Tillman Gerngross (Adagio)

Till­man Gern­gross on Omi­cron: 'It is a grim sit­u­a­tion...we’re go­ing to see a sig­nif­i­cant drop in vac­cine ef­fi­ca­cy'

Till­man Gern­gross, the rarely shy Dart­mouth pro­fes­sor, biotech en­tre­pre­neur and an­ti­body ex­pert, has been warn­ing for over a year that the virus be­hind Covid-19 would like­ly con­tin­ue to mu­tate, po­ten­tial­ly in ways that avoid im­mu­ni­ty from in­fec­tion and the best de­fens­es sci­en­tists de­vel­oped. He spun out a com­pa­ny, Ada­gio, to build a uni­ver­sal an­ti­body, one that could snuff out any po­ten­tial mu­ta­tion.

As the world scram­bles to face a new vari­ant, Omi­cron, that pre­dic­tion looks par­tic­u­lar­ly pre­scient. Re­mark­ably lit­tle is known yet about the new vari­ant. Com­pa­nies and aca­d­e­m­ic labs have not even had enough time yet to run the most ba­sic stud­ies in lab dish­es to see whether an­ti­body treat­ments and an­ti­bod­ies pro­duced from vac­ci­na­tion can still neu­tral­ize the virus.

Jesse Bloom

But, as Gern­gross ex­plained in an in­ter­view with End­points News ed­i­tor John Car­roll late Sun­day, we know from se­quenc­ing its genome that among the virus’ more than 30 mu­ta­tions, are sig­nif­i­cant changes in the three re­gions that most neu­tral­iz­ing an­ti­bod­ies — those made in the lab and those from in­fec­tion or vac­ci­na­tion — bind to.

That sug­gests, he said, that “sev­er­al” of the an­ti­body treat­ments now au­tho­rized in the US will have re­duced ef­fi­ca­cy. He de­clined to name which will be blunt­ed, but Jesse Bloom, an evo­lu­tion­ary vi­rol­o­gist at Fred Hutch, had few­er com­punc­tions: Eli Lil­ly and Re­gen­eron will be im­pact­ed, Bloom said on Twit­ter. Vir and As­traZeneca should fare bet­ter, Bloom said.

The im­pact on vac­cine ef­fec­tive­ness should be less se­vere. Vac­cines work not on­ly via an­ti­bod­ies but al­so T cells and oth­er parts of the im­mune cells. Still, Gern­gross said, there will like­ly be a “sig­nif­i­cant” im­pact.

“I think it is su­per wor­ri­some,” he said. “It is a grim sit­u­a­tion.”

Pre­cise­ly how sig­nif­i­cant? Will it drop be­low 50%? Gern­gross wouldn’t say. But his pre­dic­tions are in line with fears from oth­ers in the field. Bob Shafer, a Stan­ford pro­fes­sor track­ing vari­ants, cau­tioned that lab stud­ies would tell us more, but said in an email that “based on the spe­cif­ic mu­ta­tions in the Omi­cron vari­ant, vac­cine ef­fi­ca­cy will like­ly de­crease more than what has pre­vi­ous­ly been ob­served with all oth­er vari­ants.”

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