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Vaccine vs Mutation COVID-19

FABRIKAM RESIDENCES

F a iz a Hatim
Outlines
Epidemiology COVID 19

COVID-19 Mutation

COVID-19 Vaccine Platform

COVID-19 Vaccine Effectiveness in

Different Variants
 January 28th
2022: Daily
Cases 9905

https://www.worldometers.info/coronavirus/country/indonesia/
COVID-19 cases per 100.000 population (17-23 January 2022)

World Health Organization. COVID-19 Weekly Epidemiological Update. 2022.

COVID-19 Vaccination in Indonesia

https://covid19.go.id/artikel/2022/01/27/data-vaksinasi-covid-19-update-27-januari-2022
COVID-19 Mutation
• The emergence of various variants of Covid-19 is caused by
mutations.
• A mutation refers to a single change in a virus’s genome (genetic
code)
• A variant is a viral genome (genetic code) that may contain one or
more mutations.
• Mutation might “potentially” cause vaccine less efficient, but not
inefficient.
• One or even three mutations, it’s expected the antibodies will still
recognize the variant
• RNA viruses mutate faster than DNA viruses.
COVID-19 Mutation
Disease
Transmission
severity

Vaccine and Diagnostic

therapeutics Tools

Public health
and social
measures

https://www.who.int/news-room/feature-stories/detail/the-effects-of-virus-variants-on-covid-19-vaccines
SARS-CoV-2 Variant Classifications and Definitions

Variants Under
Variant of
Monitored
Interest (VOI)
(VUM)

Variant of Variant of High

Concern (VOC) Consequence
https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern
 SARS-CoV-2 Variant Classifications and Definitions
Variant of Interest (VOI)
• Genetic changes that are predicted or known to affect virus characteristics such as
transmissibility, disease severity, immune escape, diagnostic or therapeutic escape;
AND
• Identified as causing significant community transmission or multiple COVID-19 clusters
• or other apparent epidemiological impacts to suggest an emerging risk to global public
health

Variant of Concern (VOC)

• increase in transmissibility in COVID-19 epidemiology; OR
• increase in virulence or change in clinical disease presentation; OR
• decrease in effectiveness of public health and social measures or available diagnostics,
vaccines, therapeutics
https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern
Variants of Concern

https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/
Variants of Concern
WHO label Alpha Beta Gamma Delta Omicron
Transmissibility Increased transmissibility Increased Increased Increased Increased
transmissibility transmissibility transmissibility transmissibility
Disease severity Possible increased risk of Possible increased risk Possible increased risk Possible increased Reduced risk of
hospitalization, possible of hospitalization, of hospitalization, risk of hospitalization and
increased risk of severe possible increased in- possible increased risk hospitalization severe disease
disease and death hospital mortality of severe disease

Risk of reinfection Neutralizing activity retained, Reduction in neutralizing Moderate reduction in Reduction in Increased risk of
risk of reinfection remains activity reported; T cell neutralizing activity neutralizing reinfection
similar response elicited by reported activity reported
D614G virus remains
effective

Impacts on Limited impact--no impact on No impact on RT-PCR or None reported to date No impact on RT- PCR continues to detect
diagnostics overall result from multiple Ag RDTs observed PCR or Ag RDTs Omicron. Impact on Ag-
target RT-PCR; No impact on observed RDTs is under
Ag RDTs observed investigation: Results are
mixed as to whether or
not there may be
decreased sensitivity to
detect Omicron

World Health Organization. COVID-19 Weekly Epidemiological Update. 2022.

COVID-19 Vaccine Platforms
Vaccine Performance Against Variants of Concern

World Health Organization. COVID-19 Weekly Epidemiological Update. 2022.

Variant
Omicron (B.1.1.529)
Delta (B.1.617.2)
World Health Organization. COVID-19 Weekly Epidemiological Update. 2022.
mRNA vaccine clinical effectiveness
Pfizer-BioNTech:
Significantly reduced effectiveness against
infection in the UK (Andrews, 2021)
Pfizer-BioNTech vaccine:
Slightly reduced effectiveness against infection
but preserved effectiveness*** against severe
COVID-19 after 2 doses in the U.S. (Tartof
2021), U.K. (Bernal 2021, Stowe 2021 , Sheikh
2021) and Canada (Chung 2021)
Moderna vaccine:
Slightly reduced effectiveness against infection
but preserved effectiveness against severe COVID-
19 in Canada (Chung, 2021)
Viral vector vaccine clinical effectiveness
AstraZeneca
Significantly reduced effectiveness
against infection in the UK (Andrews,
2021)
AstraZeneca vaccine:
Slightly reduced effectiveness against
infection but preserved effectiveness***
against severe COVID-19 after 2 doses in
the U.K. (Bernal 2021, Stowe
2021, Sheikh 2021) and Canada (Chung,
2021)
 Viral vector vaccine clinical
Variant mRNA vaccine clinical effectiveness effectiveness
Beta (B.1.351) Pfizer-BioNTech vaccine: Oxford-AstraZeneca vaccine:
Slightly reduced effectiveness against infection No effectiveness against infection in
but preserved effectiveness against severe South Africa (Madhi, May 2021)
COVID-19 in Qatar (Abu-Raddad, May 2021) Reduced effectiveness against
infection but preserved
Moderna vaccine: effectiveness against severe COVID-
Slightly reduced effectiveness against infection 19 in Canada (Chung, August 2021)
but preserved effectiveness against severe
COVID-19 in Canada (Chung, August 2021) Johnson & Johnson vaccine:
Reduced effectiveness against
infection but preserved
effectiveness against severe COVID-
19 in South Africa (Sadoff, May
2021)

World Health Organization. COVID-19 Weekly Epidemiological Update. 2022.

 Viral vector vaccine clinical
Variant mRNA vaccine clinical effectiveness effectiveness
Alpha (B.1.1.7) Pfizer-BioNTech vaccine: Oxford-AstraZeneca vaccine:
Preserved effectiveness against Slightly reduced effectiveness
infection and severe COVID-19 in the against infection
U.K. (Hall, May 2021), Israel (Haas, but preserved effectiveness
May 2021), Qatar (Abu-Raddad, May against severe COVID-19 in
2021) and Canada (Chung, August the U.K. (Emary, April
2021) 2021) and Canada (Chung,
August 2021)
Moderna vaccine:
Preserved effectiveness against
infection and severe COVID-19 in
Canada (Chung, August 2021)
 Coronavac effectiveness against COVID-19 Variants
• Two-dose CoronaVac+single BNT162b2 booster induces elevated virus
specific antibody levels and potent neutralization activity against wildtype
and Delta strains.
• NAbs against Omicron 1,4 fold higher in Two-dose CoronaVac+single
BNT162b2 than two-doses of mRNA vaccines.
• Phase 3 trial in Indonesia1 efficacy 65,3%, neutralization assay
seroconversion rate of 87,15%

Then EP, et al. Nature. 2022, Fadiyana E, et al. Vaccine. 2021.

 mRNA1273 Effectiveness against COVID-19 Variants

B.1.1.7 B.1.351 (Beta) B.1.617.2 B.1.1.529

(Alpha) (Delta) (Omicron)
Moderna 98,4% after 96,4% after 86,7% after 2nd 30,4% after 2nd
(mRNA1273) 2nd dose1 2nd dose1 dose1 dose2

Bruxvoort KJ, et al. BMJ. 2021.

Tseng HF, et al. MedRxiv. 2022.
Vaccine effectiveness of 2-
dose mRNA-1273
Tseng et al:

• 2 dose MRNA-1273 → VE in
14-90 days against delta
variant 82,8%.
• 2 dose MRNA-1273 → VE in
14-90 days against omicron
variant 30,4%

Tseng HF, et al. MedRxiv. 2022.

Vaccine effectiveness of 3-dose mRNA-1273

Tseng et al:

• 3 dose MRNA-1273 → VE
against delta variant 95.9%
• 3 dose MRNA-1273 → VE
against omicron variant
64,1%

Tseng HF, et al. MedRxiv. 2022.

 BNT162b2 effectiveness against COVID-19 Variants

B.1.1.7 B.1.351 (Beta) B.1.617.2 B.1.1.529

(Alpha) (Delta) (Omicron)
Pfizer 93,7% after 75% after 2nd 88% after 2nd 70%
(BNT162b2) 2nd dose1 dose2 dose1

Bernal JL, et al. N Engl J Med. 2021.

Collie S, et al. N Engl J Med. 2021.
ChAdOx1 nCOV-19 effectiveness against COVID-19 Variants

B.1.1.7 (Alpha) B.1.617.2 (Delta)

Astra Zeneca 74,5% after 2nd dose1 67% after 2nd dose1
(ChAdOx1)

Bernal JL, et al. N Eng J Med. 2021.

Effectiveness of one dose and two doses of the BNT162b2 and
ChAdOx1 ncov-19 vaccines

Bernal JL, et al. N Eng J Med. 2021.

Zififax
• Phase III trial in China → efficacy of ZF2001 against alpha
variant is 93% and delta variant is 78%1
• Phase III trial in Padjajaran University → efficacy 81,51%
• > 60 years old → 87,58%
• Efficacy after 7 days full vaccinated → 81,71%
• Efficacy after 14 days full vaccinated → 81,41%

1https://clinicaltrials.gov/ct2/show/study/NCT04646590
Andrews N, et al. 2022.
Vaccine effectiveness (%) against symptomatic diseases for
Delta and Omicron

Andrews N, et al. 2022.

2 dose Sinovac + Moderna booster: Immunogenicity in
Indonesia

• Previous SARS-CoV-2 infection, longer

time interval between second vaccine
and mRNA-1273 boost were
associated with a higher pre-boost
IgG titer.
• Post-booster, median IgG titer
increased 9.3-fold, from 250 (IQR32-
1389) to 2313 (IQR1226-4324)
binding antibody units (BAU/mL)
(p<0.001).
Sinto R, et al. medRvix (preprints)
Heterologous and homogous COVID-19 booster after 2 doses of
CoronaVac in Brazil

• Anti-spike IgG after 28 days in all

heterologous regimens were superior to
that induced by homologous boost (all
p<0.0001)
• Pseudovirus neutralisation titres in all
heterologous regimens were superior to
the homologous boost
• 8.7 for Ad26.COV2-S
• 21.5 for BNT162b2
• 10.6 for ChAdOx1 nCoV-19

Clemens SAC, et al. Lancet. 2022. doi: 10.1016/S0140-6736(22)00094-0

Immunogenicity of booster after two doses of AstraZeneca

• Neutralization antibody (wild-type)

• Anti-spike IgG post booster post booster
• AstraZeneca: 3.25 fold • AstraZeneca: 2.47 fold
• NovaVax: 8.75 fold • NovaVax: 8.86 fold
• Half-dose NovaVax: 5.82 fold • Half-dose NovaVax: 5.89 fold
• Pfizer: 24.48 fold • Pfizer: 21.58 fold
• Valneva: 2.2 fold • Valneva: 2.68 fold
• Half-dose Valneva: 1.81 fold • Half-dose Valneva: 2.01 fold
• Johnson & Johnson: 5.84 fold • Johnson & Johnson: 6.85 fold

Munro APS, et al. Lancet. 2021; 398:2258-76

Immunogenicity of booster after two doses of mRNA vaccine
(Pfizer)

• Neutralization antibody (wild-type)

• Anti-spike IgG post booster post booster
• AstraZeneca: 5.33 fold • AstraZeneca: 6.01 fold
• NovaVax: 4.78 fold • NovaVax: 5.39 fold
• Half-dose NovaVax: 3.07 fold • Half-dose NovaVax: 3.5 fold
• Pfizer: 8.11 fold • Pfizer: 8.35 fold
• Valneva: 1.31 fold • Valneva: 1.38 fold
• Half-dose Valneva: 1.25 fold • Half-dose Valneva: 1.22 fold
• Johnson & Johnson: 5.63 fold • Johnson & Johnson: 7.84 fold

Munro APS, et al. Lancet. 2021; 398:2258-76

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FABRIKAM RESIDENCES
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