Table 3.
Virus mutations of concern and of recent interest
| First detection, Country | Notable mutations |
Evidence of clinical changes |
Protected by | |||
|---|---|---|---|---|---|---|
| Transmissibility | Virulence | Antigenicity | ||||
| Alpha (B.1.1.7*) | September, 2020, UK | N501Y, 69–70del, P681H, and some also acquire E484K | Increased by approximately 74% (NERVTAG) | 61% (42–82%) more lethal44 | Reduced antigenic activity (ECDC); in the 484K variants: six-fold decrease of immune sera (mRNA vaccines) and 11-fold decrease in sensitivity to convalescent sera | BNT162b2 (Pfizer–BioNTech), mRNA-1273 (Moderna), ChAdOx1 nCoV-19 (Oxford–AstraZeneca), and NVX-CoV2373 (Novavax) |
| Beta (B.1.351†) | December, 2020, South Africa | N501Y, K417N, and E484K | Increased 50% (ECDC) | No evidence of increased virulence | Reduced neutralisation by antibodies (ECDC) | BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) might be two-thirds less effective (serum neutralising antibodies); ChAdOx1 nCoV-19 (Oxford–AstraZeneca) is effective only in 10% of cases; Ad26COV2.S (Janssen) has 89% efficacy; and NVX-CoV2373 (Novavax) has 60% efficacy |
| Gamma (P.1†) | January, 2021, Brazil and Japan | N501Y, E484K, and K417T | Likely increased (CDC) | 10–80% (approximately 45%) more lethal (CADDE) | Overall reduction in effective neutralisation (ECDC) | Possible reduction of vaccine efficacy (ECDC) |
| Eta (B.1.525*) | December, 2020, Nigeria and the UK | E484K and F888L | Likely increased (CDC) | Likely increased (CDC) | Modestly reduced neutralisation (COG-UK) | No data available yet |
| Epsilon (B.1.427*; B.1.429*) | May, 2020, USA; July, 2020, USA | L452R, D614G* plus S131, W152C | Around 20% increased (CDC) | Increased (CDC) | 4·0–6·7-fold and two-fold decrease in neutralisation titres from convalescent patients and vaccine recipients (CDC); CoronaVac equally effective45 | No data available yet |
| Iota (B.1.526*; B.1.526.1*) | November, 2020, USA | E484K,1 D614G, A701, L5F,1 T95I, D253, S477N,1 D80G, Δ144, F157S, L452R, D614G, and D950H | Likely increased (CDC) | Increased (CDC) | Reduced neutralisation by convalescent and post-vaccination sera, reduced susceptibility to monoclonal antibody cocktail of bamlanivimab and etesevimab | No data available yet |
| Kappa B.1.617.1* | October, 2020, India | E484Q, L452R, and P681R | Higher transmissibility | Under investigation | Reduction in effective neutralisation | No major impairment of efficacy of vaccines used in India reported |
| Delta B.1.617.2† | October, 2020, India | T478K, L452R, and P681R | Under investigation | Under investigation | Reduction in effective neutralisation | No major impairment of efficacy of vaccines used in India reported |
CADDE=Centre for adenovirus, discovery, detection, genomics & epidemiology. CDC=Center for Disease Control and Prevention. COG-UK=COVID-19 Genomics UK Consortium. ECDC=European Center for Disease Prevention and Control. NERVTAG=New and Emerging Respiratory Virus Threats Advisory Group.
*
Variants of interest.
†
Variants of concern.