Coronavirus variants are multiplying: What to know about boosters now

Georgia appears to be in a relative lull in the pandemic, but an explosion of new coronavirus subvariants are steadily gaining ground, leaving researchers worried by startlingly low interest in the latest updated COVID-19 booster.

Just as cold weather and the holiday travel season have arrived, a slew of new subvariants of the omicron strain of the virus are appearing in the U.S. and around the world. Public Health experts worry the rapidly evolving virus could bring yet another wave of illnesses if it evades the updated vaccine, which became available in early September. For now, the retooled vaccine is still considered the best way to protect against severe illness.

Infections are already rising in Europe, and the U.S often follows suit.

The seven-day rolling average of new confirmed COVID cases in Georgia was 434 Wednesday, down from 749 a month ago, and down from 16,372 on Jan. 11, the peak of the first omicron surge, according to the Georgia Department of Public Health. The trend here is encouraging even though case counts in recent months don’t show the full picture of infections, because so many more people are taking home tests.

While many of the emerging variants contain a mutation that may allow them to evade vaccine-induced and natural immunity, health experts say the new booster should provide some protection. The new booster vaccines are “bivalent” meaning they target both the original strain that emerged in China more than two years ago along with two versions of the omicron variant, which has outcompeted older variants of the original virus to become the most common circulating.

Although the omicron BA.5 subvariant remains dominant in the U.S., it is on the decline, now accounting for just 67.9% of circulating variants, according to data from the Centers for Disease Control and Prevention. The number of omicron offshoots popping up is dizzying, and now include BA.4.6 and BQ.1.1 and BQ.1 and BF.7. The World Health Organization officials said earlier this month that scientists are monitoring more than 300 sublineages of omicron.

Credit: Con

Credit: Con

The Atlanta Journal-Constitution interviewed Dr. Evelyn Twentyman, leader of CDC’s COVID-19 Vaccine Policy Unit to learn more about current vaccines and variants. The interview has been edited for clarity and length.

Q: Why is it recommended people get a COVID booster?

A: COVID-19 vaccines are actually the single best measure we currently have to protect ourselves, our loved ones, and our communities from COVID-19. And especially its severe outcomes. We are able to collect a lot of data and do a lot of studying about outcomes for people who are unvaccinated and compare that to outcomes for people who are up to date on vaccinations and recommended boosters. In August of this year, those who were unvaccinated were almost 6 times as likely to be hospitalized for COVID when compared to those who were up to date with vaccinations (and boosters). And unfortunately, it was a bit higher in folks of more advanced age. For example, if you look only at adults who were ages 50 to 74, those who were unvaccinated were actually 7.4 times more likely to be hospitalized with COVID compared to those who were up to date with their vaccination.

Q: This updated vaccine was designed to target omicron’s BA.4 and BA.5 subvariants but what about new emerging variants and their ability to possibly evade immune responses triggered by vaccines?

A: What I think is most exciting about this updated bivalent booster is that it is specifically designed to target not just the original strain of the virus that causes COVID, but also the currently predominant strain, so that is to say BA.4 and BA.5 strains.

We at the CDC are following the emergence of multiple variants super closely. Here’s the exciting thing about where we are today: 97% of the variants currently in circulation are BA.4 or BA.5 variants so you can feel really good about getting a booster that protects you. Does that mean we’re going to stop looking at variants? Never. ... I find it super encouraging that, actually, we are targeting them quite well with the current bivalent booster.

Q: Is the expectation the bivalent booster will continue to provide protection against new and emerging variants?

A: Yes. The bivalent boosters will do two things. They will both restore protection that a person who got their primary series may have had wane over time ... and expand protection against these newer COVID-19 viral variants.

You can rest assured that we at the CDC and with our other federal agency partners and partners across academia are continuing to follow that data really closely. Both to see if any additional doses are recommended and if so, when, and if any changes to these vaccines are needed.

Q: For people who have had a coronavirus infection over the summer months, July for example, should they get the booster now or wait until closer to the winter holidays when they are likely to travel and gather more inside with family and friends?

A: So if someone got COVID-19 disease in July, I would say go ahead and get it now. If you’re asking, ‘Should that person wait until the holidays?’ I would say definitely not. I would say now is a great time to prepare your immune system. Not just for that subsequent travel but for anything that happens before then, any exposures you have before then. Now is the time.

Q: Are COVID boosters going to be an annual requirement like a flu vaccine?

A: I think the flu analogy is a pretty good analogy. We don’t know what kind of change the virus will make. We don’t know what kind of change will therefore be needed in the vaccine. We do know we have super strong structures in place to monitor all of this — the virus, the vaccines, effectiveness, and the vaccines’ safety, so we’re in a really good position to make the best possible recommendation for public health at any given time.

I will also point out one exciting thing happening today is considering how to integrate COVID-19 vaccines into standard immunization schedules. That is to say, we are acknowledging that is probably going to be part of our standard, good medical care going forward. And just to be super clear, this is not anything to do with a mandate at all.

John Perry, the technical director of the AJC’s data journalism team contributed to this article.


Bivalent boosters

The bivalent booster is now available for anyone age 5 or older who received an initial vaccination or booster shot at least two months ago. Uptake has been extremely low in the U.S. including Georgia, where about 5% those age 12 and up have had a bivalent vaccine. Not everyone in this age group would qualify to get the booster yet, including people who recently had COVID. Children ages 5 to 11 only recently became eligible to get a bivalent vaccine so they are just starting to be administered to this age group, and no statistics are yet available on this youngest age group.

Pfizer

10,906: ages 12 to 17

161,635: 18 to 65

108,872: 65+

Moderna

94: ages 12 to 17

65,884: 18 to 65

88,529: 65+

Credit: Georgia Department of Public Health and John Perry, the technical director of the AJC’s data journalism team