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Ask an Infectious Disease Expert: Will COVID-19 Vaccines Work Against New Variants?

ask an infectious disease expert makeda robinson

Makeda Robinson, MD, PhD, is an infectious disease specialist currently studying the differences in early immune responses between adults and children to COVID-19 at Stanford University. Dr. Robinson breaks down complicated COVID-19 topics and addresses pressing public health concerns.

The emergence of new variants of SARS-CoV-2, the virus behind COVID-19, is raising some alarms about our ability to combat the virus and reach herd immunity. While mutations in the virus’ genetic material are expected, especially given the amount of time it’s circulated in our population, the potential vaccine-evading aspects of these variants has prompted public concern.

The United Kingdom, South Africa, Brazil, and Japan are all places where new strains developed, with some strains proving to be more transmissible and infectious than the original strain.

Will the vaccines currently in rotation (Pfizer and Moderna) be able to suppress these new strains? Can we keep pace with evolving pathogens? And could these strains prove more lethal than their previous manifestations? Dr. Robinson spoke to Verywell to shed light on everything we know so far regarding new COVID-19 variants.

Verywell Health: Why are people worried about COVID-19 variants and the vaccines?

Dr. Robinson: Given the potential increased fitness of these variants, they will likely overtake the original SARS-CoV-2 virus eventually. Understanding how well each of the vaccines fares against each of the variants is an important process to determine vaccine dosing and the potential need for “booster” shots.  

The U.K. variant B.1.1.7 and the South African variant B.1.351 each have multiple mutations in the spike protein. This protein is important for the vaccines; it's what mRNA in the Pfizer and Moderna vaccines uses to stimulate the immune system, allowing us to develop antibodies against SARS-CoV-2. So if it's mutated, that's cause for concern.

However, these mRNA-based vaccines create a “polyclonal” response to the virus, meaning they can detect many different parts of the spike protein, some of which may not have been disturbed by the recent variant mutations.

The South African variant has a specific mutation (E484K) in the SARS-CoV-2 spike protein which is incredibly rare in the U.K. variant. This mutation, specifically, is causing concern about vaccine efficacy and how well antibodies from the vaccine will be able to work.

While the current vaccines will likely retain some protective effect, we will have to see how multiple new variants will affect the number of cases and mortality rates.

Verywell Health: If the vaccines don't work well against new variants, will researchers have to create new ones from scratch?

Dr. Robinson: I’m hopeful that the current mRNA vaccines will retain a significant level of efficacy [against COVID-19]. But if there proves to be a dramatic reduction in their ability to prevent severe outcomes, the benefit of the mRNA vaccine platforms is that they are adaptable. Changes could potentially be made to the mRNA sequence fairly quickly, allowing for a COVID-19 vaccine 2.0 in record time—especially if they are eligible for expedited FDA approvals.  

Verywell Health: While mRNA vaccines like Pfizer and Moderna are thought to work against the new variants, what about other vaccines in the pipeline, like Johnson & Johnson or AstraZeneca?

Dr. Robinson: Outside of the mRNA vaccines, things remain more opaque. The efficacy of the two up-and-coming adenoviral vaccines have demonstrated a lower level of defense against the virus in general—closer to 66-70% efficacy. While the developers of these vaccines have said they believe that they will remain effective against the variants, how effective remains unclear.

Verywell Health: Are the new variants more lethal and harmful, or just more contagious? 

Dr. Robinson: Preliminary findings appear to show that while these new variants may not be causing more severe symptoms, their intrinsic infectivity may lead to increasing numbers of hospitalizations and deaths due to the rise in cases.

Verywell Health: Can a variant simultaneously become more infectious and more lethal?

Dr. Robinson: While early studies suggest that one of these variants will likely become dominant, the virus itself is going through a trial-and-error phase where it makes a lot of different mutations. Some of them don't change anything about the virus. Some of them don't affect the overall transmission or severity. But when the virus stumbles across mutations that have a survival benefit, it can spread like wildfire. It is entirely feasible that a variant could be both more infectious and lethal. However, until we learn more about how and why different groups of people respond differently to the same exposure, it will be difficult to know whether these new variants will lead to a shift in our risk profiles.

Verywell Health: Should we take added measures to protect ourselves from the new variants besides wearing a mask and social distancing?

Dr. Robinson: I would suggest upgrading your mask if possible. While we are not out of the woods as far as issues with sufficient protective equipment for our front line workers—especially for those in an at-risk group who has not been prioritized for vaccination—upgrading your mask from a cloth mask or wearing two masks together to give yourself more protection would be a reasonable step. These variants appear to be causing higher levels of virus to circulate, so there may be more viral particles in our respiratory secretions. This makes an encounter that may not have resulted in an active infection previously more likely to lead to asymptomatic infection now. 

As someone who has recently been vaccinated, I would also remind all those who have had one or two doses of a vaccine that we have to continue to live our lives as though we have not been vaccinated, continuing to social distance, wear masks, and wash hands. 

Verywell Health: How can we stop misinformation about the variants? 

Dr. Robinson: Many of us are spending considerably more time on our computers and using social media outlets more than ever. This has led to even more personalities cropping up vying for our time and attention. Finding useful information in an entertainment space is like trying to find a needle in a haystack. But comparatively, resources like the Centers for Disease Control and Prevention may not be as engaging.

Spend some time vetting any resources that allow you to share your opinion. And see if those resources are doing any vetting of their own. Twitter, for example, has identified and evaluated a group of COVID-19 experts, granting them the blue verification check mark to discuss the pandemic. Efforts like this can make an impact on those willing to search them out. 

Verywell Health: How can I check when I will qualify for a vaccination, and which state resources can I use to sign up for one?

Dr. Robinson: There has been a lot of confusion surrounding vaccine availability, access, and eligibility. There are several different avenues to take to explore your options. I would suggest going to your local department of public health website to learn more about the vaccine tiers in your state or county and your current eligibility. Many of the websites will have a survey to help you determine whether you are currently eligible and provide updates when additional vaccines are available. 

I would also consider contacting your healthcare provider or employer to explore other distribution points that may be less overwhelmed. The process can be frustrating, and even though you may be eligible for the vaccine, there may not be sufficient supply in your location. One county may be vaccinating different age groups, like people 75 and over instead of 65 and over.

Being persistent is key. If you are an older adult having difficulty navigating the system, please don’t be shy to ask a relative or friend to help figure out the best way forward. 

Verywell Health: Is there anything else you want to add? 

Dr. Robinson: I’m sure this is something many people have already heard, but it’s even more important for us to get as many people vaccinated as possible as quickly as possible. The rise of these new variants have the potential to spread faster, infecting more people and once again opening up the Pandora’s box of possible re-infections. If you have an opportunity to take a vaccine, I highly recommend you take it.

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.

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