The World Health Organization (WHO) Monday elevated India’s COVID variant B.1.617 from a “variant of interest” to a “variant of global concern.” The variant, which was first isolated in India, is believed to be driving the country’s brutal second wave.

In a follow-up statement today, the WHO said the B. variant has since spread throughout India and at least “44 countries in all six WHO regions.”

Maria Van Kerkhove, the WHO’s technical lead for COVID, said during Monday’s press conference new data under peer review shows B.1.617 is more transmissible than earlier strains of the virus.

Van Kerkhove said the variant may be able to evade some of the protections provided by vaccines, as a surprising number of patients who have already been fully vaccinated have been found to be infected with the strain.

“Even though there is increased transmissibility demonstrated by some preliminary studies, we need much more information about this virus variant in this lineage in all of the sub lineages, so we need more sequencing, targeted sequencing to be done,” Van Kerkhove said.

One version of the variant, which first emerged in the state of Maharashtra in late 2020 or early 2021, was elevated to a “variant of concern” in the UK last week.

Variants are classified as “variants of concern” when there is evidence they spread more rapidly, cause more severe disease, evade previously acquired immunity better than circulating versions of the virus, or reduce the effectiveness of public health measures, vaccines or medications.

Van Kerkhove said there was nothing to suggest diagnostics, therapeutics and vaccines don’t work.

“With millions of people around the world infected with this virus, new mutations arise every day,” Gregg Gonsalves, associate professor of epidemiology at Yale University, said in March. “Unless we vaccinate the world, we leave the playing field open to more and more mutations, which could churn out variants that could evade our current vaccines and require booster shots to deal with them.”

Quarraisha Abdool Karim, associate scientific director of the Centre for the Aids Programme of Research in South Africa and professor in clinical epidemiology at Columbia University, said scientists, advocates and decision-maker must ensure that as many people are vaccinated all over the world and as soon as possible so that everyone will be safe from COVID and prepared for the next pandemic.

New variant evades Pfizer vaccine

After the WHO’s press conference, the Financial Times reported on a new study that showed the B.1.617 variant has “modest ability” to avoid antibodies elicited by Pfizer’s COVID vaccine, though an extensive vaccination campaign is likely to reduce transmissions.

Research by Ravindra Gupta, a virologist at the University of Cambridge, UK, suggests antibodies are slightly less effective against the variant than against others. The team collected blood serum from nine people who had received one dose of the Pfizer vaccine and tested it against a harmless carrier virus modified to contain the SARS-CoV-2 spike protein, with the mutations from B.1.617.

Gupta’s team discovered neutralizing antibodies generated by vaccinated individuals were about 80% less potent against some of the mutations in B.1.617. Researchers also found that healthcare workers in Delhi vaccinated with the Oxford–AstraZeneca vaccine were reinfected mostly with the B.1.617 variant.

A German team tested serum from 15 people who were previously infected with SARS-CoV-2, and found their antibodies neutralized B.1.617 about 50% less effectively than previously circulating strains. When they tested serum from participants who received two doses of the Pfizer vaccine, they found antibodies were about 67% less potent against B.1.617.

According to vaccinologist Philip Krause, chair of the WHO working group on COVID-19 vaccines, if vaccine-resistant SARS-CoV-2 strains emerge, vaccines might need to be updated and regulators might balk at authorizing them without seeing updated safety and efficacy data. If new variants circulate alongside older strains, multivalent vaccines, effective against several lineages, might be needed.

“The not-so-good news is that the rapid evolution of these variants suggests that if it is possible for the virus to evolve into a vaccine-resistant phenotype, this may happen sooner than we like,” said Krause.

Mass vaccination could cause highly infectious variants

Geert Vanden Bossche, Ph.D., certified expert in biology and virology and seasoned vaccine developer who’s worked with GSK Biologicals, Novartis Vaccines, Solvay Biologicals and the Bill & Melinda Gates Foundation, argued in a letter to the WHO that mass infection prevention and mass vaccination with leaky COVID-19 vaccines in the midst of the pandemic will only breed highly infectious variants.

Vanden Bossche’s concerns center around the notion that a combination of lockdowns and extreme selection pressure on the virus induced by the intense global mass vaccination program might diminish the number of cases, hospitalizations and deaths in the short-term, but ultimately could induce the creation of more concerning mutants.

Selection pressure will cause greater convergence in mutations that affect the critical spike protein of the virus that is responsible for breaking through the mucosal surfaces of our airways, the route used by the virus to enter the human body. The virus will outsmart the highly specific antigen-based vaccines that are being used and tweaked, dependent on the circulating variants leading to an increase in serious and potentially lethal cases — in effect, an out-of-control pandemic.

This is the result of what Vanden Bossche calls “immune escape” — incomplete sterilization of the virus by the human immune system or following vaccination resulting in more people who have had COVID remaining susceptible to reinfection.

Immune escape induces vaccine companies to further refine vaccines that will add, not reduce, the selection pressure, producing ever more transmissible and potentially deadly variants.

“There can be no doubt that continued mass vaccination campaigns will enable new, more infectious viral variants to become increasingly dominant and ultimately result in a dramatic incline in new cases despite enhanced vaccine coverage rates,” Vanden Bossche said. He added that mass vaccination could “lead to complete resistance of circulating variants to the current vaccines.”

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