Vaccinations vs. Variants

Viruses including SARS-CoV-2, the virus that causes COVID-19, constantly change. Genetic variations occur with changes over time leading to the emergence of new variants having different characteristics. For example, some variant viruses  spread easier, cause more severe disease, or may escape the body’s immune response. CDC recently introduced a classification system to rank the risk of the variants. The classification system delineates emerging variants based on characteristics and the resulting actions and consequences for public health. CDC’s three classification categories include Variants of Interest (“VOI”), Variants of Concern (“VOC”), and Variants of High Consequence (“VOHC”). The CDC currently monitors five variants of concern in the United States.  The CDC classifies no variants circulating in the United States VOHC.  Unfortunately, researchers fear that the delays in ramping up surveillance of the coronavirus SARS-CoV-2 in the United States allows virus variants—which evidence shows  could make vaccines less effective—to spread undetected in one of the countries hit hardest by the disease.  Multiple variants of the virus that causes COVID-19 are circulating globally, including within the United States. Currently, four variants are classified as a Variants of Concern (VOC) NOWCAST estimates of COVID-19 cases caused by these VOCs for the week ending August 21, 2021, are summarized here. Nationally, the combined proportion of cases attributed to Delta is estimated to be greater than 99%; Alpha proportion is estimated to decrease to 0.2%; Gamma proportion is estimated to decrease to 0.1%; and Beta is estimated to be less than 0.1%. NOWCAST estimates that Delta will continue to be the predominant variant circulating in all 10 U.S. Department of Health and Human Services (HHS) regions. Alpha is estimated to be 0.3% or less in all HHS regions. Gamma is estimated to be 0.3% or less in all HHS regions and Beta is estimated to be less than 0.1% in all HHS regions. 

According to the Global Influenza Surveillance System (“GISAID”), which collaborates, supplies, and syndicates genomic data sets concerning SARS-CoV-2 variants to the CDC, the World Health Organization (“WHO”), the U.S. Department of Health (“DOH”), the European Union, other world governments and tens of thousands of researchers worldwide reports that the United States genomically identifies less than 1.6% or 0.29% as a global genomics contributor of its positive COVID-19 cases a month.   This ranks the U.S. as 38th out of 130 countries in terms of sequencing Positive COVID-19 cases, which is the only current defense against identifying potentially variant strains. According to the WHO, the United States is doing so little of the genetic sequencing needed to detect new variants of the coronavirus—like the ones first identified in Great Britain and South Africa—that such mutations are probably proliferating quickly, undetected.  Currently, NOT DEEMED as VOHC, the coronavirus variant known as B.1.1.7, which studies show is both more deadly and transmissible than the original version of SARS-CoV-2, now serves as the most common strain circulating in the United States, and its growing prevalence alarms prominent epidemiologists.

According To Infectious Disease Specialist Jesse Goodman, MD, MPH, Who, As A Then-Chief Scientist At The U.S. Food And Drug Administration (“FDA”), Led The Agency’s Response To The H1N1 Influenza A Pandemic, Said In An Interview “Even If We Don’t Have A Critical Situation Right At The Moment … There Is A Realistic Possibility That Variants Will Continue To Evolve That Have The Potential To Avoid Vaccine Immunity.”  In States Such As Massachusetts,  Three Highly Infectious COVID-19 Variants In Estimates Now Account For More Than Half Of All Infections In Massachusetts, Expert Witnesses Confirm During A State Legislative Hearing, As Infection Rates, ICU Beds, And Death Tolls Climb.  On The International Front, New Reports Show That Pfizer/BioNTech, The Pfizer/BioNTech COVID-19 Vaccine Is Less Effective Against The South American And U.K. Variants Than The Original Virus.  A Growing Number Of Researchers Believe The Rapidly Developing Mutations Advancing The COVID-19 Pandemic Will Cause The Virus To Change To The Extent Rendering The Majority Of First-Generation Vaccines Ineffective, Requiring New Or Modified Vaccines Within The Next 2-9 Months.  These Genetic Variants Will Result In Current Covid-19 Vaccine Resistance In The Near Future. 

Key Takeaways:

  • VOI and VOC account for more than 70% of all new cases in many states in the United States.
  • The U.K. and Brazilian variants are considered VOC because the first has proven to cause more severe outcomes while the second may be more resistant to vaccines.
  • Variant(s) causes a higher risk of reinfection by other variants and/or are more resistant to vaccines.
  • Current vaccines may be ineffective in as little as 2-9 months.

* Centers for Disease Control Covid Data Tracker Weekly Review, Updated September 2, 2021.

* Estimates of SARS-CoV-2 Prevalence >40,000 sequences (NOT PATIENTS) collected through CDC’s national genomic surveillance since Dec. 20, 2020 and grouped in 2-week intervals. Estimated 300 Sequences per Specimen or 133 patients.

* McCallum, M., et al. Preprint at bioRxiv (2021).

* Garcia-Beltran, W. F., et al. Cell (2021).

* CDC NOWCAST is a model that projects more recent proportions of circulating variants and enables timely public health action. (9-2-2021)

* Genomic sequence and data shared via GISAID Initiative. JHU CSSE COVID-19 Data (Dong, et al, 2020, Lancet Inf Dis.).

* Why America is ‘flying blind’ to the coronavirus mutations racing across the globe, by William Wan, Washington Post (01-29-2021).

* How this more contagious virus variant became dominant in the U.S., by SANJAY MISHRA, National Geographic (04-09-2021).

* COVID-19 Vaccines vs Variants—Determining How Much Immunity Is Enough, Rita Rubin, MA, JAMA. 2021;325(13):1241-1243. (03-17-21).*