medRxiv · 2022 · 144 citations · 58 references
Veterinary MedicineImmunologyInfectious DiseasesImmunizationMolecular VirologyVaccinologyVaccinationVaccines For Emerging PathogensViral VaccinesBooster Vaccination TrialsCoronavirus VaccinesReal-world Vaccine EffectivenessReceptor Binding Domain VaccinesSars-cov-2 InfectionVaccine EscapeVariant AdaptationViral Escape Mutations
Abstract Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron, the fifth VOC to be described, harbours 30 amino acid mutations in spike including 15 in the receptor-binding domain. Here, we demonstrate substantial evasion of neutralisation by Omicron in vitro using sera from vaccinated individuals. Importantly, these data are mirrored by a substantial reduction in real-world vaccine effectiveness that is partially restored by booster vaccination. We also demonstrate that Omicron does not induce cell syncytia and favours a TMPRSS2-independent endosomal entry pathway. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant.
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