Emerging SARS-CoV-2 Variants of Concern Selected CDC/World Health Organization Designees with Published Clinical Data Version 7/30/21

Variant Location/ Clinical effects (WHO label/ Year of Treatment efficacy Vaccine effectiveness against selected variant* (by vaccine platform) Pango lineage) Origin (in vitro)** mRNA Viral vector Nanoparticle/subunit

Bamlanivimab + Pfizer-BioNTech vaccine: Oxford-AstraZeneca vaccine: Novavax vaccine: etesevimab: Preserved effectiveness against Slightly reduced effectiveness Preserved effectiveness against Retains neutralization infection and severe COVID-19 against infection but preserved infection and severe COVID-19 in efficacy (FDA EUA) in the U.K. (Hall, May 2021), effectiveness against severe the U.K. (Heath, June 2021) Israel (Haas, May 2021), Qatar COVID-19 in the U.K. (Emary, April REGEN-COV (casirivimab + (Abu-Raddad, May 2021) and 2021) and Canada (Nasreen, July imdevimab): Canada (Nasreen, July 2021 - 2021 - preprint) Retains neutralization preprint) Alpha U.K. efficacy (FDA EUA) B.1.1.7 2020 Moderna vaccine: Sotrovimab: Preserved effectiveness against Retains neutralization infection and severe COVID-19 efficacy (FDA EUA) in Canada (Nasreen, July 2021 - preprint) Convalescent sera: Retains neutralization efficacy (Planas, March 2021)

Bamlanivimab + etesevimab: Pfizer-BioNTech vaccine: Oxford-AstraZeneca vaccine: Novavax vaccine: Markedly reduced efficacy Slightly reduced effectiveness No effectiveness against infection Reduced effectiveness against (FDA EUA; Chen, June 2021) against infection but preserved in South Africa (Madhi, May 2021) infection (Shinde, May 2021) Beta South Africa effectiveness against severe Reduced effectiveness against B.1.351 2020 REGEN-COV (casirivimab + COVID-19 in Qatar (Abu- infection but preserved imdevimab): Raddad, May 2021) effectiveness against severe Retains neutralization COVID-19 in Canada (Nasreen, efficacy (FDA EUA; Wang, Moderna vaccine: July 2021 - preprint) March 2021)

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Markedly reduced Slightly reduced effectiveness Johnson & Johnson vaccine: neutralization with against infection but preserved Reduced effectiveness against casirivimab alone effectiveness against severe infection but preserved COVID-19 in Canada (Nasreen, effectiveness against severe Sotrovimab: July 2021 - preprint) COVID-19 in South Africa (Sadoff, Retains neutralization May 2021) efficacy (FDA EUA)

Convalescent sera: Moderately reduced neutralization (Planas, March 2021)

Bamlanivimab + No data No data No data etesevimab: Markedly reduced (Presumed to be similar to Beta (Presumed to be similar to Beta (Presumed to be similar to Beta neutralization (FDA EUA) variant based on relevant variant based on relevant variant based on relevant mutations) mutations) mutations) REGEN-COV (casirivimab + imdevimab): Retains neutralization Gamma Brazil efficacy (FDA EUA) P.1 2020 Sotrovimab: Retains neutralization efficacy (FDA EUA)

Convalescent sera: Moderately reduced neutralization (Wang, June 2021)

Delta India Pfizer-BioNTech vaccine: Oxford-AstraZeneca vaccine: No data Bamlanivimab + 2020 Slightly reduced effectiveness Slightly reduced effectiveness B.1.617.2 etesevimab: against infection but preserved against infection but preserved

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Retains neutralization effectiveness*** against severe effectiveness*** against severe efficacy (FDA EUA) COVID-19 after 2 doses in the COVID-19 after 2 doses in the U.K. Bamlanivimab alone U.K. (Bernal, May 2021 - (Bernal, July 2021), Stowe, May inefficacious preprint; Stowe May 2021 - 2021 - preprint), Scotland (Sheikh, preprint), Scotland (Sheikh, June June 2021) and Canada (Nasreen, REGEN-COV (casirivimab + 2021) and Canada (Nasreen, July 2021 -preprint) imdevimab): July 2021 -preprint) Retains neutralization efficacy (FDA EUA; Planas, Moderna vaccine: July 2021) Slightly reduced effectiveness against infection but preserved Sotrovimab: effectiveness against severe Retains neutralization COVID-19 in Canada (Nasreen, efficacy (FDA EUA) July 2021 - preprint)

Convalescent sera: Potential moderately reduced neutralization (Planas, March 2021)

*As compared with vaccine efficacy/effectiveness against wildtype or D614G variant SARS-CoV-2. **The susceptibility results refer, as a default, to in vitro testing of sotrovimab against both pseudotyped virus-like particles and authentic SARS-CoV-2 virus. Where results are discordant, both pseudotyped and authentic virus susceptibility is presented. Where only one type of virus was tested, it was in all cases pseudotyped virus. In the case of the Delta variant, binding of the monoclonal antibodies to variant strain was tested with the S-Fuse binding assay. The extent of correlation of neutralizing activity in in vitro cell culture experiments with clinical outcomes is as yet unknown. *** As compared with vaccine efficacy/effectiveness against Alpha/B.1.1.7 variant.

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