Keeping on top of COVID-19 and the impact on your health care environment is a never-ending task. With variants of the SARS-CoV-2 virus continuing to threaten both patient health and hospital capacity, we know the importance of providing up-to-date information.
The CDC actively monitors all coronavirus variants to make recommendations about the classification of variants (variant of concern, variant of interest, and variants being monitored). Some are considered variants of interest: based on how easily they spread, how severe symptoms are, and how they get treated. High-consequence variants can lead to an increase in COVID-19 cases, hospitalizations, and even death, making it critical to increase patient understanding.
Even as COVID-19 cases level off, the vast majority of people hospitalized or dying today from COVID-19 are unvaccinated.8 That makes vaccination conversations crucial. Patients look to you and your staff as a source of truth. Here are some commonly asked questions to keep your patients informed about the COVID-19 variants and revisiting vaccination.
How do variants emerge?
Viruses constantly change to adapt and survive, and variants emerge when a strain has one or more mutations that differ from others. Mutations occur in the process called replication: copying errors during the transcription of viral RNA result in changes to the genetic material.1 When these mutations get passed down, the altered virus is called a variant.
Mutations occur often and for no particular reason – some new variants will emerge and disappear, others will persist and become dominant.1 Some mutations allow a virus to evolve into a more robust version of itself, helping it spread significantly faster, causing more severe illness, or becoming resistant to treatment and vaccines.
Pharmaceutical and biomedical companies continuously evolve their strategies to treat and protect against the coronavirus and its variants. Of course, the best way to slow the emergence of dangerous new variants is to reduce the spread of infection in the first place.
What are the dominant COVID-19 variants?
As of April 2022, the current coronavirus Variant of Concern (VOC) is omicron.2 Like other variants, omicron has a higher resistance to antibodies—whether from available treatments, antibodies generated by previous COVID-19 infection, or vaccination. The omicron variant continues to spread throughout communities and can infect people who have been vaccinated or have previously had COVID-19.2
Omicron (B.1.1.529, BA.1, BA.1.1, BA.2, BA.3, BA.4 and BA.5)
The omicron variant is classified as a VOC because there is evidence of increasing transmission, more severe disease, and reduced effectiveness of treatments or previous vaccines.1 As of August 2022, BA.5 has caused just under 90% of COVID-19 infections in the U.S.3
Staying current on recommended vaccines and boosters is effective in preventing severe illness, hospitalizations, and death. Studies show the vaccines provide about 90% protection against symptomatic infection, severe illness, and death. 9
Variant Being Monitored
Several COVID-19 variants are categorized as Variant Being Monitored (VBM). This classification is based on evidence showing that: 1
- The amount of variant in circulation at national and regional levels has fallen significantly and has continued to fall.
- The variant does not currently pose a significant risk to U.S. public health.
VBMs currently include:1
- Alpha (B.1.1.7 and Q lineages)
- Beta (B.1.351 and descendent lineages)
- Gamma (P.1 and descendent lineages)
- Delta (B.1.617.2 and AY lineages)
- Epsilon (B.1.427 and B.1.429)
- Eta (B.1.525)
- Iota (B.1.526)
- Kappa (B.1.617.1)
- 1.617.3
- Mu (B.1.621, B.1.621.1)
- Zeta (P.2)
Do existing COVID-19 vaccines protect against the variants?
COVID-19 vaccines are about 90% effective at preventing symptomatic infection, severe illness, and death from COVID-19.3 For best protection, everyone 6 months and older is advised to stay up to date with COVID-19 vaccines, which includes getting boosters if eligible.4
The annual flu shot is a good example of how vaccines protect against multiple strains. The flu virus indeed mutates much more frequently than the coronavirus, leading scientists to redesign the flu vaccine each year based on what research determines will be the most common strain.5 But even if the exact flu strain isn’t targeted by the season’s shot, it can effectively reduce the number of hospitalizations and deaths due to the flu.5
Are COVID-19 vaccine boosters needed to protect against the variants?
Yes. The CDC advises a booster dose for all people ages 5 years and older.12 Since September 2022, the updated boosters from Pfizer-BioNTech and Moderna are bivalent because they protect against both the original virus that causes COVID-19 and the omicron variants BA.4 and BA.5.12 Original boosters were monovalent, because they protected against the original virus and provided some protection against omicron. The updated boosters provide better protection again omicron
Children who are age 5 years are advised to get the Pfizer-BioNTech bivalent booster at least 2 months after their second primary dose or last monovalent booster. Children ages 6 to 11 can get either the Pfizer-BioNTech or Moderna booster at least 2 months after their second primary dose or last monovalent booster.12
Everyone age 12 or older should get a booster of either the Pfizer-BioNTech or Moderna vaccine 2 months after their last primary dose or last monovalent booster. Adults 18 and older who got the Johnson & Johnson or Novavax vaccine are advised to get the bivalent Pfizer-BioNTech or Moderna booster. A monovalent Novavax booster is available in limited situations.12
Notably, the majority of COVID-related hospitalizations and deaths reported today are among unvaccinated people.3 You can follow updates regarding COVID-19 booster shots from the CDC website.
What are other health and safety precautions that need to get followed?
While the vaccines remain effective to reduce symptoms and severity, masks and respirators help reduce the actual spread of COVID-19 and its variants.10 For patients with a weakened immune system–from age or an underlying medical condition–or who are unvaccinated, masks or respirators are critical to avoid the severity of COVID-19.11 Maintaining distance and frequent and thorough handwashing also are recommended for vulnerable populations.
If you are in an area with a medium or high COVID-19 Community Level, reinforce with your patients who are at high risk of getting very sick to wear a high-quality mask or respirator indoors in public. If community level is high, encourage all your patients to wear a high-quality mask or respirator, even if they are fully vaccinated. This is true for anyone age 2 or older. Encourage them to be aware of their Community Level.6
References
1 SARS-CoV-2 Variant Classifications and Definitions. CDC Web site.https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-classifications.html. Updated April 26, 2022. Accessed October 24,2022.
2 Variants of the Virus. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/variants/about-variants.html Updated August 11, 2022. Accessed October 24, 2022.
3 Benefits of Getting A COVID-19 Vaccine. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html. Updated August 17, 2022. Accessed October 24, 2022.
4 COVID-19 Vaccines Work. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/work.html. Updated June 28, 2022. Accessed October 24, 2022.
5 Key Facts About Seasonal Flu Vaccine. CDC Web site. https://www.cdc.gov/flu/prevent/keyfacts.htm. Updated August 25, 2022. Accessed October 24, 2022.
6 COVID-19 by County: Know Your COVID-19 Community Level. CDC Web site.https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html. Updated August 11, 2022. Accessed October 24, 2022.
7 Different COVID-19 Vaccines. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html. Updated January 21, 2022. Accessed March 10, 2022.
8 COVID Data Tracker. CDC Web site. https://covid.cdc.gov/covid-data-tracker/#covidnet-hospitalizations-vaccination. Updated March 1, 2022
9 Benefits of Getting A COVID-19 Vaccine. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html. Updated August 17, 2022. Accessed October 24, 2022.
10 Types of Masks and Respirators. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/types-of-masks.html. Updated September 8, 2022. Accessed October 24, 2022.
11 People Who Are Immunocompromised. CDC Web Site. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-who-are-immunocompromised.html. Updated October 11, 2022. Accessed October 24, 2022.
12 Staying Up to Date with DOVID-19 Vaccines Including Boosters. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fbooster-shot.html. Updated October 24, 2022. Accesses October 24, 2022.
