Vep Annotator

Create a high-performance C++ tool that replicates the core functionality of Ensembl's Variant Effect Predictor (VEP). I need it to take variant data and perform comprehensive annotation. Key features must include consequence prediction using Sequence Ontology terms, calculating impact classifications (HIGH, MODERATE, LOW, MODIFIER), and generating HGVS notations (HGVSc, HGVSp, HGVSg). The tool should support multiple output formats: TSV (default), JSON, and VCF. Additionally, please incorporate support for pathogenicity predictions using scores like SIFT, CADD, and gnomAD, as well as structural variant annotation and handling of regulatory features like promoters and enhancers.