A year ago we were in lockdown, quarantining the mail for fear that it would give us COVID-19. Now, more than 20% of people in Massachusetts are fully vaccinated against this behemoth, and we know how to protect ourselves from it while we wait our turn for the jab: mask, ventilate, distance, wash your hands, get tested. We can see the light at the end of this tunnel.
But there’s a nasty little group blocking our way, like a group of bandits trying to stop the train and steal the Postal Service money. They have peculiar, unmemorable names: B.1.1.7, B.1.351, P.1, and B.1.427/429. We call them the variants.
Whenever viruses reproduce, mutations—changes in a virus’s genetic code—can happen. Most of those mutations either do nothing or they kill the virus. But every so often a mutation changes the virus in a way that makes it easier for the virus to survive and/or reproduce.
These souped-up viruses are the variants public health folks are most worried about. All of them have mutations that do one or both of the following: They make it easier for the virus to infect human cells, or they help the virus evade part of the immune response.
B.1.1.7 is the leader of the pack. This little bugger first showed up in England and is about 50% more transmissible than the original or “wild type” virus. It’s also probably about 65% more deadly. According to the Department of Public Health, B.1.1.7 is now “widespread in Massachusetts and . . . circulating within communities,” and I’ll bet you anything that it’s here in Harvard and/or the towns next door. I don’t have hard evidence for that claim, but seriously— you don’t want to bet against me on this one.
B.1.351 is the second in command. First identified in South Africa, it may also be about 50% more transmissible, but its claim to fame is its ability to evade one part of the immune response (more about that later). According to the CDC, this guy is nowhere near as widespread as B.1.1.7 around here. Yet.
P.1 is the quiet gang member nobody pays attention to until they realize he’s Seriously Evil. P.1 isn’t that prevalent across the U.S., but its behavior in Brazil, where it was discovered, suggests that it has a disturbing capacity to reinfect folks who’ve already had COVID-19. It’s been spreading on Cape Cod recently, and national surveillance indicates that Massachusetts now has the highest number of P.1 cases in the country.
B.1.427/429 is the leader of the rival gang that’s trying to take over the territory. It was first documented in California, where it now represents more than 50% of cases, according to the CDC. It’s similar to B.1.351 in its effects but appears only about 20% more transmissible than the wild type of SARS-CoV-2 (the virus that causes COVID-19).
So, the big question: Do the vaccines work against the variants? If you’re asking, “Will these vaccines keep people from dying of COVID-19,” the answer so far is yes. They’ll also keep people out of the hospital. And that, it’s critical to remember, is the goal of these vaccines: to keep people from dying and to keep the health care system from being overwhelmed.
When it comes to preventing moderate, mild, or asymptomatic COVID-19, it depends on the vaccine and the variant. Other than B.1.1.7, all the variants have ways of eluding some antibodies, which are one of the immune system’s first lines of defense. But antibodies are just one weapon in the system’s complicated arsenal. The vaccines put the whole arsenal on alert, and they do it more effectively than a COVID-19 infection does. So if you’re wondering which vaccine is the best one to get, that’s easy: It’s the one you can get the soonest.
That being said, none of the vaccines is 100% effective against moderate to asymptomatic disease. That’s why the CDC recommends that vaccinated folks wear masks and keep their distance in public; while they’re much less likely to carry and transmit the virus than unvaccinated people are, it can still happen. And every new infection is another chance for the virus to mutate, and for a new, even nastier member of the gang to show up. The variants don’t care that we’re all tired of this stupid pandemic. So hang in there, wear your mask, and wash your hands. The cavalry is coming.
Liz Ruark is the founder of covidsafeschools.org and co-chair of COVID-Safe Schools, Harvard Public Schools’ community COVID-19 screening program. She holds a DVM degree from Tufts Cummings School of Veterinary Medicine.