WOMENew lab data suggests that vaccines and previous infections may not provide adequate protection against some of the new COVID-19 variants emerging in the United States and around the world .
Dr. David Ho, director of Columbia University’s Aaron Diamond Center for AIDS Research, and his team reported results from a series of studies published in the journal Nature. They showed that some of the newest variants — BQ.1, BQ.1.1, XBB and XBB.1, all derived from Omicrons — are dodging both vaccine- and infection-derived immunity.
These new variants all have mutations in the region that binds to cells and infects them, which means they are highly transmissible, like previous Omicron variants. BQ.1 is growing steadily in France, according to a public database of SARS-CoV-2 . variants GISAID. In mid-November, European health officials expected the variant to be accounts for 50% of cases in Europe, and become the dominant strain in that region by early 2023. XBB is growing rapidly in Singapore and India. Both variants produce new strains that each have an additional mutation to produce BQ.1.1 and XBB.1. As of early November, BQ.1 and BQ.1.1, combined, now form about 35% of new cases in the US
Other learn found a similar decrease in antibody protection against BQ.1 in vaccinated individuals. But Ho’s team has conducted what may be the most comprehensive look to date of BQ.1, BQ.1.1, XBB and XBB.1, and how immunity is now available — from the original mRNA vaccine. , new Omicron boosters and natural infections — is up to them. Scientists took the serum from 88 people in 5 groups (below) and exposed it to 4 variants in the lab. Here’s what they found:
- People who have been fully vaccinated and vaccinated once (total of three initial mRNA vaccinations) had a 37- and 55-fold lower neutralizing potency for BQ.1 and BQ.1.1, respectively, than they were against the original SARS-CoV-2 virus. and about 70 times lower neutralization level against XBB and XBB.1.
- Those who are fully immunized and boosted twice (total of four initial mRNA vaccinations) had 43 and 81-fold lower neutralization for BQ.1 and BQ.1.1, respectively, than they had against the primary virus, and lower neutralization 145 and 155 times for XBB and XBB.1, respectively.
- Those who are fully immunized and boosted twice (three doses of the original vaccine plus one dose) Enhanced Omicron) were 24 and 41 times lower in neutralization against BQ.1 and BQ.1.1, respectively, than against the primary virus, and 66 and 85 times lower in neutralization against XBB and XBB.1, respectively. response.
- Persons who have been fully vaccinated, those who have received their primary booster, and those who have been infected with BA.2 had 20-fold and 29-fold lower neutralization levels than BQ.1 and BQ.1.1, respectively, than against baseline virus, and 103- and 135-fold lower neutralization than XBB and XBB.1 respectively. , corresponding.
- Persons who have been fully immunized, those who have received their primary booster, and those who have been infected with BA.4 or BA.5 had 13 and 31 times lower neutralization levels than BQ.1 and BQ.1.1, respectively, compared with when they were against the original virus, and 86 and 96 times lower neutralization levels compared to XBB and XBB.1 respectively. , corresponding.
The results showed that people who had been infected with BA.2, BA.4 or BA.5 had the smallest reduction in the level of neutralizing antibodies against BQ.1 and BQ.1.1. But those who received three doses of the original vaccine and one booster dose of Omicron produced only slightly better neutralizing antibody protection against XBB and XBB.1 than those who received three doses of the original vaccine. . Public health experts say that while vaccines may be less effective against newer variants, they continue to protect people from severe COVID-19. There is early evidence that vaccine-induced immunity may also produce more antibodies against the virus over time.
However, these results are a reminder that vaccines and drug treatments need to evolve with the virus. “These new variants are extremely good at evading our antibodies and could very well compromise the effectiveness of the vaccine,” Ho said. They may also shy away from available antibody-based treatments for COVID-19, he said. The National Institutes of Health’s COVID-19 Treatment Guidelines currently includes only one monoclonal antibody therapy, bebtelovimab, because the virus has evaded all previously allowed antibody treatments. But in an update in October, the NIH scientists acknowledged that “subvariants BQ.1 and BQ.1.1 are resistant to bebtelovimab.” Therefore, the drug is only recommended if people cannot take antiviral drugs Paxlovid or remdesivir, or if these drugs are not available. Viruses can also evade these treatments, but they are still the first line of defense against severe SARS-CoV-2.
The good news is that in places where these variants are widespread, they do not appear to be associated with more severe COVID-19 disease — as measured by hospitalizations and deaths — than with other Omicron repeats. However, public health experts say the spike in infections could still strain health resources, especially for other respiratory infections, including flu and RSV, also get motivated. The combination of several circulating infectious diseases can mean more illnesses overall, and as a result, more people can become seriously ill and require intensive medical care.
The proliferation of BQ.1, BQ.1.1, XBB and XBB.1 shows the fact that when it comes to immunity, viruses can always be one step ahead, especially with regard to vaccines. “I will start making these vaccines and start testing them on animals,” Ho said. Even if those efforts had begun now, it is possible that they would still lag behind the virus and the new mutations it continues to acquire. That’s why researchers are working on developing vaccines that can be more widely applied to a wide range of different coronaviruses, which could shorten the amount of time it takes to build up immunity. vaccinated population.
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