E484K Mutation Might Make COVID Strain Vaccine-Resistant

A lot of attention has been paid to two mutant strains of coronavirus disease 2019 (COVID-19) that have cropped up recently. There’s the B.1.1.7. strain that first appeared in the United Kingdom. It may be 70% more infectious than the strain the world’s been fighting for the last year. But indications are that the COVID-19 vaccines will be effective against B.1.1.7.

Then there’s 501.V2. That’s a strain that first appeared in South Africa. That may prove to be more of a problem. Within that strain scientists have found what they’re calling an “escape mutation” named E484K. It’s feared that this escape mutation will do just what the name implies, allow the South African COVID strain to escape some of the antibodies that a vaccine will throw at it. So far, scientists say that it won’t render the vaccines useless, but it might weaken their effectiveness.

Meanwhile, the rollout of the COVID-19 vaccines that has not been going smoothly, might get even more problematic. The idea was that health care workers on the frontlines and all residents and workers in long-term care facilities should be first in line for the vaccines. Yesterday, that changed. Alex Azar, the head of the US Department of Health and Human Services, said that that approach has led to a vaccine distribution bottleneck. Only about 9.3 million people have received their first dose of the vaccine, according to the US Centers for Disease Control and Prevention even though 38 million doses of the vaccine have been made available to the states so far.

Azar yesterday pushed about 163 million more people to the front of the vaccine line. That’s about half of the adult population of the US. He did that with a directive saying that everybody 65 and older and anybody 16 or older with a comorbidity, such as diabetes or even someone who smokes, should now be considered priority targets for getting the vaccines.

In making the announcement, Azar used an analogy of boarding an airplane, saying that “you might have a sequential order in which you board people. But you don’t wait until literally every person from a group is boarded before moving on to the next.”

But does that analogy work in this case? Will the changed guidelines for who gets to be first in line make the COVID vaccine bottleneck even worse?

The CDC’s Advisory Committee on Immunization Practices (ACIP) created the COVID vaccine rollout guidelines that put health care workers and nursing homes at the front of the line. Beth Bell, a professor at the University of Washington, who chaired the ACIP working group, expressed dismay at Azar’s decision. She tells STAT that while everybody wants the most efficient vaccine rollout possible, she’s quite concerned that Azar’s changes aren’t the way to get there. Some experts, like Bell, fear that it will lead to longer lines and more confusion as to who should get vaccinated. For instance, as STAT points out, a 24-year old smoker will have the same vaccine priority as somebody who’s 85 and frail.

This goes on as COVID-19 continues to surge to unprecedented levels. Yesterday, 4320 people in the United States died from coronavirus disease 2019 (COVID-19), according to Johns Hopkins University, a record and only the second time that more than 4000 people have died from the disease in a single day. Over the past week, an average of 3300 people have died from COVID-19 each day. That represents a 217% increase from the average number of deaths per day in mid-November.

Since the pandemic began in the United States, there have been almost 23 million confirmed cases of COVID-19. About 381,000 people have died from the disease. In the world, there have been over 91 million confirmed cases of COVID-19. And, in the world, nearly 2 million people have died from COVID-19. Johns Hopkins University brings you these stats as well.