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Feature Covid-19

How are vaccines being adapted to meet the changing face of SARS-CoV-2?

BMJ 2022; 377 doi: (Published 01 June 2022) Cite this as: BMJ 2022;377:o1257

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COVID-19 Pandemic, COVID-19 Vaccines and Rapidly Transmuting SARS-CoV-2 Variants/Sub-variants: The Quest for Pan-Sarbecoviruses Vaccine Variants; A Further Imperative to Guard Against Global Interventional Precocity in Downing Guards

Dear Editor

The ‘COVID-19 Pandemic’ remains a persisting devastating unprecedented 21st Century Scourge peculiarly characterized by ‘Rapidly Transmuting COVID-19 Pandemic Specifics’ enabling the ‘Evolving Pandemic Realities’ outweighing and being ahead of ‘Global COVID-19 Pandemic Interventions’ thus necessitating equally ‘Rapidly Dynamically Evolving Research Undertakings-Outpourings’ to keep pace with the ‘Increasingly Changing Face of the Pandemic’.

The recent ‘Communication’ in the BMJ concerning the ‘Rapidly Transmuting COVID-19 Pandemic Specifics’ with particular focus on the ‘Rapidly Transmuting SARS-CoV-2 Variants and Sub-variants’ and the continuing ‘Experimental COVID-19 Vaccine Variants Pursuits’ is intriguingly instructive. [1] While regarding COVID-19 Vaccine Development as a ‘Miracle of Modern Science’, equally acknowledged is SARS-CoV-2 adaptations posing challenges questioning the effective responses of Manufacturers and Researchers [1] It is suggested that, in spite of the several ‘COVID-19 Vaccine Variants Research’, the continued ‘COVID-19 Vaccine Roll-outs’ still largely reflect the use of the initially and originally approved ‘COVID-19 Vaccines’ with the first being the Pfizer-BioNTech Vaccine administered to a recipient on 8th December 2020. The challenges to the progress in the ‘COVID-19 Vaccine Variants Research’ have largely related to the ‘Rapidly Transmuting SARS-CoV-2 Variants/ Sub-variants’ and the increasing use of ‘Updates on Existing COVID-19 Vaccines’ making it doubtful if success will be achieved with this approach in the current ‘COVID-19 Pandemic Vaccines Interventions’. Therefore, the possibilities of developing ‘COVID-19 Multivalent Vaccines’ hold the promise for the future.

The Moderna Preprint releasing its results on the investigation of its ‘Modified COVID-19 Vaccine’ against the ‘SARS-CoV-2 Beta Variant Spike Protein’ reportedly was reassuring with superior immune responses in an already ‘Immunized Population’ [2]. The potential usefulness of possible ‘Mixtures of parts of the Spike Protein from several different SARS-CoV-2 Variants’ as ‘Pan-Sarbecovirus Vaccine Variants’ is to be explored [1]. A Clinical Trial exploring the use of such ‘Mixtures’ commenced in December 2021 [3]. It is also reported that a ‘COVID-19 Multivariants Vaccine’ from early Trials commenced in September 2021 showed some promise with immune response albeit with production of neutralizing antibodies similar to the approved mRNA Vaccines [4]. The thrust has thus increased for the search for ‘COVID-19 Vaccine Variants’ with possible assured cover for ‘Multiple SARS-CoV-2 Variants’. This will certainly be a challenging enterprise in the current ‘Global Fight against the COVID-19 Pandemic’ as the world envisions the deployment of ‘Widely Efficacious COVID-19 Multivariants Vaccines’ [1].

The optimism by the WHO Officer [5] for success in the next two years towards realizing possible ‘Pan-Coronaviruses Vaccine Variants’ through ‘Huge SARS-CoV-2 Research with much Immunology Understanding’ must be latched on to with unalloyed caution given some known facts: No ‘Pan-Influenza Vaccines’ after 80 years of ‘Influenza Vaccines Research’, No ‘Effective Vaccines against HIV’ which similarly shares ‘Rapidly Transmuting Variants’ with the SARS-CoV-2, Protection is Uncertain and Duration of Immunity is short and bothersome even after ‘Natural SARS-CoV-2 Infection’ [1]. Additionally, much ‘SARS-CoV-2 and COVID-19 Pandemic Research Endeavours’, prompted by the ‘Rapidly Transmuting COVID-19 Pandemic Specifics’, increasing Uncertainties, Controversies, Politics-Science Conflicts, Infodemic and without strictly and rigorously kowtowing to the ‘Robust Research Governance Principles and Pillars’, have resulted in unacceptable avalanche of ‘COVID-19 Research Wastes’ which certainly will potentially eclipse the ‘WHO Pan-Coronavirus Vaccines Optimism’ [6-25].

The ‘Issues’ and ‘Uncertainties’ with the ‘COVID-19 Vaccines’, the continued ‘COVID-19 Vaccine Variants Research’ and the quest for a possible ‘Pan-Sarbecoviruses Vaccine Variants’, all still ‘Difficult Works in Progress’, rekindle a further imperative to guard against ‘Global Interventional Precocity’ in downing guards regarding the ‘Non-Pharmaceutical Interventions (NPIs)’ that work [26].

The ‘Sarbecoviruses (SARS Betacoronaviruses)’ are a Subgenus of the Genus Betacoronavirus of which the ‘SARSr-CoV (SARS-related CoV)’ is a member and characterized by infecting host cells through attachment to ACE 2 Receptors and include SARS-CoV-1 and SARS-CoV-2 among others [27].

1. Stokel-Walker C. How are vaccines being adapted to meet the changing face of SARS-CoV-2? BMJ 2022; 377: o1257
2. Moderna. Moderna announces clinical update on bivalent covid-19 booster platform. 19 April 2022.
3. Brierley C. Cambridge coronavirus vaccine enters clinical trial. University of Cambridge. 14 Dec 2021.
4. Manchester University NHS Foundation Trust. Early data for multivariant COVID-19 vaccine booster shows promise. 6 Jan 2022.
5. Looi M-K. The BMJ Interview: WHO chief scientist optimistic for a pan-coronavirus vaccine in two years. BMJ 2022; 377:o1003
6. Godlee F. COVID-19: Weathering the storm. BMJ 2020; 368:m1199 of 26th March 2020
7. Eregie C.O. COVID-19 Pandemic: The difficult unresolved increasing challenges in weathering the storm. of 31st March 2020
8. Eregie C.O. COVID-19 Pandemic: Still on the difficult unresolved increasing challenges in weathering the storm. of 2nd April 2020
9. Kickbusch I, Leung GM, Bhutta ZA, Matsoso MP, Ihekweazu C, Abbasi K. Covid-19: how a virus is turning the world upside down. BMJ 2020; 369:m1336 of 3rd April 2020
10. Eregie C.O. COVID-19 Pandemic: Further perspectives on the difficult unresolved increasing challenges in weathering the storm. of 5th April 2020
11. Eregie C.O. COVID-19 Pandemic: The daunting challenges of assuring sustainable benefits from weathering the storm. of 8th April 2020
12. Clinical History of changes for study. NCT04280705, 1 May 2020.
13. Yan W. Coronavirus tests science’s need for speed limits. New York Times 2020 Apr 14.
14. Glasziou PP, Sanders S, Hoffmann T. Waste in covid-19 research. BMJ 2020; 369:m1847
15. Karmakar S, Dhar R, Jee B. Covid-19: research methods must be flexible in a crisis. BMJ 2020; 370:m2668
16. Eregie C.O. ‘COVID-19 Pandemic, the quest for urgent information and solutions and the paradox: making haste slowly to avoid ‘COVID-19 Research Waste’. of 17th July 2020
17. Eregie C.O. ‘COVID-19 Pandemic, the quest for urgent information and solutions and the paradox: making haste slowly to avoid ‘COVID-19 Research Waste’; time for strategic ‘COVID-19 Research Retreat for a Decad’’. of 21st July 2020
18. Eregie CO. COVID-19 Pandemic and the Value of Antibodies Testing: Still More Matters in the Works. of 14th August 2020
19. Mahase E. Covid-19: Vaccine brands can be mixed in ‘extremely rare occasions’ says Public Health England. BMJ 2021; 372:n12
20. Eregie CO. COVID-19 Pandemic and vulnerability of science to assault: Imperatives to uphold research governance principles. of 22nd January 2021
21. Eregie CO. ‘COVID-19 Pandemic, beyond the ‘Vaccines Marathon Finish Line’ and ‘Post-Vaccine Approval Programmatic Haze’: The Evolving ‘2nd Dose Uncertainties’. of 24th January 2021
22. Eregie CO. ‘COVID-19 Pandemic, beyond the ‘Vaccines Marathon Finish Line’ and ‘Post-Vaccines Approval Programmatic Haze’: The evolving ‘2nd Dose Uncertainties’; still more unfolding ‘Matters in the Work’. of 27th January 2021
23. Eregie CO. ‘COVID-19 Pandemic, COVID-19 Vaccines and ‘2nd Dose Uncertainties’: Still unresolved evolving matters’. of 8th February 2021
24. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and successful vaccination programmes: a further clarion call to observe research governance-related best practices and a critical look at preprints. of 23rd February 2022
25. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and Boosters: More Unresolved Evolving Matters in the Works. of 17th December 2021
26. Eregie C.O. Covid-19 Pandemic, Reinfection, Reactivation and Covid-19 Rebound: Efficacy of Covid-19 Pharmaceutical and Non-Pharmaceutical Interventions; The Imperative to Guard Against Interventional Precocity in Downing Guards. of 15th June 2022
27. Virus Taxonomy. 2018 Release. International Committee on Taxonomy of Viruses (ICTV). October 2018.

Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria.
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer,
ICDC-Trained in Code Implementation,
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria,
*No Competing Interests.

Competing interests: No competing interests

17 June 2022
Institute of Child Health, College of Medical Sciences, University of Benin, Benin City, Nigeria
University of Benin, PMB 1154, Benin City, 300001, Edo State, Nigeria