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Vaccination

SARS-CoV-2 Vaccines and the Growing Threat of Viral Variants

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To identify the key insights or developments described in this article
1 Credit CME
JAMA
Published Online: January 28, 2021
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John P. Moore, PhD1;
Paul A. Offit, MD2
Author Affiliations
  • 1Department of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York
  • 2Division of Infectious Diseases, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Coronavirus Variants and Vaccines
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In November 2019, a bat coronavirus made its debut in the human population. Since that time, the virus has continued to adapt, resulting in a series of viral variants. The question that the world faces in early 2021 is whether these new variants will escape recognition by vaccine-induced immunity.

Protection against coronavirus disease 2019 (COVID-19) is mediated in large part by an immune response directed against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S)-protein. The S-protein is responsible for virus-cell binding and is the target for virus-neutralizing antibodies (NAbs). Although this is not strictly proven, most vaccine researchers believe that NAbs induced by vaccination are protective against COVID-19. NAbs bind to the S-protein at a few sites, usually in or near the receptor-binding domain (RBD); in doing so, NAbs prevent the virus from attaching to the ACE2 receptor on human cells.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

See More About

Vaccination Public Health Coronavirus (COVID-19)
Article Information

Corresponding Author: Paul A. Offit, MD, Division of Infectious Diseases, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th St & Civic Center Blvd, ARB, Room 1202C, Philadelphia, PA 19104-4399 (offit@email.chop.edu).

Published Online: January 28, 2021. doi:10.1001/jama.2021.1114

Conflict of Interest Disclosures: None reported.

Editor’s Note: Although preprints are rarely included as references in JAMA articles, in the midst of the COVID-19 pandemic some of the information in this article is based on rapidly developing and emerging science that is only available as preliminary communications on preprint servers.

References
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Korber  B , Fischer  WM , Gnanakaran  S ,  et al; Sheffield COVID-19 Genomics Group.  Tracking changes in SARS-CoV-2 spike: evidence that D614G increases infectivity of the COVID-19 virus.   Cell. 2020;182(4):812-827. doi:10.1016/j.cell.2020.06.043 PubMedGoogle ScholarCrossref
2.
Hou  YJ , Chiba  S , Halfmann  P ,  et al.  SARS-CoV-2 D614G variant exhibits efficient replication ex vivo and transmission in vivo.   Science. 2020;370(6523):1464-1468. doi:10.1126/science.abe8499PubMedGoogle Scholar
3.
Starr  TN , Greaney  AJ , Hilton  SK ,  et al.  Deep mutational scanning of SARS-CoV-2 receptor binding domain reveals constraints of folding and ACE2 binding.   Cell. 2020;182(5):1295-1310. doi:10.1016/j.cell.2020.08.012 PubMedGoogle ScholarCrossref
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Xie  X , Zou  J , Fontes-Garfias  CR ,  et al  Neutralization of N501Y mutant SARS-CoV-2 by BNT162b2 vaccine-elicited sera.   bioRxiv. Preprint posted online January 7, 2021. doi:10.1101/2021.01.07.425740Google Scholar
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Wu  K , Werner  AP , Moliva  JI ,  et al.  mRNA-1273 vaccine induces neutralizing antibodies against spike mutants from global SARS-CoV-2 variants.   BioRxiv. Preprint posted online January 25, 2021. doi:10.1101/2021.01.25.427948Google Scholar
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Zhang  W , Davis  BD , Chen  SS ,  et al.  Emergence of a novel SARS-CoV-2 strain in Southern California, USA.   medRxiv. Preprint posted online January 20, 2021. doi:10.1101/2021.01.18.2124978Google Scholar
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Wang  Z , Schmidt  F , Weisblum  Y ,  et al.  mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants.   bioRxiv. Preprint posted online January 19, 2021. doi:10.1101/2021.01.15.426911Google Scholar
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Wibmer  CK , Ayres  F , Hermanus  T ,  et al.  SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma.   BioRxiv. Preprint posted online January 19, 2021. doi:10.1101/2021.01.18.427166Google Scholar
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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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