What You Need to Know About the New COVID Variant BQ.1.1

COVID-19 variants appear to have mutated far enough from the original virus that certain therapies no longer work against them. BQ.1.1, the newest Omicron subvariant, threatens to evade monoclonal antibodies in treatments like Evusheld.

BQ.1.1 and its sister variant BQ.1 have been detected in the U.S. and several other countries. They account for about 11% of the new U.S. COVID-19 cases, although the proportions might be undercounted due to declines in virus surveillance efforts and PCR testing.

“There’s a lot of fog in this system in terms of what’s really increasing and how fast it’s increasing, because those sequencing efforts have been minimized over the past couple of months,” said Andrew Pekosz, PhD, a virologist and researcher at Johns Hopkins Bloomberg School of Public Health.

By the same token, more COVID-19 variants could be circulating undetected, he added.

For now, BA.5 is still the dominant variant, responsible for around 68% of new cases. But the disease severity of COVID-19 appears to be decreasing as both daily hospitalizations and deaths remain in a downward trend.

How Dangerous Is BQ.1.1?

BQ.1.1 and its sister variant BQ.1 are both descendants of BA.5, with some mutations similar to those of BA.5.

“BA.5 is like this big family,” Pavitra Roychoudhury, PhD, MSc, an instructor at the department of laboratory medicine and pathology at the University of Washington, told Verywell. “Within the BA.5, you can have diversification, and as evolution progresses, you get mutations.”

As these new subvariants compete with one another, one of them could become dominant and more resistant to vaccines as winter indoor gatherings may allow the variants to spread faster, she added.

Still, Roychoudhury said researchers have learned not to assume how a variant will take off in the future.

Will the New Bivalent Boosters Protect Against BQ.1.1?

Since BQ.1.1 is similar to BA.5 in composition, the new bivalent booster vaccines should just be as effective against this new variant, according to Pekosz.

According to Pfizer’s latest announcement, ongoing clinical trials show that the bivalent booster shot “demonstrated a substantial increase in the Omicron BA.4/BA.5 neutralizing antibody response” seven days after administration.

“The antibodies generated by the vaccine will still be recognizing these variants that are circulating now,” Pekosz said. “So, if there’s a positive thing people can do, it’s going out and getting the bivalent booster. It absolutely will provide better protection.”

He said that the vaccines are better at reducing hospitalizations and deaths than reducing infection risks, but the updated booster shots are still the best tool available against COVID-19.

Will Current Treatments Work Against BQ.1.1?

A recent preprint study suggested that monoclonal antibody drugs like Evusheld may not be effective against the BQ.1.1 variant. These treatments are meant for immunocompromised individuals, who are most at risk of antibody-evading variants like BQ.1.1, Pekosz said.

Since COVID-19 monoclonal antibody treatments were developed earlier in the pandemic, they may not work as well against Omicron subvariants, which look very different from the original strain, he added.

“We’re still working with that first generation of treatments. We’re not seeing this second-generation development of treatments in the way that we’re going to need,” Pekosz said.

To fight the pandemic equitably, commercial manufacturers need to build updated versions of treatment for the Omicron variants, he added.

“Our way out of this pandemic is to keep the sword sharpened and keep using it effectively,” Pekosz said. “If we let up a little bit, we run the risk of limiting the tools that we can use to fight the virus, and seeing larger numbers of cases.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.