Just as you're starting to feel a little more hopeful about the pandemic, thanks to the approval and rollout of three vaccines, there's a new boogeyman in town. We're talking about the variants of the novel coronavirus.
A variant means that the virus has mutated, or changed. This may then affect how contagious the virus is or its severity. Some variants simply disappear while others go on to infect the population.
According to the Centers for Disease Control and Prevention (CDC), there are multiple novel coronavirus variants circulating the world. Some are more concerning than others, though, because they may be more contagious.
The World Health Organization now refers to these variants of concern using letters of the Greek alphabet. They include variants Alpha, Beta, Gamma and Delta, which were first detected in the U.K., South Africa, Brazil and India, respectively.
The CDC estimates that the Alpha and Beta variants are about 50 percent more contagious compared to prior variants of the coronavirus. They have a specific mutation called N501Y that may allow the virus to replicate more quickly in cells in the respiratory tract.
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"The thing about variants is that they're really to be expected. All viruses change," Patricia Couto, MD, an infectious disease physician with Orlando Health, tells LIVESTRONG.com.
As they replicate in the body, the virus makes more "virus babies," she says, which can cause replication mistakes in its genetic material. Often, this doesn't go anywhere, but sometimes these changes make the virus more easily transmissible from person to person.
In the coronavirus, there may be a small change in one of its spike proteins (the little hooks it has around its surface), allowing it to better latch onto the proteins or receptors of the person to infect them, Dr. Couto explains.
While the CDC notes that research is underway to examine if these variants are more deadly or cause more severe illness, they could still cause more death if they're able to infect more people, Dr. Couto says.
What's more, emerging data suggests that the Alpha variant indeed "has the potential to cause substantial additional mortality compared with previously circulating variants," according to a March 2021 study in The BMJ.
So, Will the COVID-19 Vaccine Work Against the Variants?
One problem is that there is not a centralized system for analyzing how all of the vaccines perform against all of the variants, John P. Moore, PhD, of Weill Medical College of Cornell University, said in a JAMA Network interview in early March. What we know right now is from smaller-scale studies, and really, we're piecing together the information as it comes in.
There is also less known about how the Johnson & Johnson vaccine stands up to these variants. In press materials, the company said it offered protection "across countries with different variants." Their trials were conducted in the United States, South Africa and Latin America.
In short, however, the vaccine provides at least some protection against all of the known variants, so you shouldn't skip it. Here's a deeper look:
The Alpha Variant
The CDC says there's no evidence that this variant will affect how well the vaccine works. In fact, data suggests the vaccine from Pfizer will be effective against the N501Y mutation, reports the AP. And a January 2021 preprint study on bioRxiv found that this is indeed the case for the Alpha variant.
Both studies still need to go through peer-review, but it's reassuring preliminary news.
The Beta Variant
This variant has multiple mutations to the spike protein, including N501Y but also E484K, according to the CDC, which may affect vaccine efficacy.
The Moderna vaccine still protects against this variant, although it is slightly less effective, according to the company. Pfizer has not yet reported data on this variant, but the nation's top infectious disease official, Anthony Fauci, MD, has said both vaccines produce immune protection against it.
"There is a very slight, modest diminution in the efficacy of a vaccine against it, but there's enough cushion with the vaccines that we have that we still consider them to be effective," he said on the "Today" show on January 25.
Dr. Moore echoed that on JAMA Network. Because these vaccines provoke such a strong antibody response, we should still be able to cope with a modest reduction in efficacy. You're simply going from "strong" to "reasonably strong," he said.
As for the Johnson & Johnson vaccine, The New York Times noted that while it was found to have a 72 percent efficacy rate in the United States, it offered slightly less protection in South Africa (where the Beta variant originated), with 64 percent efficacy.
The vaccine from AstraZeneca-Oxford (which has not been approved in the U.S.) did not protect against mild or moderate illness caused by this variant in South African clinical trials, The New York Times reported February 7. The vaccine may protect against more severe cases, but as with the other variants and vaccines, more research is needed as the virus continues to evolve.
The Gamma Variant
This variant is similar to the Beta variant in that it contains both the E484K and N501Y mutations, per the CDC. Initial news regarding vaccine efficacy is promising. In an April 2021 analysis in The New England Journal of Medicine, data from Pfizer show that the vaccine was similarly as effective against both the Alpha and Gamma variants. (It was "robust but lower" when it came to the Beta variant.)
The Delta Variant
The Delta variant has been classified as a "variant of global concern" by the World Health Organization. A May 2021 preprint study on bioRxiv suggests it may spread more easily and that the COVID vaccine may be less effective against it, which is why the authors believe it has spread so quickly in India. This research is preliminary, though, and still needs to go through peer review.
Again, this doesn't mean you should skip your shot.
The vaccine works by stimulating your immune system to make antibodies against different sections of the spike protein, explains Viviana Simon, MD, PhD, professor of microbiology, medicine and infectious diseases at the Icahn School of Medicine at Mount Sinai. And basically, it seems like the spikes in the variants haven't mutated quite enough to escape these antibodies altogether.
Out of "an abundance of caution," Moderna announced January 25 that it will test an additional booster dose of its vaccine to see if it offers any additional protection against emerging variants.
Will We Need Booster Shots?
One way of ensuring protection against the coronavirus variants is to administer a booster shot if it becomes clear that the current vaccines are less effective. The process to do so will be fast-tracked, per the FDA.
As the administration noted in a brief, these variants are expected, and while it appears that the vaccines remain effective against the circulating strains of the virus, if that is ultimately not the case, the vaccines will be specifically tailored to address them. (This happens with the flu shot each year; that vaccine is tailored to what is believed will be the dominant circulating strains of the season.)
And you won't have to wait long for that to happen. As Reuters noted, Dr. Janet Woodcock, acting commissioner of the FDA, said that if vaccines need to be modified, the manufacturers will not have to perform large trials as was originally needed. Essentially, these boosters could be fast-tracked. (The FDA's full proposed guidelines were released in late February.)
How Do the Variants Affect COVID Testing?
The mutations could affect the results of some COVID-19 tests, according to the Food and Drug Administration (FDA). Tests that look for the virus' genetic material that's been altered by the mutation could produce a false-negative result (that's when you're infected, but the test says you're not).
The risk of a false negative is low, according to the FDA, but it could potentially occur with the Accula SARS-Cov-2 Test, the TaqPath COVID-19 Combo Kit and the Linea COVID-19 Assay Kit.
If your doctor uses one of these tests but still suspects you have COVID-19 based on your symptoms and COVID data for your area, he or she may decide to have you take a different test just to be sure.
A variant that's potentially more contagious means it's even more important to keep up all those smart public health practices, like masking up when necessary, washing your hands and, most importantly, getting the vaccine when you're eligible to do so.
"Every opportunity to close a door is a good opportunity. Try to hang in there as much as you can and close all the roads for the virus to walk from one person to the other," Dr. Couto says. "The more people doing that at the same time, the greater the chance we have to slow it down."
Read more stories to help you navigate the novel coronavirus pandemic:
Is This an Emergency?
- Centers for Disease Control and Prevention: “Emerging SARS-CoV-2 Variants”
- CMMID Repository: “Estimated transmissibility and severity of novel SARS-CoV-2 Variant of Concern 202012/01 in England”
- Reuters: “FACTBOX-UK says new coronavirus variant up to 70% more transmissible”
- AP: “Pfizer study suggests vaccine works against virus variant”
- Food and Drug Administration: "Genetic Variants of SARS-CoV-2 May Lead to False Negative Results with Molecular Tests for Detection of SARS-CoV-2 - Letter to Clinical Laboratory Staff and Health Care Providers"
- bioRxiv: "Neutralization of SARS-CoV-2 lineage B.1.1.7 pseudovirus by BNT162b2 vaccine-elicited human sera"
- Moderna: "Moderna COVID-19 Vaccine Retains Neutralizing Activity Against Emerging Variants First Identified in the U.K. and the Republic of South Africa"
- The New York Times: "AstraZeneca’s Vaccine Does Not Work Well Against Virus Variant in South Africa"
- BMJ: "Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study"
- The New England Journal of Medicine: "Neutralizing Activity of BNT162b2-Elicited Serum"
- bioRxiv: "SARS-CoV-2 variant B.1.617 is resistant to Bamlanivimab and evades antibodies induced by infection and vaccination"
- World Health Organization: "Tracking SARS-CoV-2 variants"