Researchers are afraid that vaccinations will not proceed quickly enough to prevent new, perhaps more deadly coronavirus strains from occurring.
New variants that can avoid existing vaccines can create a cycle where people need to continue to get new coronavirus shots for years.
UK officials said on Friday that the variant identified there could have a higher mortality rate than the original, although the evidence is “uncertain.”
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The global rollout of vaccines is running counter-clockwise: New, more contagious variants of coronavirus are spreading around the world, and it is unclear how well existing vaccines work against these strains.
So far, vaccines are effective against the strain identified in December in the UK, called B117. However, preliminary research suggests that vaccines may be less effective against B1351, the strain identified in South Africa.
“That’s so much more the reason we need to vaccinate as many people as possible,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday. “Viruses do not mutate unless they replicate, and if you can suppress it by a very good vaccine campaign, you can actually avoid this harmful effect that you can get from the mutations.”
But the process of getting shots in arms is starting slowly in many countries. The United States has administered more coronavirus vaccines than any other nation, but they have only distributed approx. 19 million doses as of Friday.
Researchers fear that the current rate of vaccinations may give rise to too many new strains. This could lead to a scenario where researchers have to update vaccines regularly.
Michael Worobey, a viral evolutionary biologist at the University of Arizona, recently told the BBC that the emergence of new coronavirus strains could be “a glimpse of the future where we will be in an arms race with this virus just as we are with the flu.”
It is also possible that a more deadly strain will appear before most people are vaccinated. In that case, coronavirus shots may routinely be required for adolescents, similar to polio or measles vaccines.
Coronavirus can eventually look like the common cold
The future of coronavirus depends heavily on our ability to quickly control transmission. The more people develop immunity – whether through natural infection or vaccines – the faster the virus will reach an endemic state, meaning it will circulate sustainably but no longer hit pandemic-level peaks.
In a recent study, researchers at Emory University and Pennsylvania State University suggested that coronavirus could eventually look like a cold that infects humans in childhood.
Under the most likely scenario of the study, children would get their first COVID-19 infection on average between 3 and 5. Almost all children would be infected by the age of 15. Since pediatric infections are generally mild, there would be no need to vaccinate. children in advance. Infants may also have some degree of immunity at birth.
“For the first six months of life, or maybe longer if you are breastfeeding, children have the mother’s antibodies from their mother, both from the umbilical cord and from breast milk, so there is some time in the first year or so of life when children do not get a primary infection, ”said Jennie Lavine, lead author of the study, Insider.
The researchers estimated that re-infections would be even milder – and perhaps even increase immunity to related coronavirus strains.
If vaccinations continue rapidly, the New York Times reported, the virus could reach this endemic state in as little as six months to a year. Fauci recently estimated that life could return to normal in the fall if 70-85% of Americans were vaccinated by the end of the summer.
However, based on observed patterns of other human coronaviruses, the researchers’ model suggested that the new coronavirus was likely to become endemic within five to ten years. Without rapid vaccinations, in other words, outbreaks could continue for some time.
Updating of vaccines to new variants
Vaccines trigger the production of virus-specific antibodies, so if people are exposed to the virus after vaccination, the same antibodies will recognize the virus and destroy it before it has a chance to replicate widely.
In an ideal scenario, coronavirus vaccines would protect against all strains of the virus for several years.
However, researchers are afraid that new coronavirus variants may be different enough from the original that they could avoid the antibodies that were developed in response to vaccines. If that happens, researchers may have to constantly adjust the vaccines’ genetic instructions to defeat new strains. The process is not necessarily difficult, but it will mean that people need follow-up shots.
“If we ever have to change the vaccine, it’s not something that is very stressful,” Fauci said Thursday. “We can do that given the platforms we have.”
But a scenario where new strains require people to be regularly revaccinated – as is already the case with flu shots – is becoming more and more likely the longer it takes to get the current shots in arms.
However, it is also possible that other layers of immunity may protect people from new strains. White blood cells known as T cells and B cells also remember foreign invaders, often for longer periods than antibodies. A recent study suggested that recovered coronavirus patients had robust T-cell and B-cell immunity for at least eight months. A study of SARS caused by a genetically similar coronavirus showed that recovered patients had T cell immunity 17 years after their infection.
A more lethal strain could make coronavirus shots routine
By rapidly vaccinating people, public health officials hope to avoid the worst-case scenario: the emergence of a more deadly coronavirus strain.
“Things that we need to keep an eye on would prevent this from becoming a very mild, endemic thing that does not require vaccination would be if the virus somehow changed so that infections in childhood became more serious,” said Lavine.
In that case, she added that all young people should get shots before acquiring their first coronavirus infection.
There is already some evidence that the British coronavirus strain may be more deadly than the original. Britain’s top scientific adviser, Patrick Vallance, said on Friday that the new variant could have up to 30% higher mortality among some age groups, although the evidence remained “uncertain.”
The good news, though, is that existing coronavirus shots seem to work against it.
“From what we’ve seen so far, the variants described do not alter the ability to neutralize antibodies induced by vaccination to neutralize the virus,” Modern’s chief physician Tal Zaks told the JP Morgan Healthcare Conference earlier this month.
But it makes the task of vaccinating people even more urgent.
“Everyone will probably get infected once,” Lavine said. “Let’s turn it into an infection after the vaccination so you don’t get really sick from it.”
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