years ago

Hubris

bpodgursky• 5 years ago

"Peer review" is not a suicide pact. In the middle of a pandemic, where days matter, you publish information as you get it, and act with that understanding.

Nightshaxx• 5 years ago

I disagree. In a pandemic it's important to get solid and clear information to the population. If you start saying things that don't go through the proper channels to be verified as reasonably true, then you create massive confusion when you potentially have to go back on that information. Scientists can and do make mistakes. A lay person might not understand what "preprint" or "not peer reviewed" mean yet this article is on the BBC which the average lay person does trust as a source for reasonably true information.

schoolornot• 5 years ago

The more guessing and conjecture I hear about the effectiveness of current vaccines on mutations, the angrier I get. Are there any clinical trials going on right now to determine how well various strains respond to the current vaccines? Until Pfizer or Moderna puts out a press release saying their products cover the top 4 major strains, I'm not believing anything.

bdonlan2• 5 years ago

There are two ways to do clinical trials on vaccine effectiveness. One is to vaccinate someone and then deliberately infect them; this gives you good data quickly, but due to the deadliness of COVID-19, this is generally regarded to not be an option. Another is to vaccinate a very large number of people and wait to see if they get sick with the virus from natural exposure. This is ongoing right now on a very large scale; millions of people have been vaccinated, and sooner or later people will come in contact with these new variants. However, it takes time to collect enough data with this approach to provide useful results, and in this case it can be confounded by the lack of a control group (you don't know how many exposure events happened that did not lead to infections).

Regardless, the current vaccination campaign is highly effective against the original - still very widespread and deadly - virus, so it's worth getting it, and as people get vaccinated with it, it will eventually be apparent whether it works against various variants as well. If it doesn't, it's likely that a booster vaccination can be developed for these variants (and indeed, Moderna has begun work, as an insurance policy, on a booster for the south african variant).

kaycebasques• 5 years ago

is there a well known name for opposite of FUD?

False hope

thehappypm4• 5 years ago

Sample size of 8 is not really a huge issue for this kind of analysis.

The hypothesis is that the Moderna vaccine produces antibodies against the new variant.

8/8 people sampled produced antibodies.

Can we confidently say that 100% of people will produce antibodies? No, not with a sample size of 8.

Can we say confidently that 50% of people will produce antibodies? That the vaccine gives you a coin toss's odds? If it's just a coin toss, this result would be the same probability as 8 "heads" in a row, or 1 in 256.

So, the result is hardly FUD or meaningless. They've also submitted to journals for the world to inspect the results.

renewiltord• 5 years ago

Well, in your analysis, what's the minimum sample size and why?

ogre_codes• 5 years ago

This result is the absence of bad news. No more, no less.

Regardless of what this early result is, the only thing most of us can do is try to keep social distancing, use masks, and get vaccinated to protect ourselves as best as possible.

If the vaccine doesn't actually protect us against the newer strains, we should still take it because we need protection from the more widely strain regardless. The only difference is whether we'll need to take a second vaccine in another year.

Exmoor• 5 years ago

Here's a link to the actual study: https://www.biorxiv.org/content/10.1101/2021.01.25.427948v1

I believe most of the vaccines approved or pending approval (Johnson and Johnson) target the spike protein, so I would expect their results to likely (hopefully) be similar.

_ink_• 5 years ago

Do not be so sure. The spike protein has two states, pre fusion and post fusion. It makes a difference what exactly the vaccine is targeting. My understanding of this is very limited though.

traveler013• 5 years ago

Since there are probably specialists out there, can you answer me a question?

Since these vaccines are targeting spike proteins, shouldn't they work with every variant? Is there (big) risk of a mutation actually changing the spike protein?

raphlinus• 5 years ago

I'm not a specialist, but I can link you to the answer: [1]

Key quote: "B.1.1.7 is defined by 23 mutations from the original Wuhan strain, 8 of which are in the spike protein. The 3 mutations hypothesized to have the largest potential biological effect are N501Y, spike deletion 69-70del and P681H."

The B.1.351 (South Africa) variant has N501Y but not the 69-70 deletion. We're still learning, but virologists I follow are concerned that N501Y may be a driver of higher transmission. But it's likely that multiple mutations contribute.

[1] https://asm.org/Articles/2021/January/B-1-1-7-What-We-Know-A...

thehappypm4• 5 years ago

When the immune system creates antibodies, they basically hug the spike protein and build antibodies on every nook and cranny they can find a way to bind an antibody. These regions are called epitopes, and the immune system creates many antibodies for each invader.

If the spike protein mutates, it means that the structure of the spike is different. Obviously the spike can't change too much, because it needs to still be able to latch onto cells, and many changes would be irrelevant. Even if one antibody suddenly stops working because of a slight shift in the protein, there are other antibodies targeting different parts of the protein that would still be effective.

Only if the spike changes so dramatically that literally none of the antibodies you had before are relevant anymore. That's why it's not super expected that we'll get a version of the virus that these vaccines won't at least produce some antibodies against.

traveler013• 5 years ago

Thank you. Basically they could just change the actual vaccine a bit to cover all those variants right?

CyanLite22• 5 years ago

ELI5: The spike protein itself is changing on the virus.

sjg0075• 5 years ago

Yes there is a big risk that the vaccines won't work if the viral spike protein has sufficiently diverged from the one encoded by the vaccine's mRNA template. Viral proteins are constantly changing. They accumulate sequence mutations both naturally and due to selective pressure. There's a limited landscape of acceptable changes but we don't know what those are and how they relate to each other. All we can do is generate new mRNA templates to the more popular strains and revaccinate. This means that we will most likely we will end up taking a cocktail of mRNA vaccines and yearly boosters.. with new mRNA templates.

"Won't work" in this case is defined on a spectrum. Moderna's vaccine is currently about 90% efficacious. Newer variants could reduce that down to say 60% or more. At some point the current vaccine could become useless.

traveler013• 5 years ago

But could they become useless before we "solve" this pandemic? Is actually my fear and other "noobs" in this matters.

amelius• 5 years ago

Is the efficacy still in the 94% range?

niea_11• 5 years ago

From the abstract of the paper linked in the article: No change for the UK variant, but lower efficacy for the South African variant (if my understanding of the abstract is correct):

No significant impact on neutralization against the B.1.1.7 variant was detected in either case, however reduced neutralization was measured against the mutations present in B.1.351.

Paper : https://www.biorxiv.org/content/10.1101/2021.01.25.427948v1

bdonlan2• 5 years ago

This study was done in a laboratory based on blood samples and does not directly equate to a percentage effectiveness. Collecting data on actual effectiveness in the wild, as it were, will require a sufficient number of vaccinated people to come into contact with the variant strains in question, and will therefore take a few months, most likely.

SpicyLemonZest• 5 years ago

They believe so ("neutralizing titer levels with B.1.351 remain above levels that are expected to be protective"), but this was a blood sample study that can't definitively demonstrate population efficacy.

hehehaha• 5 years ago

The question should be can you get re-infected via SA variant. And what’s the mortality rate on re-infection? At this point, you have to assume vaccine rollout is too slow to catch up with the spread.

dehrmann• 5 years ago

I'm not surprised. These new variants started taking over months ago before many people were vaccinated, so there was no pressure to adapt to the vaccines.

My theory is that what they are adapting to is all the other mitigation measures that we've been doing for a while--think masks and social distancing.

jerf5• 5 years ago

Viruses can't really "adapt" to "not being spread". It's not quite zero, I suppose we could hypothesize some superior ability to survive on a surface for some period of time or something, but there's not much they can do about it.

Bacteria would have more options, since they're so much more complex. Viruses just don't have much they can do.

Skunkleton• 5 years ago

Viruses can't really "adapt" to "not being spread".

Of course they can. We have this pandemic because a coronavirus became highly transmissible.

lazide5• 5 years ago

They mutate, and mutations more successful in causing infections cause more infections and become dominant.

There are many ways for this to happen, some of which covered in this thread - changes in the surface presented to the host, more viral load produced and expelled by an infected host earlier being some obvious ones.

Some potential methods that have occurred with other diseases in the past include additional methods of infecting hosts (from prior versions), such as viral envelopes that can insert against additional types of cells, or changes to the way the virus hijacks cell replication machinery to produce products that are better at hiding what is going on to the immune system.

jeofken3• 5 years ago

If we fail to totally eradicate these strains of coronavirus from earth, like we have never ever in history managed, is lockdown forever right - the end of free life? Or was it just something required in 2020 for some reason?

iso16312• 5 years ago

Lockdown is required when there is a risk of more paitents from an infectious disease than there are beds. Lockdown isn't the purpose, the purpose is to stop the number of new paitents requiring hospital from outnumbering the number of paitents leaving hospital (either walking or in a bodybag)

When was the last last time we had a disease that spread this quickly and caused this many hospitalisations, on a global scale?

chasd00• 5 years ago

even CA is lifting their stay at home order. I think the political costs of these hobby authoritarian regimes are finally getting too expensive.

jeofken3• 5 years ago

The lockdowns are created by states and are political. If their goal has been archived, they can be lifted.

jerf5• 5 years ago

Coronavirus will naturally evolve into the attraction basin for viruses of its type, which is the common cold: https://www.sacbee.com/news/coronavirus/article248455480.htm...

It's already well on its way, from what I can gather.

One frustrating aspect of the reporting for me is people talking about "more infectious" variants without describing whether or not they are more or less dangerous. In general, the virus putting more work into being infectious is good news; it generally comes at the cost of being less dangerous in other ways as it hyper-optimizes into replication rather than anything else. We should expect and want to hear about "more infectious" variants, which double as natural vaccines to some extent against other less infectious, more dangerous strains still using the same external protiens.

watt• 5 years ago

There is some talk that it also _is_ deadly. https://www.theguardian.com/world/2021/jan/22/new-uk-covid-v...

InitialLastName• 5 years ago

There's a substantial lag, though, between finding out how infectious a variant is and how deadly it is (AIUI the rough averages are 2 weeks from infection to hospitalization and another 2 weeks from hospitalization to deaths, but that might have changed). That means that the data on how infectious a variant is becomes available ~1month ahead of information about how dangerous it is. Have we even had confirmed spread of these variants for a month?

NLips2• 5 years ago

BBC’s _More or Less_ did a bit on this. 70% more deadly (per person) would actually be better than 70% more infectious. Deaths increase linearly with deadliness of virus, but they increase exponentially with infectiousness.

Say the current mortality rate is 2% and each infected person passes on the disease to one other after a week, then stops being infectious. If 100 people have the virus in week 0, after 10 weeks 1000 people will have had the virus and 20 will have died.

Increase the death rate by 70% and you’d have 34 deaths instead. Increase the transmission rate by 70%, and you’d have 170 people newly infected in week 1, then 289 in week 2, totalling 285,000 infected people, of which 2% die. That’s now 570 deaths.

Obviously the numbers can all be changed somewhat depending on treatment, or whether you expect everyone to be infected at some point anyway, but the takeaway is that more deadly is not necessarily worse than more infectious.

ceejayoz4• 5 years ago

like we have never ever in history managed

Smallpox would like a word.

Polio, too, for the most part.

paganel2• 5 years ago

Those two took decades to eradicate, we won't be able to keep the Earth's population on lockdown/no-lockdown cycles for that long.

mlindner2• 5 years ago

SARS and MERS as well, which is notably more relevant. These don't exist anymore.

lostapathy• 5 years ago

COVID is different in that it appears to have numerous animals it can live in. It's one thing to lock down people, but another entirely to lockdown animals.

jeofken3• 5 years ago

Sorry if I could have worded it more clearly - I meant that we have never successfully eradicated a member of the coronavirus family. If we have, I appreciate a correction, preferably with a source. Reread my comment and I think this will be clear

maxerickson4• 5 years ago

A big change is that there is vaccine production capacity now, and the new vaccines can go through an approval process like is used for annual flu shots, meaning a new vaccine can start mass production in a few months vs the (very quick) year that it took this time.

A year ago there wasn't much more than experimental capacity to make mRNA vaccines. Now we are at tens of millions of doses a month and scaling up.

mlindner2• 5 years ago

Actually much faster than months. MRNA-based vaccines can be brewed up in days to weeks.

Moderna vaccine appears to work against variants

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