In this current video from MedCram, Dr. Seheult explores the latest COVID risk assessment on the new BA.2.86 variant also known as Pirola.
Is there an uptick in COVID-19?
Testing nowadays is inconsistent, so Dr. Seheult went to review the analysis from wastewater data. The graphs do show that there is some increase in the wastewater detection of SARS-CoV-2 virus concentration, but it is not anywhere near the levels back in January 2022. However, in the last six months there has been a steady increase in the prevalence of the disease throughout the country. For hospitalizations, both in the U.S. and Canada, we are seeing an increase as well. There is still a benefit being seen in those individuals that have been vaccinated as compared to those who have not been vaccinated in decreasing hospitalizations. For ICU admissions, in the United States, there is also an increase being noted. Hospitals are no longer doing routine testing for SARS-CoV-2 so only individuals who are symptomatic are being tested. Daily deaths are not showing an increase.
What is the current dominant strain?
The current circulating variants show that EG.5 is the dominant variant. The BA.2.86 is not seen in any significant numbers, but due to it having so many mutations in it, there was a concern that this was going to cause greater escape from existing immunity from vaccines and previous infections compared with other recent variants. It had changes that represented over 30 amino acid differences compared with BA.2 which was the dominant Omicron lineage. This number of genetic differences is of the same magnitude as seen between the initial Omicron variant and the previous variants such as Delta. The current increase in hospitalizations and ICU admissions is not being affected by the BA.2.86 variant. Recent articles are showing that the latest COVID variant ie BA 2.86 is less worrisome than first expected.
What about vaccinations and boosters?
In terms of vaccinations, we don’t have clinical data that is published yet on the most recent boosters that will be coming out this fall. There was a clinical data press release from Moderna that stated the clinical trial data from research assays confirmed that Moderna’s updated COVID-19 vaccine showed an 8.7 to 11 fold increase in neutralizing antibodies against circulating variants including BA.2.86, EG.5 and FL.1.5.1 variants. They also note in the release that postmarketing data demonstrate increased risks of myocarditis and pericarditis particularly within 7 days following the second primary series dose or first booster dose. We already know this data from this study that was released that looked at the risk of myocarditis after the sequential doses of COVID-19 vaccine and SARS-CoV-2 infection by age and sex. This study involved 43 million people who received at least 1 dose of vaccine, 21 million people receiving 3 doses and 6 million having a SARS-CoV-2 infection before or after vaccination. Myocarditis occurred in 0.007% of people with 617 events 1 to 28 days after vaccination. They risk stratified it and showed that the Moderna second dose had the highest risk associated with it for myocarditis especially in males under the age of 40. The next highest risk category were males and females over the age of 40 who were unvaccinated.
When people are considering whether to get boosted, they need to evaluate what their comorbidities are as well as their sex and age group to determine what each individual risk is. This is something you should discuss with your physician if you have concerns.
LINKS / REFERENCES:
The Biobot Network of Wastewater Treatment Plants (Biobot) | https://biobot.io/data/
Coronavirus (COVID-19) Cases (Our World In Data) | https://ourworldindata.org/covid-cases
EG.5 now dominant COVID variant in US. Here’s what to know (ABC News) | https://abcnews.go.com/Health/eg5-now…
Risk Assessment Summary for SARS CoV-2 Sublineage BA.2.86 (CDC) | https://www.cdc.gov/respiratory-virus…
Sensitivity of BA.2.86 to prevailing neutralising antibody responses (bioRxiv) | https://www.biorxiv.org/content/10.11…
New Data from Barouch Lab (Twitter/X) https://twitter.com/lasradoN/status/1…
Should you be worried about latest COVID variant? Will the new vaccines fight BA.2.86? (USA Today) | https://www.usatoday.com/story/news/h…
MODERNA CLINICAL TRIAL DATA CONFIRM ITS UPDATED COVID-19 VACCINE GENERATES STRONG IMMUNE RESPONSE IN HUMANS AGAINST BA.2.86 (Moderna) | https://investors.modernatx.com/news/…
Risk of Myocarditis After Sequential Doses of COVID-19 Vaccine and SARS-CoV-2 Infection by Age and Sex (Circulation) | https://www.ahajournals.org/doi/full/…
The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study (NIH) | https://www.ncbi.nlm.nih.gov/pmc/arti…
Pfizer and BioNTech Receive Positive CHMP Opinion for Omicron XBB.1.5-adapted COVID-19 Vaccine in the European Union (Pfizer) | https://www.pfizer.com/news/press-rel…
Information about the Novavax COVID-19 Vaccine, Adjuvanted (Novavax) | https://us.novavaxcovidvaccine.com/no…
Myocarditis and pericarditis have been reported with Nuvaxovid (Medsafe) | https://www.medsafe.govt.nz/safety/Al…