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. 2021 Jul 6;11(7):993. doi: 10.3390/biom11070993

Table 6.

Effect of SARS-CoV-2 variants on vaccine efficacy and therapeutics.

Name Country of Origin Mutations in Spike Protein Effect on Monoclonal Antibody Treatment Regimens and Neutralization of Convalescent Sera Effect on Vaccine Efficacy
B.1.1.7 (Alpha) † United Kingdom N501Y *, A570D, D614G, P681H *, T716I, S982A, Δ69/70 *, Δ144 *

  1. Retains susceptibility to EUA monoclonal antibody treatments [204]

  2. Modest reductions in the neutralizing activity of plasma from convalescent patients (2.7–3.8-fold) [201,202]

 Vaccine efficacy slightly lower or unchanged, largely preserved neutralizing titers

  1. BNT162b2: 89.5–93.4% [210,233]

  2. NVX-CoV2373: 86% [234].

  3. ChAdOx1 nCoV-19 vaccine: 70% [235,236]
B.1.351 (Beta) † South Africa D80A, D215G, Δ241/242/243, K417N *, E484K *, N501Y *, D614G, A701V

  1. Activity of LY-CoV555 (Bamlanivimab), and REGN10933 (Casirivimab) completely abolished [204]

  2. Significant decrease in susceptibility to the combination of bamlanivimab and etesevimab monoclonal antibody treatment [204]

  3. The combination of casirivimab and imdevimab appears to retain activity [204]

  4. Markedly more resistant to neutralization by convalescent plasma (9.4-fold) [201]

 Reduced efficacy for some vaccines, completely abolished for others.

  1. BNT162b2: ~20% lower [93,211,212]

  2. Novavax vaccine: 60% [235]

  3. ChAdOx1 nCoV-19: 10% [209]

  4. Ad26.COV2.S: 52% efficacy against moderate disease, 72% efficacy against severe disease [236]

  5. Gam-COVID-Vac: abolished [203]

  6. Complete or partial loss of neutralization against BBIBP-CorV (Sinopharm) or CoronaVac (Sinovac) vaccines [207]
P.1 (Gamma) † Japan/Brazil L18F, T20N, P26S, D138Y, R190S, K417T *, E484K *, N501Y *, D614G, H655Y, T1027I

  1. Marked reduction in susceptibility to bamlanivimab and bamlanivimab plus etesevimab in vitro [204]

  2. Reduction in casirivimab activity, although the combination of casirivimab and imdevimab appears to retain activity [204]

  3. Reduced neutralization by convalescent and post-vaccination sera [217].

  4. Neutralizing activity was lower by factor of:
    1. BNT162b2: 6.7
    2. mRNA-1273: 4.5

  1. CoronaVac: 49.6% [207]

  2. Ad26.COV2.S: Efficacy 68.1% (against moderate to severe/critical disease), 87.6% (against severe/critical disease), where P1 was detected in 30.6% of sequences [237]
B.1.617.2 (Delta) † India L452R *, E484Q *, D614GD111D, G142D, P614R, P681R *

  1. Abolished neutralizing activity of bamlanivimab [234]

  2. Partially evaded neutralization by the antibodies induced through natural infection [234]

  1. BNT162b2 vaccine: 90% [233]

  2. ChAdOx1 nCoV-19: 60% [233]

  3. BBV152 (Covaxin) vaccinated individuals offer reduced but significant protection against B.1.617 as compared to B1 strain [238]
CAL.20C California, USA S13I *, W152C *, L452R *, D614G

  1. Abolished neutralizing activity of Etesevimab and Bamlanivimab [204]

  2. Modest decrease in susceptibility to the combination of bamlanivimab and etesevimab [204]

  3. Reduced neutralization by convalescent and post-vaccination sera. Neutralization potency (as compared to wildtype (D614G),
    1. mRNA1273-elicited plasma reduced 2.8-fold
    2. BNT162b2-elicited plasma reduced 4 fold [230].
 No evidence yet

† WHO label. * Key mutations responsible for driving transmissibility and evading treatments to vaccines and therapeutics. Note: Vaccine efficacies reflect those against symptomatic infection unless otherwise specified. Vaccine efficacies between different vaccines are not to be compared directly due to variations in study design.