After a year of COVID-19, the country (and the world) is in a race to get people vaccinated before the new, more transmissible variants of the coronavirus can gain the upper hand. We talk with two experts on these COVID-19 vaccines and variants of the SARS-CoV-2 virus to get you the information you need.
Health departments and healthcare systems have been administering the mRNA vaccines from Moderna and Pfizer/BioNTech for a few months. Now, the FDA Advisory Panel will be reviewing information about the vaccine from Johnson & Johnson. The agency is considering whether to authorize its use in this pandemic emergency. Dr. Paul Offit is on that panel and describes what the reviewers are looking for in these vaccine hearings.
There is new data suggesting that the immunizations are effective at reducing severe illness and death from COVID-19. In Israel, where nearly half the population has now been vaccinated, cases are dropping dramatically.
Nonetheless, there are worries on the horizon. Scientists are not sure how well the current vaccines will prevent the B.1.1.7 variant first identified in the UK. A clinical trial in South Africa convinced officials there that the AstraZeneca vaccine being tested is substantially less effective against the B.1.351 variant that now dominates there. Both of these variants are spreading rapidly around the world and have been identified in parts of the US.
Even after you get your second shot, the variants mean you can’t just let down your guard. Until most of the country has been immunized, it will make sense to continue wearing masks to stop the possible spread of the variants. Although most people who have recovered from COVID-19 don’t get it again, there are a few credible reports of reinfection, possibly due to variants that can trick the immune system. In the future, the vaccine makers may develop boosters specifically for these new forms of SARS-CoV-2.
Dr. Ralph Baric has been studying coronaviruses since long before the pandemic began, for more than three decades. He was not taken by surprise, and he suggests that we should be preparing better for future pandemics. We asked him to describe strains, mutations and variants and to tell us how exactly masks work.
Difficult as it has been to get the vaccine into millions of arms, this is the way to achieve herd immunity. At that point, the virus can no longer spread easily because an infected person doesn’t encounter any unprotected people.
Dr. Baric describes medications to treat COVID-19. He was instrumental in studying remdesivir. Now, data show that baricitinib and remdesivir are more effective than remdesivir alone (NEJM, Dec. 11, 2020).
Another medication, molnupiravir, is also under study. Initially, when Dr. Baric’s lab collaborated on its development, they called it EIDD2801. Currently, laboratory research is promising, but we still need clinical trials. When those begin, molnupiravir will have advantages over remdesivir and monoclonal antibodies such as bamlanivumab. As an oral medicine, molnupiravir will be more easily administered to people early in the course of their illness. It might also help to prevent infection in exposed individuals.
Dr. Baric concluded with some approaches to help prevent pandemics in the future.
Paul A. Offit, MD is the Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.
Ralph Baric, PhD, is the William R. Kenan, Jr. Distinguished Professor in the Department of Epidemiology and Professor in the Department of Microbiology and Immunology of the University of North Carolina at Chapel Hill. He is a Harvey Weaver Scholar from the National Multiple Sclerosis Society and an Established Investigator Awardee from the American Heart Association. In addition, he is a World Technology Award Finalist and a fellow of the American Association for Microbiology.
He has spent the past three decades studying coronaviruses and is responsible for UNC-Chapel Hill’s world leadership in coronavirus research. For these past three decades, Dr. Baric has warned that the emerging coronaviruses represent a significant and ongoing global health threat, particularly because they can jump, without warning, from animals into the human population, and they tend to spread rapidly.