A more contagious variant of the coronavirus is spreading across the United States. But vaccines must work against that.

Variant B.1.1.7, first detected in the United Kingdom, is not only more easily transmitted, but also appears to be more deadly. Dr. Anthony Fauci warned of this on Friday in an update of the coronavirus at the White House.

It was first detected in Colorado in late December, said Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Biden.

“Since then, it has been detected in 50 jurisdictions in the United States and is probably responsible for about 20 to 30% of infections in this country. And that number is growing,” said Fauci.

“It is worrying that there is an increase of about 50% in transmission with this particular variant that has been documented in the UK and there is likely to be an increase in the severity of the disease if infected with this variant,” he said.

Fauci pointed to a study that shows a 64% higher risk of death for people infected with B.1.1.7 compared to those infected with the oldest, the so-called wild type variant. He showed a second study that indicated a 61% higher risk of death with B.1.1.7.
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But vaccines seem to protect well against B.1.1.7 and treatments like monoclonal antibodies also seem to work against this particular variant, said Fauci.

That makes it more important than ever to get people vaccinated quickly, he said.

“The way to combat 1.1.7, which is a growing threat in our country, is to do two things: Vaccinate as many people as quickly and as quickly as possible with the vaccine that we know works against this variant, and finally , to implement the public health measures that we talk about all the time … masking, physical distance and avoiding congruent environments, especially in closed environments “, he said.

Vaccines appear to protect against variant B.1.1.7

The three vaccines that have so far obtained emergency use authorization from the US Food and Drug Administration appear to protect people well against B.1.1.7.

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The real-life use of Pfizer / BioNTech and Moderna vaccines indicates that, although variant B.1.1.7 may somehow elude the immune response induced by immunization, it is not enough to make vaccines less effective in protecting people. . That’s because vaccines cause a broad immune response so that, even if it is slightly weakened, it is still powerful enough to prevent serious illness and death.

There is less evidence about the vaccine made by Johnson & Johnson’s Janssen vaccine arm, although it was tested in the United States after B.1.1.7 began to circulate.

“Preliminary evidence suggests that currently authorized COVID-19 vaccines may provide some protection against a variety of strains, including B.1.1.7 (originally identified in the United Kingdom),” says the CDC in its guidance for fully vaccinated people.

Both BioNTech and Moderna helped coordinate various tests of their vaccines against the variants.

Ugur Sahin of BioNTech and colleagues tested the blood of 40 volunteers immunized with the Pfizer / BioNTech vaccine against laboratory engineering versions of variant B.1.1.7.

“The vaccine remained effective against B.1.1.7 with a slight but significant decrease in neutralization that was most apparent in participants under 55 years of age. Thus, the vaccine provides a significant ‘cushion’ of protection against this variant.” , reported in science.
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Likewise, Kai Wu of Moderna and a team from NIAID tested the blood of volunteers in laboratory versions of B.1.1.7. The variant “had no significant effect on serum neutralization obtained from participants who received the mRNA-1273 vaccine in the phase 1 trial,” they reported in the New England Journal of Medicine.
Ravindra Gupta, from the University of Cambridge, UK, and colleagues there and South Africa studied blood collected from older adults with an average age of 62 who had been immunized with the Pfizer / BioNtech vaccine. They saw a “small reduction in vaccine serum neutralization that was more pronounced after the first dose than the second dose,” they reported in the journal Nature – but again not enough to have an important effect.

The virus can acquire more mutations

What worried them was if more mutations were acquired by the virus. Several variants are of concern to doctors, including variant B.1.351 seen for the first time in South Africa and variant P.1, which is now common in Brazil. Both carry a mutation known as E484K that appears to significantly escape the body’s immune response.

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“It is worrying that we have shown that there are several B.1.1.7 sequences in the UK with E484K with initial evidence of transmission, as well as independent acquisitions,” they wrote.

Several experiments indicate that B.1.351 and P.1. variants can escape the immune response provoked by vaccines much more easily and also by some treatments with monoclonal antibodies, which implant proteins of the immune system designed in the laboratory to increase the immune response.

Few experiments have been done using the most recently authorized Johnson & Johnson vaccine, but it was tested in the USA after B.1.1.7 was beginning to spread; in South Africa after B.1.351 it was already the most common variant; and in Brazil after P.1 became widespread.

Although it was less effective against moderate illnesses in South Africa and Brazil than in the United States, it still strongly protected people against serious illnesses, hospitalizations and deaths in clinical trials.

Viruses mutate all the time, and some of the mutations occurred in variants that appeared in the United States, mainly in California and New York. The changes they carry include some of the changes that make variants B.1.351 and P.1 much more dangerous than B.1.1.7. Therefore, Fauci and the CDC claim that this makes it even more important to vaccinate as many people as possible before these variants spread.

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