South Africa Variant: What Mutation Means For Vaccines And You

A really simple guide to the Covid variant that’s got everyone talking.

South Africa has suspended its rollout of the Oxford vaccine after a study suggested it wasn’t effective at preventing mild illness against the country’s mutation. South Africa will only use the Johnson & Johnson and Pfizer vaccine.

However, the UK’s vaccines minister, Nadhim Zahawi, told the public to have confidence in the Oxford/AstraZeneca vaccine, and believes the vaccine would still protect against severe disease from the variant.

Zahawi urged people to keep faith, as scientists working on the vaccine raised the prospect of having a booster dose available by the autumn.

“While it is right and necessary to prepare for the deployment of an updated vaccine, we can take confidence from the current roll out and the protection it will provide all of us against this terrible disease,” he wrote.

Here’s what you need to know about the South African variant.

What is the South African (SA) variant?

The South Africa variant, was first detected in the UK in December. A rise in cases in South Africa was the result of 501Y.V2, which is said to carry a heavier viral load and seems to be more prevalent among young people.

As of Monday (February 8) there are 147 known cases of the variant in the UK. While some of these cases can be linked to foreign travel, not all can be. Variants of coronavirus are occurring due to spontaneous mutation. A mutation is a change to genetic material and it’s not unusual for a virus to mutate.

A spontaneous mutation is the result of errors in natural biological processes. Basically, “when viruses replicate, they make mistakes,” Dr Julian Tang, virologist at the University of Leicester, previously explained.

“But if they are replicating in a new host [person] and immune system, then more of these mistakes may form a pattern that allows the virus to adapt to the new host – like the 501Y, 484K, 417N S protein mutations that we are seeing already in the South African/Brazilian variants.”

It’s “not entirely clear” how the South African variant is spreading among communities in the UK, Dr Tang said, but “the aerosol route of transmission is likely unchanged”.

Jonathan Van-Tam, England’s deputy chief medical officer, said it’s unlikely the South Africa variant will become dominant in the UK. Instead, the Kent strain has a “distinct transmissibility advantage”, which has allowed it to become dominant.

Why did South Africa halt the rollout of the Oxford vaccine?

A small-scale study suggested the vaccine wasn’t effective at preventing mild illness.

The study was limited, as it involved 2,000 people “who were mostly young and healthy”, according to AstraZeneca, and more research is needed to confirm the vaccine’s impact on older patients and more severe cases with the new variant.

“We do believe our vaccine could protect against severe disease, as neutralising antibody activity is equivalent to that of other Covid-19 vaccines that have demonstrated activity against more severe disease, particularly when the dosing interval is optimised to eight to 12 weeks,” a spokesman reportedly said.

It’s therefore still hoped the vaccine may reduce hospital admissions among those with the South African variant.

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Do the vaccines work against the SA variant?

Sir Patrick Vallance said during a press briefing on January 22 that the Brazilian and South African variants are of more concern than the UK strain because there are fears they may be less susceptible to vaccines.

Oxford Vaccine

Sir John Bell, regius professor of medicine at Oxford University, who helped develop its vaccine, also aired concerns over the South African variant, as it has undergone “substantial changes in the structure of the [virus] protein”.

He told Times Radio: “My gut feeling is the [Oxford] vaccine will be still effective against the Kent [ie. UK] strain. I don’t know about the South African strain – there’s a big question mark about that.”

However, AstraZeneca has since said it is on track to develop a Covid-19 vaccine against new strains of the disease by the autumn, which could be given to Brits as a ‘booster’ jab.

Pfizer Vaccine

One preprint study found the Pfizer vaccine did work against the spike protein behind both the strains from the UK and South Africa. Professor Lawrence Young, from the University of Warwick, said this was “encouraging news”.

Professor Stephen Evans, an expert in pharmacoepidemiology from London School of Hygiene & Tropical Medicine, said that while this finding was “good news”, it did not yet give total confidence that the Pfizer (or other) vaccines would definitely give protection against the variants.

“We need to test this in clinical experience and the data on this should be available in the UK within the next few weeks,” he said.

Novavax Vaccine

The vaccine from US company Novavax has been shown to be 89% effective in preventing Covid-19 and preliminary analysis has shown it to be nearly as effective in protecting against the UK variant, and about 60% against the South African strain. The UK has secured 60 million doses of the jab.

Will we need an “autumn booster” to protect us from this strain?

Zahawi said he and Jonathan Van-Tam, England’s deputy chief medical officer, agreed there was likely to be a follow-up jab programme later in the year.

“We see... a booster in the autumn and then an annual (jab), in the way we do with flu vaccinations where you look at what variant of virus is spreading around the world, rapidly produce a variant of vaccine and then begin to vaccinate and protect the nation,” he told BBC One’s Andrew Marr Show.

Health Minister Edward Argar agreed that a third jab may be needed in the UK, but stressed that boosters are not unusual in vaccination programmes.

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“In terms of how these jabs work, when we have our flu vaccinations every winter, we do that because we look at how the genomics have changed – how the virus has tried to outwit the vaccine we’ve got and mutate and come up with new variants – and then we tweak the vaccine so that we catch those new vaccines that come up every year,” he told the Today programme on Feb 8.”

“That’s the nature of how these viruses change and how they behave and there’s no reason to think we wouldn’t do the same with this, because although it’s hugely more significant in terms of the number of people it’s killed, sadly, and in terms of the illness it causes than winter flu, the principle is the same that these viruses mutate and change and we need to keep up with them.”

While there are cases of the South African variant in the UK, he said it’s not the dominant strain. “The dominant strain is the one we’ve been dealing with since last year and to a large degree the so-called Kent variant,” he said.

Professor Sarah Gilbert, Oxford vaccine’s lead researcher, said her team was working on an adapted version of their jab to tackle the South Africa mutation, available for the autumn. The group is aiming to start trials in the spring so vaccination programmes can begin before next winter. It’s cutting the time needed to reach production at scale to between six and nine months, it added.

Chief executive Pascal Soriot said the company’s current vaccine is thought to provide a “good level of protection” against severe disease caused by the new variants, such as the Kent and South African strains, but will need to be adapted to prevent milder symptoms.

What else is being done to stop the SA variant in UK?

Hotel quarantines will also begin in the UK from February 15, in an attempt to limit the spread of variants from other countries. However, spontaneous mutation means that certain policy changes – such as hotel quarantines and controlling borders – will have some impact, but not totally remove the problem.

“It’s incredibly important to snuff it where you can and seek it out where you can – and use that time of suppression to maximise vaccination within the population,” Professor Calum Semple, a member of the government advisory group Sage, said on Radio 4.

“But...the other mutations that can occur, will occur in time. It’s very important to take every opportunity to catch the so-called South African variant, suppress it, keep it down and allow the vaccine schedule to get ahead of it.”