With the welter of news about the Delta variant spreading around the world, one theme has emerged: this form of the virus that causes COVID-19 is challenging, but vaccination works to protect people against it, reports MedicalBrief.
According to Elizabeth Cooney writing in Stat, a recent study published in Nature adds new detail about the dominant variant, analysing how well Delta, in a lab dish, was able to evade monoclonal antibody drugs such as bamlamivimab and natural antibodies made in our bodies after infection or vaccination.
Looking at both kinds of antibodies in blood drawn from 162 patients and how they reacted to Delta, researchers from the Institut Pasteur in France found lower protection against the variant than against three other variants also notable for how easily they spread from person to person.
“This is an important study for confirming the immune evasiveness property of Delta, which is a feature that adds to its enhanced transmissibility, making it the most formidable version of the virus to date,” said Eric Topol, director and founder of the Scripps Research Translational Institute. “No surprises, but further characterisation of the variant, which reinforces why it is so challenging.”
The findings underscore the effectiveness of vaccines against the Delta variant if people get the recommended two doses. They also highlight the added immunity a single dose of vaccine provides people previously infected with another COVID variant.
“All the data shows that people who are fully vaccinated still enjoy robust protection against Delta and every other variant described so far,” said Angela Rasmussen, a virologist and research scientist affiliated with the Georgetown Center for Global Health Science and Security and VIDO-InterVac at the University of Saskatchewan. “Delta remains a threat primarily to unvaccinated or partially vaccinated people.”
Indeed, the study found the lack of protection against Delta compared with two other recent variants, Alpha and Beta, and a reference variant similar to the early virus, was most pronounced in unvaccinated, uninfected people. Delta now accounts for more than half of COVID-19 infections in the United States, the Centers for Disease Control and Prevention estimates. That proportion shoots up in certain states and soars in countries where vaccination levels are lower.
Antibodies from 56 people who were infected with SARS-CoV-2 in the past did not neutralise Delta very well, but after one dose of either the AstraZeneca, Pfizer/BioNTech, or Moderna vaccines, antibodies from all 56 neutralised all four strains.
That makes sense, Rasmussen said, because there is a much larger range in both the magnitude and potency of immune responses in infection, compared with vaccination.
Topol said we need to know more about the variant, which first emerged in India and has been surging around the world.
It is concerning about the natural immunity providing less protection, but to date [Public Health England-UK] has not demonstrated that to be a major issue,” Topol said. “Certainly more study about reinfection vulnerability to Delta is vital.”
In uninfected people who had only their first vaccine dose, their antibodies weren’t up to the task until after their second dose, when protection against Delta jumped to 88% of the people studied for AstraZeneca and 100% for Pfizer/BioNTech.
“The data about a steep reduction in neutralisation in people with only one shot is consistent with real-world data on Delta from partially vaccinated people, which shows that people with only one shot don’t have much protection against Delta relative to unvaccinated people,” Rasmussen said.
Monoclonal antibodies were unable to bind to the spike protein of the Delta variant, the study found, which prevented them from neutralising the virus. Like other variants of concern, Delta harbours changes in the characteristic spike protein that gives the coronavirus its name.
“We show that the increased transmissibility of variant Delta is associated with partial resistance to neutralisation by antibodies,” Olivier Schwartz, head of the Virus & Immunity Unit at Institut Pasteur and a study co-author, said in an interview. “It is reassuring to see that a two-dose regimen protects against all known variants so far,” he said, but added “the virus will probably continue to evolve.”
The study’s limitations include its small size, its authors noted. Rasmussen cautioned that the research took place in a lab.
“Evasion of neutralising antibodies in-vitro do not explain what happens in the real world, and also fail to account for the breadth and complexity of the immune response, which is not restricted to neutralising antibodies,” she said. “Based on what we’ve seen so far in people, vaccines continue to offer strong protection — particularly regarding severe illness and death — against all known variants of concern.”
Study details
Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization
Timothée Bruel, Etienne Simon-Lorière, Felix A. Rey, Olivier Schwartz
Published in Nature 8 July 2021
Abstract
The SARS-CoV-2 B.1.617 lineage was identified in October 2020 in India1–5. It has since then become dominant in some indian regions and UK and further spread to many countries.. The lineage includes three main subtypes (B1.617.1, B.1.617.2 and B.1.617.3), harbouring diverse Spike mutations in the N-terminal domain (NTD) and the receptor binding domain (RBD) which may increase their immune evasion potential. B.1.617.2, also termed variant Delta, is believed to spread faster than other variants.
Method
Here, we isolated an infectious Delta strain from a traveller returning from India. We examined its sensitivity to monoclonal antibodies (mAbs) and to antibodies present in sera from COVID-19 convalescent individuals or vaccine recipients, in comparison to other viral strains. Variant Delta was resistant to neutralization by some anti-NTD and anti-RBD mAbs including Bamlanivimab, which were impaired in binding to the Spike. Sera from convalescent patients collected up to 12 months post symptoms were 4 fold less potent against variant Delta, relative to variant Alpha (B.1.1.7). Sera from individuals having received one dose of Pfizer or AstraZeneca vaccines barely inhibited variant Delta. Administration of two doses generated a neutralizing response in 95% of individuals, with titers 3 to 5 fold lower against Delta than Alpha.
Conclusion
Thus, variant Delta spread is associated with an escape to antibodies targeting non-RBD and RBD Spike epitopes.
See more from MedicalBrief archives:
Single shot of AstraZeneca or Pfizer-BioNTech vaccines reduce hospital treatment for elderly
COVID-19 recoverees may need only a single vaccine dose — Small US study
Pfizer mRNA vaccine induces persistent human germinal centre responses
Delaying second vaccine dose may be an effective pandemic strategy — Canada study