Multiple SARS-CoV-2 vaccines have shown protective efficacy, which is most likely mediated by neutralizing antibodies recognizing the viral entry protein, Spike. As new SARS-CoV-2 variants are rapidly emerging, exemplified by the B.1.1.7, B.1.351 and P.1 lineages, it is critical to understand if antibody responses induced by infection with the original SARS-CoV-2 virus or current vaccines remain effective. In this study we evaluate neutralization of a series of mutated Spike pseudotypes based on divergence from SARS-CoV and then compare neutralization of the B.1.1.7 Spike pseudotype and individual mutations. Spike-specific monoclonal antibody neutralization was dramatically reduced, in contrast, polyclonal antibodies from patients infected in early 2020 remained active against most mutated Spike pseudotypes, however potency was reduced in a minority of samples. This work highlights that changes in the SARS-CoV-2 Spike can alter neutralization sensitivity and underlines the need for effective real-time monitoring of emerging mutations and their impact on vaccine efficacy.

People with disabilities make up about 20% of the population, yet only a tiny fraction of matriculants to medical school have disabilities. Attempts to define core technical standards and competencies have not kept pace with technological changes, diverse specialization, and changing practice options. This has resulted in the inappropriate exclusion of some people with disabilities. Medical schools determine how any qualified applicant, regardless of physical or cognitive ability, can be effectively accommodated and counseled in achieving the most appropriate medical career. A serious effort to redefine the technical standards and core competencies of the 21st century medical education at the undergraduate and graduate levels would likely resolve many of the troubling questions regarding medical students with disabilities. We have made some recommendations to organized medicine for constructing an agenda to address these issues.