Vaccines Should Work Against New COVID-19 Strain

There is no doubt that the major news story of the week is that Coronavirus disease 2019 (COVID-19) has mutated. And as the public begins to panic, one must ask: What has really changed? We have known for some time now that the strain, G614D, which devastated the Northeastern United States was different and more infectious than the Wuhan strain. And that SARS-C0V-2 virus can have a plethora of mutations, literally thousands, many of which are being tracked on https://nextstrain.org/.

And then a significant mutation occurred in the Danish mink industry which infected both animals and 12 husbandry workers. Public health officials felt this strain may will be resistant to vaccines. Seventeen million minks were killed to prevent the spread of this mutation.

Kevin Kavanagh, MD

So as I tried to sound the alarm that we need to be both vigilant and strictly follow public health advice, much of our nation was living in a false sense of reality, depending upon herd immunity. The same public which for a large part will not follow public health advice because the infection “only” has a 1% fatality rate and at the same time are now expressing concerns regarding the vaccine because of an extremely rare non-fatal allergic reaction.

And a new more infectious variant has now emerged in Southern England. Its infectivity may have increased by 70%, but initial reports have indicated the severity of illness has not changed. The world has started to almost panic, and finally realizes the dangers of a highly mutable RNA virus.

Yes, we must treat this strain with the respect and diligence it deserves, but we must also not panic. There is no doubt that increased infectivity equates with increases in deaths, but it does not mean the vaccines will not work. Here’s why.

The new mRNA vaccines elicit a myriad of neutralizing antibodies aimed at just the virus’s spike protein (the structure it uses to attach to a plethora of many different types of cells in the body). These include heart, kidney, gastrointestinal and lung. All of which contain the ACE II receptor. To avoid these antibodies the virus has to change its spike protein in such a way that the antibodies do not attach but are still able to bind to the ACE II receptor. This is a difficult task, even for a highly mutable virus.

Currently, the virus has produced mutations to avoid single monoclonal or cocktails of two antibodies and still retaining the ability to cause severe and fatal disease. Obviously, we do not want this to happen. But it is unlikely the virus will be able to avoid the myriad of antibodies produced by the vaccine. As aptly pointed out by Greaney, et al. “…even antibodies targeting the same surface often have distinct escape mutations.” This is a similar situation to the Measles virus, which has had many mutations. None of which could evade the vaccine and still maintain viral infectivity.

And if the virus does find a combination which allows it to still avoid the vaccine and maintain its severity of illness and infectivity, the new mRNA vaccine technology can readily adjust and print out a new vaccine. The current mRNA vaccines are created totally in the laboratory by inserting the spike protein’s mRNA code. It is an automated, relatively fast process which the CEO of BioNTech estimates would take about 6 weeks to accomplish.

It is imperative that we follow public health advice. Just remember what happened to the snow leopards in the Louisville Zoo, they are exceptionally good at enforcing social distancing, but not so good at wearing masks. They caught COVID-19. Thus, you must do both. And be steadfast, since we have to slow down the spread of SARS-CoV-2, so the viruses natural production laboratory does not outstrip the capacity of our pharmaceutical giants.

We have the knowledge on how to stop the virus’s spread and the tools to kill it. The only question is, do we care enough for one another to change our lives for a relatively short period of time so our children and grandchildren can have a bright future?