At least 217 countries and territories have administered over five billion doses of a Covid-19 vaccine, including over two billion in the People’s Republic of China1,2. Billions of people throughout the world would love to become vaccinated if they could. Only 1.9% of people in low-income countries have received at least one dose2. At the same time, countless millions of misinformed people in the USA and other high-income countries refuse to get vaccinated and subsequently die of Covid-193. Also, unvaccinated people who become infected with the SARS-CoV-2 virus are potential factories producing new variants or mutants that could be quite deadly. For example, the World Health Organization (WHO) has designated a new variant of interest (VOI) and called it Mu4. They fear that its many mutations might make it resistant to currently used vaccines. Hopefully, we will reach herd immunity eventually. One encouraging sign is that 80% of Americans 16 and older have some immunity to coronavirus5. The goals of this month’s article are to describe the Mu variant as well as recent results concerning the long-term effectiveness of current vaccines and the controversy over booster shots.
Long-term effectiveness of Covid-19 vaccines
One of the most important questions is how long are vaccines effective? Clinical trials found that the Astra-Zeneca AZD1222, Novavax NVX-CoV2373, Moderna and Pfizer/BioNTech vaccines were over 90% effective in preventing viral infection in clinical trials6. More than 80% of Americans 16 and older have some level of immunity against the virus, mostly through vaccination, a survey of blood donations indicated7. So, breakthrough infections are rare. In the USA, over 853,000 people were hospitalized for Covid-19 in May, 20218. About 0.1% (less than 1200) were fully vaccinated. Of the 18,000 Covid-19 deaths in May, only 150 (0.8%) were people who were fully vaccinated. Children are relatively safe so far. In the USA, only about 1.7% of all the people who have tested positive for the SARS-CoV virus are children younger than 18 years (1.1% in the Netherlands, and 2.0% in the UK). As of April 7, 2021 only 0.0167% of all Covid-19 deaths in the USA were in the age group of 0 – 4 years, despite being about 6% of the total population8. A recent multistate interim analysis of 32,867 medical encounters among adults of all ages during June–August 2021 vaccine efficiency (VE) of all three authorized Covid-19 vaccines remained high against hospitalization (86%) and need for intensive care (82%)9. This was when the Delta variant was predominant. These overall VE estimates were similar to those during the months before Delta became predominant. However, VE against Covid-19 hospitalization among adults aged ≥75 years was significantly lower than that among adults aged <75 years, which had not been observed previously from this data source. This suggests that a booster shot might be advisable for people ≥75 years of age.
Booster shots
Results from a recent study in Israel showed that a booster shot of the Pfizer/BioNTech vaccine dramatically decreased the incidence of severe Covid-1910. This vaccine is also known as BNT162b2 and Comirnaty. Israel began giving booster shots on 1 August and has given it 2.8 million people so far. The study looked at more than a million Israelis over the age of 60 who received a booster between July 30 and August 22. It found that 12 days or more after the booster was given, the relative risk of severe illness decreased more than ten times and the relative risk of confirmed infection decreased more than 11 times. Moreover, they found that 7-13 days after the booster shot there was a 48-68% reduction in the odds of testing positive for infection by the SARS-CoV-2 virus and that 14-20 days after the booster this increased to 70-84%. As a result, the FDA is expected to approve the booster soon. On 17 Sept., they had a virtual meeting of its Vaccines and Related Biological Products Advisory Committee to discuss the matter of additional doses of Covid-19 vaccines and specifically to discuss the Pfizer-BioNTech supplemental Biologics License Application for the administration of a third dose of Comirnaty in individuals 16 years of age and older11.
However, the WHO and others feel that the available vaccines would be more useful if they were donated to countries with low levels of vaccination.
As of 13 September, 42% of the world population was fully vaccinated1. The global 7-day moving average of administered doses is about 31 million per day. Over 80% of people in Portugal and 72% of people in Chile are fully vaccinated. Only 53% and 52% of the people in the USA and Switzerland, respectively, have been vaccinated. Less than 1% of the people in many African countries have been vaccinated1. In the meantime, the virus continues to spread and mutate into new variants.
The Mu variant
A new strain of the SARS-CoV-2 virus called Mu, or B.1.621, has been designated as a VOI because it has several mutations that may make it resistant to vaccines4. It was first identified in Colombia and cases have since been recorded in 38 other countries, predominantly in South America and Europe. Since it’s the fifth such VOI, it has been given the name of the fifth letter in the Greek alphabet. There are several mutations in the viral genome that code for the spike protein, which is targeted by most vaccines, including Moderna, Pfizer, Astra-Zeneca and Johnson&Johnson. Some of the mutations are common in other VOIs (E484K, N501Y, P681H) while others are new (R346K, Y144T, Y145S and 146N insertion). Here is a list of the five VOIs:
Although the global prevalence of the Mu variant has declined and is currently below 0.1 % the prevalence in Colombia (39 %) and Ecuador (13 %) has consistently increased4.
Another variant known as C.1.2 is also causing concern because it is more transmissible and possibly resistant to vaccines than other variants of the virus12. It was first detected in South Africa in May, has since been found in Botswana, China, the Democratic Republic of the Congo, the United Kingdom, Mauritius, New Zealand, Portugal and Switzerland. The newly-discovered variant seems to have an unusually high mutation rate and more mutations of other variants of concern (VOCs)12.
So, new and potentially dangerous variants are being formed. We are a long way from reaching herd immunity. The virus doesn’t recognize borders. No nation will be safe until we are all safe.
In the meantime, human civilization remains threatened by a much greater threat – global climate change. The global elite are insane13,14. They think that their money can save them. There is a better way. There are things we can do14.
Appendix
Amino acid abbreviations: A – alanine; C – cysteine; D – aspartic acid; E – glutamic acid; F – phenylalanine; G – glycine; H – histidine; I – isoleucine; K – lysine; L – leucine; M – methionine; N – asparagine; P – proline; Q – glutamine; R – arginine; S – serine; T – threonine; V – valine; W – tryptophan; Y – tyrosine.
So, D614G is when a mutation changes an aspartic acid (D) is changed into a glycine (G), N501Y is when a mutation changes an asparagine (N) into a tyrosine (Y); L452R is when a mutation changes a leucine (L) into an arginine (R); K417N is when a mutation changes a lysine (K) into an arginine (R); P681R is when a mutation changes a proline (P) into an arginine (R).
Notes
1 Pettersson, H. et al. Tracking Covid-19 vaccinations worldwide. CNN Health, 13 Sept., 2021.
2 Our World in Data, Coronavirus (Covid-19) vaccinations. Accessed 13 September, 2021, but updated daily.
3 Smith, R.E. The unvaccinated are dying from Covid-19. The delta variant is now the dominant strain in the USA and many other countries. Wall Street International, 24 July, 2021.
4 Lock, S. Mu Covid variant, which scientists fear is resistant to vaccines, detected in 39 countries. Newsweek, 1 Sept., 2021.
5 Caldwell, T. More than 80% of Americans 16 and older have some immunity to coronavirus, blood survey finds. CNN, 2 Sept., 2021.
6Smith, R.E. Vaccines based on modern RNA technology. This technology's potential for vaccines and other diseases. Wall Street International, 24 December, 2020.
7 CDC, Centers for Disease Control and Prevention. Covid-19. Accessed 15 Sept., 2021, but updated daily.
8 Al-Arshani, S. 99% of current Covid-19 deaths have one thing in common. Science Alert, 28 June, 2021.
9 Grannis, S.J. et al. Interim estimates of Covid-19 vaccine effectiveness against COVID-19–associated emergency department or urgent care clinic encounters and hospitalizations among adults during SARS-CoV-2 B.1.617.2 (Delta) variant predominance - nine states, June–August 2021. CDC Morbidity & Mortality Weekly Report, 10 Sept., 2021.
10 Patalon, T. et al. Short term reduction in the odds of testing positive for SARS-CoV-2; a comparison between two doses and three doses of the BNT162b2 Vaccine. medRxiv preprint, 31 Aug., 2021.
11 U.S. FDA. FDA in brief: FDA to hold advisory committee meeting to discuss Pfizer-BioNTech’s application for the booster. 1 Sept., 2021.
12 Scheepers, C. et al. The continuous evolution of SARS-CoV-2 in South Africa: a new lineage with rapid accumulation of mutations of concern and global detection. medRxiv preprint, 24 Aug., 2021.
13 Burrowes, R.J. The global elite is insane. Living Resilience, 2014.
14Burrowes, R.J. The global elite is insane revisited. How to create a world of peace, justice and ecological sustainability. Wall Street International, 8 Nov., 2018.