As Alabama continues to roll out vaccines, the state this week saw its first confirmed case of the highly contagious coronavirus strain from the UK.
And the steady worldwide spread of other varieties from Brazil and South Africa, which was found in South Carolina last week, increases the importance of immunizing Americans as quickly as possible.
However, new uncertainties arise as to how effective the existing vaccines will be against the mutations and whether it is necessary to roll out an amended version of the shots.
“This is the latest wrinkle with COVID,” says Dr. William Schaffner, Professor of Infectious Diseases at Vanderbilt University Medical Center. “Just when we thought we needed to respond to it and develop the vaccine and use it now, we have some new mutations popping up.”
Experts like Schaffner are hopeful that the existing vaccines will still be effective against the new strains, but say more research is needed.
On Friday, dr. Antony Fauci called the arrival of new variants in the United States “a wake-up call” to vaccinate as many Americans as possible to spread the virus and mutate further.
“It’s an incentive to do what we ‘ve been saying all along: to vaccinate as many people as possible, as fast as we can,” he said.
The current Moderna and Pfizer vaccines appear to be effective against the highly contagious British variant, which was identified this week in the Montgomery and Jefferson provinces and is fast becoming the dominant COVID-19 strain in the United States. New research this week shows that stress can also cause serious cases.
Johnson and Johnson announced on Friday that the vaccine, which has not yet been approved by the FDA, is slightly less effective, with 57 percent efficacy against the South African variant, compared to 72 percent with the original strain. The South African variant was identified in South Carolina this week in two individuals with no apparent connection and no travel history.
Moderna modifies its vaccine for use on the South African tribe, just in case it becomes necessary as more becomes known.
A Brazilian variant is of particular concern to scientists because of how fast it has spread so far. This week, the variant was identified in Minnesota in a person who traveled to Brazil.
“The problem with a new virus is that there is so much room to grow and move and change to optimize itself,” said Dr. Michael Mina, Harvard School of Public Health, said. “The question is how fast is it going to update on its own?”
According to experts, more research needs to be done into how effective the vaccines are against the South African strain, which currently deviates most from the original virus.
“Whatever the mutation happens, the vaccine manufacturers can keep up with it, but given the multiplicity of strains circulating at the same time, it can be a challenge,” said Dr. Schaffner said.
Dr Mina, of Harvard, said he was less confident that the existing vaccines could be updated for all future variants. Assuming that it is possible to successfully modify existing vaccines, it may make sense to first wait and see where the virus is headed,
“If we make a change to the vaccine, by the time it starts, we could have a new virus in our hands again or a new version of the virus,” he said.
But dr. David Kimberlin, a pediatric infectious disease specialist at the University of Alabama in Birmingham, is hopeful that a modified vaccine will not be needed.
“What we know now is quite reassuring. “It seems that the people who receive the current vaccines have protection,” he said. “What we know today may not be what we know a week from now or a month from now.”
The rollout of an updated vaccine will have complications, such as whether new trials would be necessary.
And then there will be renewed questions about which groups for vaccine priorities should give the shots first, especially if some of the most vulnerable people have already been immunized and younger people have not yet received any doses, Dr. Mina said.
“It’s going to be a big challenge to do it well and fairly,” he said.
“We are already seeing major problems in getting fairness in the distribution of vaccines.”
And it is not clear how willing some people will be to act for a hypothetical third shot, whether it is a booster or a new vaccine. Recent polls show only three-quarters of Americans say they will definitely or probably get a vaccine.
“People are already exhausted,” said Dr. Schaffner said. ‘They will come back to us and say’ what do you mean, why did you not take care of this virus the first time? Now you say there are new tribes? Give me a chance ‘”
For now, expanding rapid testing, wearing masks and social distance are the most powerful tools to prevent future mutations of the virus, Drs. Mina said.
“The best thing we can do to help the vaccines, to make sure the vaccines retain their protective nature, is to get cases as low as they can get in other ways,” he said.
Dr. Kimberlin at UAB encouraged Alabamians to get a vaccine when it was their turn.
“Pull masks between now and then and after,” and stay six feet apart, he said. “It’s going to be the kind of things we’ll get through this period as we learn more about the variants.”