Keeping on top of COVID-19 and the impact on your health care environment is a never-ending task. With emerging 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.

As COVID-19 cases rise and the vast majority of people dying today from COVID-19 are unvaccinated,1 vaccination conversations are 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.2 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.2 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 October 6, 2021, the current dominant coronavirus variant is delta. The identified variant spread faster than other variants, and delta potentially cause more severe disease. Most variants also have a higher resistance to antibody resistance—whether from monoclonal antibody treatments or antibodies generated by previous COVID-19 infection or vaccination.

Delta (B.1.617.2)

The delta variant now accounts for 83% of new coronavirus cases in the US.2 The delta variant is twice as contagious as earlier variants and responsible for more severe illness.3 Delta is also responsible for a greater number of COVID-19 cases among young people. While unvaccinated individuals are at the greatest risk, according to Mayo, vaccinated people may have a breakthrough infection and can spread the delta variant, but it appears they spread it for a shorter period.

What other COVID variants being monitored?

The current coronavirus variants are no longer a variant of concern, but continue to be closely monitored include alpha, gamma, and beta.

Alpha (B.1.1.7)

The alpha variant is associated with a 50% increase in transmission versus previous variants.3 This fast-spreading variant may also increase the risk of hospitalization and death.

Gamma (P.1)

This variant is more resistant to treatment, including certain monoclonal antibody medications and antibodies generated by previous COVID-19 infection or vaccination.3

Beta (B.1.351)

Like delta and alpha variants, beta spreads more readily than previous variants. And like gamma, neutralizing antibodies are less effective against the beta variant.3

Do existing COVID-19 vaccines protect against the variants?

The FDA-approved Pfizer vaccine and the Moderna vaccine (gained Emergency Use Authorization and completed submission for full approval) are effective to protect against severe disease, hospitalization, and death.8 While authorized COVID-19 vaccines work against the above-mentioned variants, their efficacy is being closely monitored as new variants arise.4

In clinical trial settings, neutralizing antibodies generated from current vaccines were found to be less effective against variants than the original virus; however, they still protect against developing severe symptoms or illness.4 COVID-19 variants escape more easily from antibodies (perhaps the variant’s target protein has mutated), but an increase in antibody levels – say, from a second dose – can strengthen the immune response.4

Your 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

Early research has provided insight into the vaccines’ effectiveness against COVID-19 variants:

Pfizer-BioNTech

A full dose of the Pfizer vaccine is 88% effective at preventing symptoms and 96% effective at preventing severe disease caused by the delta variant; it is 93% effective at preventing symptoms caused by the alpha variant.3

Moderna

After just one dose, the Moderna vaccine is already 72% effective at preventing symptoms and 96% effective at preventing severe disease by the delta variant.3

Janssen/Johnson & Johnson

The Johnson & Johnson vaccine is 85% effective at preventing severe illness caused by the delta variant.3

Are COVID-19 vaccine boosters needed to protect against the variants?

The CDC and FDA currently state that normally healthy fully vaccinated people do not need a vaccine booster as they get protected against severe disease and death – including from COVID-19 variants.3 Notably, the majority of COVID-related hospitalizations and deaths reported today are among unvaccinated people.3 Pfizer and Moderna, however, have recently been authorized for an additional dose in certain immunocompromised patients and those over 65 years. 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 help reduce the actual spread of COVID-19 and its variants. For patients with a weakened immune system–from age or an underlying medical condition–or who are unvaccinated, masks are critical to avoid the severity of COVID-19.4 Maintaining distance and frequent and thorough handwashing also get recommended for vulnerable populations.

 
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References
1 Wamsley L. The Lambda Variant: What you should know and why experts say not to panic. NPR. https://www.npr.org/sections/coronavirus-live-updates/2021/07/22/1019293200/the-lambda-variant-coronavirus-what-you-should-know. Published July 22, 2021. Accessed September 1, 2021.
2 Variants of Coronavirus. WebMD. https://www.webmd.com/lung/coronavirus-strains#1. Accessed September 1, 2021.
3 DeSimone D. What’s the concern about the new COVID-10 variants? Are they more contagious? Mayo Clinic Web site. https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-variant/faq-20505779. Published August 21, 2021. Accessed October 6, 2021.
4 COVID-19 Vaccines Work. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/work.html. Published August 16, 2021. Accessed September 1, 2021.
5 Key Facts About Seasonal Flu Vaccine. CDC Web site. https://www.cdc.gov/flu/prevent/keyfacts.htm. Updated August 26, 2021. Accessed September 17, 2021.
6 What You Need to Know About Variants. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/variants/variant.html. Updated September 20, 2021. Accessed October 8, 2021.
7 Tracking SARS-CoV-2 variants. World Health Organization Web site. https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/. Accessed October 8, 2021.
8 SARS-CoV-2 Variant Classifications and Definitions. CDC Web site. https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html. Accessed October 8, 2021.
9 FDA Approves First COVID-19 Vaccine. U.S. Food & Drug Administration Web site. https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine. Accessed October 8, 2021.