With companies looking to develop booster injections that target these variants, some asked – should I wait before getting the vaccine if there could be an even better one afterwards? Or does the arrival of variants mean that it is even more urgent to be vaccinated now?
We spoke with CNN medical analyst Dr. Leana Wen, an emergency physician and visiting professor at the Milken Institute School of Public Health at George Washington University, for guidance on how to think about vaccines in the midst of these emerging variants.
Dr. Leana Wen: The SARS-CoV-2 virus that causes Covid-19 is an RNA virus. These viruses are known to acquire mutations as they spread. There are strains that have certain mutations that are of concern. The variant first identified in the United Kingdom, B.1.1.7, is believed to be more contagious than existing strains. If one variant is more contagious, it can quickly become the dominant strain and exclude others. Countries that have variant B.1.1.7 have seen rapid increases in infections by Covid-19.
Two other variants of potential concern are those that were first identified in South Africa and Brazil, called B.1.351 and P.1, respectively. These two can also be more contagious. In addition, some studies have found that these variants can make reinfection more possible – meaning that if someone has had another Covid-19 strain before, they may still be infected with those strains. In addition, mutations in the variants may make them less susceptible to developed vaccines – although it is important to note that current vaccines still work against them, although perhaps with a little less effectiveness.
CNN: Isn’t that worrying? What happens if vaccines no longer work against new variants?
Wen: This is certainly something that needs to be studied and followed. Research is now being done on Pfizer and Moderna vaccines to ensure that they are still effective against emerging variants. The companies also said they are looking for reinforcement shots that specifically target the variants.
It may end up being that we need booster doses. Or maybe the Covid-19 vaccine turns out to be like a flu vaccine, where every year we have to get a vaccine that targets new variants that can develop over time.
CNN: So shouldn’t we wait until there’s a backup and just get that picture?
Wen: No, and here’s why. First, we don’t know when these booster shots can be launched. It may take months, and booster shots may require that you have completed the series of vaccines first. If you have the opportunity to get the vaccine now, do it to protect yourself. Remember that the vaccines we have are still effective against the variants.
Second, we may still have to catch up with the new mutations. These RNA viruses undergo many mutations. The more they replicate, the more they mutate. This means that the more infection there is in a community, the more viruses circulating in that community are likely to acquire mutations and new variants may arise. It may be that vaccines need to evolve continuously to keep up with variants, which means, again, we may need regular booster doses.
Third, as variants arise when there is wide dissemination in the community, it is very important to try to reduce the level of transmission. Vaccination is a fundamental part of our plan to get there, as well as masking, physical distance, avoiding crowded meetings in closed environments and other public health measures. The arrival of variants should mean that we have further increased vaccinations – and that everyone who qualifies to receive a vaccine must do so.
CNN: What about the new vaccines being developed – could they be more effective against variants?
Wen: We do not know. That is why it is difficult to compare the effectiveness of vaccines face to face. The Pfizer and Moderna vaccines were developed and tested before these most worrying variants became dominant. Johnson & Johnson and Novavax were later tested, including on some sites with these variants already in circulation.
We can do more research over time on the specific effectiveness of vaccines against each variant, although I want to draw our attention to the importance of vaccine testing: the real risk of serious illness and hospitalization. Ultimately, this is what makes Covid-19 such a serious disease. If vaccines can reduce serious illness to the extent that people who get the vaccine get so sick that they are hospitalized, this is what we really want.
CNN: What if I already had coronavirus – should I still get the vaccine? Does it matter what strain I got when I got infected?
Wen: Yes. Especially now that it appears that reinfection can occur with the variants, it is even more important that those who have had the coronavirus are vaccinated as well.
CNN: With the arrival of more contagious strains, are there any additional precautions we should take in addition to getting the vaccine when we can?
Wen: The good news about emerging strains is that they still spread in the same way, through the respiratory route, mainly by close contact and also by aerosol transmission. (Although surface transmission is also possible, it probably contributes less than these other methods.) This means that the same precautions you are taking to avoid Covid-19 still apply to the new variants.
Here’s the concern. The normal strains of Covid-19 are already quite contagious, but the new strains are even more contagious. This means that activities that we thought were low risk are now more dangerous. We have to take even more steps to protect ourselves.
An N95 or KN95 can be useful if you are staying in particularly close places where you cannot physically distance yourself, although these masks are scarce and can be uncomfortable to wear for long periods of time. You should be even more careful to avoid staying indoors with other people and, if necessary, keep your physical distance and try to stay only in well-ventilated spaces.
The arrival of the most contagious variants means that we need to double the public health measures that we know to be effective in reducing Covid-19 transmission. The race to vaccinate is also crucial. The best tool we have to slow down the development of more variants is to slow the spread of the virus. So, please, let’s get vaccinated when it’s our turn and keep safe – for you and those around you.