Could an Israeli mutation undo Israel’s mass vaccination campaign?

 
COVID-19 VACCINATIONS being administered at a Maccabi Health vaccination center in Givatayim last week.  (photo credit: MIRIAM ALSTER/FLASH90)
COVID-19 VACCINATIONS being administered at a Maccabi Health vaccination center in Givatayim last week.
(photo credit: MIRIAM ALSTER/FLASH90)

Mutations could increase the ability of a virus to become more infectious, could render the virus more pathogenic.

Israel’s mass vaccination campaign running in parallel with an active coronavirus outbreak may lead to “evolutionary pressure” on the virus, resulting in an Israeli variant that could be resistant to or have certain advantages over the vaccine.
So contended the Coronavirus National Information and Knowledge Center Saturday night in one paragraph of a nine-page report on mutations.
The result was a frenzy of headlines and panic.
Already, the world learned over the weekend that the British variant, which has spread like wildfire across Israel, could be more deadly than originally thought.
Moreover, the government and health officials have raised fears that variants that enter Israel through Ben-Gurion Airport could go against the country’s vaccination program and hurt its ability to surface from the crisis. This includes the South African variant, which was brought to Israel via South Africa and Dubai and in a preliminary study has been shown to make some vaccines less effective.
However, to date, “there is no known meaningful Israeli mutation,” Prof. Sharon Alroy-Preis, head of Public Health Services, told KAN News Sunday morning.
But “wherever there is a virus, mutations can develop,” she added.
“Viruses constantly acquire variants,” said Prof. Ephrat Levy-Lahad, director of the Medical Genetics Institute at Shaare Zedek Medical Center in Jerusalem. These variants occur when a genome changes in some way during replication, she told The Jerusalem Post.
Prof. Jonathan Gershoni of Tel Aviv University’s Shmunis School of Biomedicine and Cancer Research said: “Think about if you had to make handwritten copies of the genome. There is a very great likelihood of having a typographical error. So whereas in printing books or copying documents, typos are common and understandable, the same is true when replicating a genome. But we call those typos mutations, and the virus bearing those mutations is a mutant or variant.”
LEVY-LAHAD said most of the changes are “silent” and have no effect on the virus proteins or anything else.
But sometimes these “typos” can have a profound effect, Gershoni said. For example, “My wife is tough” versus “My life is tough” – the two phrases have one different letter but vastly different meanings.
Mutations could increase the ability of a virus to become more infectious, could render the virus more pathogenic or make it less susceptible to neutralizing antibodies stimulated or induced through vaccination, he said.
On the other hand, some mutations could make the virus less efficient and ultimately cause it to peter out, Gershoni said.
Immunization could theoretically hasten the evolution of a virus, Levy-Lahad said.
“Until coronavirus, one of the major health issues was that many germs had become resistant to antibiotics because a lot had been given in the population, often unnecessarily, and germs found a way to become resistant to those antibiotics,” she said. “Those germs that manage to achieve resistance become more predominant because they will prevail.”
“If someone who is immunized can still get some level of infection, then by chance there are going to be variants that can resist the antibodies you have thanks to the vaccination,” Levy-Lahad said.
“Basically, it is a numbers game,” she said. “If you have a lot of sick people and a lot of people immunized, and if the immunization does not completely rule out infection, then simply because you have a lot of people who can transmit coronavirus and a lot of hosts in which it can evolve, the variant could be created.”
But does not mean that this will happen, she added.
THE KNOWLEDGE Center report warned that this hypothetical “Israeli mutation” could give the virus certain potential to evade the immune response elicited by vaccination. It might therefore spread faster within the population, especially because children are not being vaccinated.
But Levy-Lahad said the situation is not so black-and-white and that this is not an “all-or-nothing phenomenon.”
“It could be, for example, that immunization does not completely eradicate infection, but it lowers the rate of severe disease from 2% [one in 50] to one in 1,000 – that is still going to have a huge impact,” she said.
The influenza vaccine is an example of a vaccine that has to be updated because the virus mutates, she added.
“I don’t know that anyone has shown this to be a result of the vaccination rate,” Levy-Lahad said.
However, fear of mutations is an argument for following Health Ministry regulations and lowering infection, she said.
Moreover, whereas Israel has no control over how random mutations occur, the country does have control over how to reduce infectious rates, Gershoni said.
“With regards to the uniqueness or not of Israel, one has to remember that of the countries with the highest number of vaccinees, we are fifth,” he said. “The United States is leading with 21 million people vaccinated, an infectious rate of 77,000 people per million and well over 150,000 total infections per day.”
“The number of infections in Israel due to the lockdown is gradually dropping and hopefully will continue to do so,” he added. “It is our responsibility to do what we can to prevent escape mutations while we increase the vaccination campaign to ensure the safety of our population.”
With replication, there is a direct relationship between how many copies are being made at a given time to the mutations that are going to be accumulated, Gershoni said. If the infection rate is low, then the number of mutations tends to be relatively small. Anytime the infection rate is enhanced, there also will be an increase in errors.
Levy-Lahad said: “What I really worry about when people come out with these announcements, like there is going to be an Israeli mutation, is that they play into the hands of those people who say there is no use in getting vaccinated or that it is really not necessary. Vaccination is the best thing we have right now.”