With companies looking to develop booster shots targeting these variants, some have asked, Should I wait before getting the vaccine when there could be an even better one later? Or does the arrival of the variants mean that it is even more urgent to get vaccinated now?
We spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and visiting professor at the George Washington University Milken Institute School of Public Health, for advice on how to think about vaccinations amid 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 during spread. There are strains with certain mutations that are of concern. The variant first identified in the UK, B.1.1.7, is believed to be more contagious than the existing strains. If one variant is more contagious, it can quickly become the dominant species and crowd out others. Countries with the B.1.1.7 variant have seen a rapid increase in Covid-19 infections.
Two other variants of concern are those first identified in South Africa and Brazil, named B.1.351 and P.1, respectively. These two can also be more contagious. In addition, some studies have shown that these variants could allow reinfection – meaning that if someone previously had another strain of Covid-19, they could still be infected with these strains. Also, the mutations the variants have can make them less susceptible to the developed vaccines – although it is important to note that current vaccines still work against them, albeit perhaps slightly less effectively.
CNN: Isn’t that concerning? What happens if vaccines no longer work against new variants?
Wen: This is certainly something to be studied and followed. The Pfizer and Moderna vaccines are now being investigated to ensure that they are still effective against the emerging variants. The companies have also said they are looking for booster shots that specifically target the variants.
We may need booster shots. Or maybe the Covid-19 vaccine will eventually become a flu shot, requiring us to get a vaccination every year that focuses on new variants that can develop over time.
CNN: Shouldn’t we wait for a booster and just take that picture?
Wen: No, and here’s why. First, we don’t know when these booster shots will come out. It can take months and for the booster shots you may need to complete the vaccination series first. If you now have the option of getting the vaccine, do it to protect yourself. Remember that the vaccines we have are still effective against the variants.
Second, we may have to keep catching up with new mutations. These RNA viruses mutate a lot. The more they replicate, the more they mutate. That means that the more infection there is in a community, the more viruses that circulate in that community, the more likely it is that mutations will develop and new variants can emerge. The vaccines may have to evolve constantly to keep up with the variants, which means we may need regular booster shots.
Third, because variants arise when there is a wide distribution in the community, it is very important to try to reduce the level of transmission. Vaccination is an important part of our plan to get there, as is masking, taking physical distance, avoiding busy indoor gatherings, and other public health measures. The advent of the variants should mean that we are ramping up vaccinations even further – and everyone who qualifies for a vaccine and is able to get it should do so too.
CNN: What about the new vaccines being developed – could they be more effective against the variants?
Wen: We do not know. Therefore it is difficult to compare the effectiveness of the vaccines against each other. The Pfizer and Moderna vaccines have been developed and tested before these more worrying variants become dominant. Johnson & Johnson and Novavax were then tested, including at some sites where these variants are already circulating.
Over time we may get more research on the specific efficacy of the vaccines against each variant, although I want to draw our attention to why vaccine research matters: the very real risk of serious illness and hospitalization. Ultimately, that’s what makes Covid-19 such a serious disease. If the vaccines can reduce serious illness to the point of preventing people who get the vaccine from getting so sick that they are hospitalized, that’s what we really want.
CNN: What if I’ve already had coronavirus – should I still get the vaccine? Does It Matter What Kind I Got When I Was Infected?
Wen: Yes. Certainly now that it appears that re-infection can occur with the variants, it is even more important that those who have already had coronavirus are also vaccinated.
CNN: With the advent of more contagious strains, are there any additional precautions we need to take besides getting the vaccine when we can?
Wen: The good news about the emerging strains is that they are still distributed in the same way, through the respiratory route, mainly through close contact and also through aerosol transfer. (While surface transfer is also possible, it is likely to contribute less than these other methods.) That means that the same precautions you took 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. That means the activities we thought were low risk are now more dangerous. We still need to take more measures to protect ourselves.
An N95 or KN95 can come in handy if you are in a particularly small space where you cannot physically keep a distance, although these masks are scarce and can be uncomfortable to wear for long periods of time. You should be even more careful not to be indoors with others and, if necessary, keep a physical distance and try to be only in well-ventilated areas.
The advent of the more contagious variants means we need to double the public health measures that we know are 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 down the spread of the virus. So let’s please get vaccinated when it’s our turn and protect ourselves – for yourself and those around you.