Thread by @DrEricDing

NOT GOOD—so it seems 🇬🇧 government researchers have discovered that the already more contagious #B117 has further acquired the other troublesome E484K mutation seen in 🇿🇦#B1351 & 🇧🇷#P1 variants—in 11 patients. E484k is blamed for partial vaccine-evasion.🧵
assets.publishing.service.gov.uk/government/upl…

2) Moreover, they believe the 11 samples of #b117 variant that acquired the new E484K acquired them independently of each other (not just one single origin). This suggests convergent evolution taking place—where it evolves to acquire E484K separately—which indicates it is key.

3) One expert thinks it’s because the E484K might enhance another mutation seen in #B117, thereby letting the virus “grip” the human ACE2 receptor (targeted entry portal into human cells) stronger in a more stable way.

https://twitter.com/_b_meyer/status/1356361237395865600

4) Previously— the E484K mutation was shown in a recent study by @jbloom_lab
that E484 mutation (inside the #SARSCoV2’s spike’s critical receptor binding domain) seemed to somewhat escape neutralizing antibodies in 9 out of 11 people tested.

5) How much affect? the E484K shows a 10x reduction of neutralization (“neutralization” = stopping the virus)
by various antibodies compared to wildtype (common #SARSCoV2) in some patients —a rather bad thing. It means the virus with E484K is worrying for “immune escape”.

6) E484K mutation is also not a 1 time fluke. Scientists decided to see what mutations can help virus escape from patients w/ convalescent plasma immunity. So they soaked virus w/ CP over 12x times to speed evolution—80 days later—

*E484K arose*!

https://twitter.com/ncholia/status/1347555563400519682

7) What does E484K mean for prior natural infection immunity and vaccines? Moderna has discovered its vaccine is less efficient for B1351 variant with E484K. But with discovery of E484K now acquired by some B117 variants—this is bad news. Hope it doesn’t become a super strain.

https://twitter.com/DrEricDing/status/1353706396282474499

8) Moreover, in the latest E484K study by South Africa 🇿🇦 CDC @nicd_sa - not only 48% (of 44 formerly infected people tested) had “complete immune escape” to the SA variant #B1351 w/ E484K, but 90% of the people tested showed reduced immunity! That’s pretty large fraction.

9) This is why South African CDC has come out straightforward that the #B1351 variant with E484K mutation has serious potential for reinfection.

https://twitter.com/DrEricDing/status/1351686170044989442

10) Similarly, the new Novavax vaccine had high efficacy for regular #COVID19 but much much lower in South Africa.

https://twitter.com/drericding/status/1354899824370462722

11) this was also recently seen in the single shot Johnson and Johnson vaccine — lower efficacy in South Africa.

https://twitter.com/drericding/status/1355141560514580482

12) Moderna, Pfizer/Biontech, Novavax, J&J have all expressed interest / already begun development of a booster shot #COVID19 vaccine dose for the new strain(s) with the E484K mutation.

current vaccine still DOES WORK, just not as efficiently as before for new variants w/ E484K.

13) Vaccines do still work. And even 50% for the few variants with the E484K is still good and better than 0% protection if you didn’t have any vaccine.

And the best news is that vaccines prevent severe #COVID19 and deaths the best!

https://twitter.com/drericding/status/1356080282286379010

14) Today, German chancellor Angela Merkel says that if vaccines do not work on variants of the virus, then "we start all over again” and has said coronavirus vaccines may be needed for "many years to come." She is a scientist herself.

amp.dw.com/en/angela-merk…

https://twitter.com/kniggem/status/1356377210366676998

15) Pfizer and partner BioNTech are developing booster shots so that their COVID-19 vaccine Comirnaty can protect against new, highly contagious variants, Pfizer CEO Albert Bourla, Ph.D., said Tuesday, according to Bloomberg.

fiercepharma.com/pharma/first-m…

16) “Every time a new variant comes up we should be able to test whether or not [our vaccine] is effective. Once we discover something that it is not as effective, we will very, very quickly be able to produce a booster dose that will be a small variation to the current vaccine.”

17) Remember when I said the new E484K seems to have evolved separately in 2 different lineages of #B117 & somehow both converged to find E484K? So here is the genome lineage @nextstrain map—one recently evolved in Wales and one separately in England. Oy.
nextstrain.org/groups/neherla…

18) there is also the likelihood that #B117 will also yield more severe outcomes. 7 out of 10 studies suggests 30% increased mortality risk. See 🧵 for details.

https://twitter.com/drericding/status/1353468238773035008

19) This is why we need to avoid the new #B117 as much as possible. Switch to a premium mask for better inhalation filtration. It is CRITICAL folks. @AbraarKaran @RanuDhillon @sri_srikrishna all endorse.

https://twitter.com/drericding/status/1353186978519539712

20) a more contagious virus also means the threshold for reaching herd immunity is now becoming higher... lots of implications what this means and what we need to do...

https://twitter.com/drericding/status/1355697452926590980

21) We need to seriously start thinking about how to rapidly test and approve booster shots. I think they should be expedited now that we know the main #COVID19 is safe. Boosters are needed if these mutations keep arising.