Vaccines In response to the
COVID-19 pandemic, a number of
COVID-19 vaccines have been developed using a variety of technologies, including
mRNA vaccines and
viral vector vaccines. Most vaccine development has targeted the spike protein. Building on techniques previously used in vaccine research aimed at
respiratory syncytial virus and
SARS-CoV, many SARS-CoV-2 vaccine development efforts have used constructs that include
mutations to stabilize the spike protein's pre-fusion conformation, facilitating development of antibodies against
epitopes exposed in this conformation.
Monoclonal antibodies (blue) and
imdevimab (orange) interacting with the receptor-binding domain of the spike protein (pink).
Monoclonal antibodies that target the receptor-binding domain of the spike protein have been developed as
COVID-19 treatments. As of July 8, 2021, three monoclonal antibody products had received
Emergency Use Authorization in the United States:
bamlanivimab/etesevimab,
casirivimab/imdevimab, and
sotrovimab. Bamlanivimab/etesevimab was not recommended in the United States due to the increase in
SARS-CoV-2 variants that are less susceptible to these antibodies. Many of these possess
mutations that change the
amino acid sequence of the spike protein. In a
World Health Organization analysis from July 2020, the spike (
S) gene was the second most frequently mutated in the genome, after
ORF1ab (which encodes most of the virus'
nonstructural proteins). Analyses of SARS-CoV-2 genomes suggests that some sites in the spike protein sequence, particularly in the receptor-binding domain, are of evolutionary importance and are undergoing
positive selection. Spike protein mutations raise concern because they may affect
infectivity or
transmissibility, or facilitate
immune escape. it may have advantages in infectivity and transmissibility increasing the proportion of binding-competent conformations or improving stability, but it does not affect vaccines. The mutation N501Y is common to the Alpha, Beta, Gamma and Omicron
Variants of SARS-CoV-2 and has contributed to enhanced infection and transmission, reduced vaccine efficacy, and the ability of SARS-CoV-2 to infect new rodent species. N501Y increases the affinity of spike for human ACE2 by around 10-fold, which could underlie some of fitness advantages conferred by this mutation even though the relationship between affinity and infectivity is complex. The mutation P681R alters the furin cleavage site, and has been responsible for increased infectivity, transmission and global impact of the
SARS-CoV-2 Delta variant. Mutations at position
E484, particularly
E484
K, have been associated with
immune escape and reduced
antibody binding. The SARS CoV-2 spike gene (S gene, S-gene) mutation 69–70del (Δ69-70) causes a
TaqPath PCR test probe to not bind to its S gene target, leading to S gene target failure (SGTF) in SARS CoV-2 positive samples. This effect was used as a marker to monitor the propagation of the
Alpha variant and the
Omicron variant.
Misinformation During the
COVID-19 pandemic,
anti-vaccination misinformation about COVID-19 circulated on social media platforms related to the spike protein's role in
COVID-19 vaccines. Spike proteins were said to be dangerously "
cytotoxic" and mRNA vaccines containing them therefore in themselves dangerous. Spike proteins are not cytotoxic or dangerous. Spike proteins were also said to be "shed" by vaccinated people, in an erroneous allusion to the phenomenon of
vaccine-induced viral shedding, which is a rare effect of
live-virus vaccines unlike those used for COVID-19. "Shedding" of spike proteins is not possible. == Evolution, conservation and recombination ==