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BA.5, now dominant U.S. variant, may pose the biggest threat to immune
protection yet

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Coronavirus


BA.5, NOW DOMINANT U.S. VARIANT, MAY POSE THE BIGGEST THREAT TO IMMUNE
PROTECTION YET

The FDA recommended that Covid vaccine makers target two omicron subvariants —
BA.4 and BA.5 — in new booster shots expected to come this fall.
00:06 /01:43

Tap to Unmute


SUMMER COVID-19 SURGE MAY BE ON THE HORIZON, OFFICIALS SAY

01:44

Link copied
July 7, 2022, 12:52 AM UTC
By Aria Bendix

A new version of omicron is dominant in the U.S.

The coronavirus subvariant known as BA.5 accounted for nearly 54% of the
country's Covid cases as of Saturday, according to the Centers for Disease
Control and Prevention. A similar subvariant, BA.4, makes up 17% more.




"They're taking over, so clearly they're more contagious than earlier variants
of omicron," said David Montefiori, a professor at the Human Vaccine Institute
at Duke University Medical Center.

The two subvariants also appear to evade protection from vaccines and previous
infections more easily than most of their predecessors.

Montefiori estimated that BA.4 and BA.5 are about three times less sensitive to
neutralizing antibodies from existing Covid vaccines than the original version
of the omicron variant, BA.1. Other research suggests that BA.4 and BA.5 are
four times more resistant to antibodies from vaccines than BA.2, which replaced
the omicron variant as the U.S.'s dominant version of the coronavirus in April.

Francois Balloux, the director of the University College London Genetics
Institute, said that's most likely another reason the subvariants have taken
over.



"At this stage now, I think all these variants actually are roughly equally
transmissible, so there’s not a huge difference," he said."It’s just some are
slightly better at infecting people who have been vaccinated or infected by
previous variants."

The Food and Drug Administration last week recommended modifying coming booster
shots from Pfizer and Moderna to target BA.4 and BA.5 directly.

Pfizer has told NBC News that it could have an updated vaccine targeting BA.4
and BA.5 ready to be distributed in October.


THE MOST COMMON SYMPTOMS OF BA.4 AND BA.5

In the U.K., where BA.4 and BA.5 also account for the majority of new Covid
cases, the most common Covid symptoms last week were runny nose, sore throat,
headache, persistent cough and fatigue. Less than one-third of people surveyed
reported fevers, according to data from the Zoe COVID Symptom Study, which asks
people to self-report their symptoms through smartphone apps.



That’s consistent with the symptoms reported in the U.K. in the spring, when the
BA.2 subvariant was dominant.

Balloux said no difference has been observed so far between BA.4 or BA.5
symptoms and those of previous subvariants. But people who were infected with
the original version of the omicron variant during the winter may be susceptible
to the newer subvariants.

"BA.1 and BA.2 are pretty different," he said, so the cross-protection "is not
as great."


DOCTOR ANSWERS YOUR TOP COVID-19, OMICRON VARIANT QUESTIONS

July 7, 202204:29


Balloux added, though, that "BA.2, BA.4 and B.5 from a neutralizing antibody
perspective are essentially interchangeable." That might mean that people who
got BA.2 infections have some protection now.



Montefiori said BA.4 and BA.5 also haven’t been found to cause more severe
disease.

"There’s really no clear evidence that they’re more or less likely to make
people sick and cause severe illness and death," he said.

Rather, rises in cases and hospitalizations observed in some places more likely
have to do with fading vaccine protection.

"We have waning immunity now in the people who got boosted half a year or more
ago," Montefiori said.


WILL WE NEED MORE BOOSTER SHOTS, AND WHEN?

The FDA estimates that omicron-specific boosters from Pfizer and Moderna will
become available in early to mid-fall.




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HEALTH NEWSU.S. TO SHIP 144,000 MORE MONKEYPOX SHOTS AND EXPAND TESTING AS CASES
TOP 700

"The companies are now scurrying to make the BA.4/BA.5-containing vaccine and
test that clinically," Montefiori said.



But experts stressed that there may not be a dramatic difference in protection
between additional boosts of the current vaccines and omicron-specific shots.
Current vaccines still work well to prevent severe illness and death.

"The virus is moving in a direction of escaping our vaccines more and more, but
it has not found a way to escape the vaccines to a really significant degree,"
Montefiori said.

For that reason, he added, people eligible for second boosters — those over 50
or the immunocompromised — may not want to wait.



"If your last boost was over six months ago, you might want to consider getting
boosted again now with the current vaccine to keep your protection strong while
we’re still getting through this pandemic," Montefiori said.

In addition, Balloux said, it’s hard to predict whether BA.5 will still be
dominant later this year.

"Given the uncertainty, there’s no right or wrong," he said. "There are only
trade-offs."


EUROPE AND SOUTH AFRICA OFFER A PREVIEW OF WHAT COMES NEXT

Reported Covid case numbers have stayed relatively flat in the U.S. since May,
but case numbers are on the rise globally.



By the end of June, new weekly cases were up by 32% in Southeast Asia, 33% in
Europe and 47% in the region comprising the Middle East, Central Asia, North
Africa and the Horn of Africa, the World Health Organization said. As of June
19, BA.5 accounted for 43% of omicron cases worldwide, while BA.4 accounted for
12%.

South Africa had a surge in cases driven by BA.4 and BA.5 this spring, and Covid
hospitalizations are rising in the U.K. Experts said the trends likely indicate
that the virus is getting better at reinfecting people and evading vaccine
protection.

Still, the future of the pandemic will depend not just on the properties of
variants, but also on human behavior and how much immunity has built up in the
population.

"People tend to overestimate actually how much the virus has changed very
recently," Balloux said. "There was a massive, massive change between delta and
omicron, and then there was, again, a fairly massive change between BA.1 and
BA.2."



That's not quite the case with BA.4 and BA.5, he said, although he noted another
major shift in the virus's evolution could still come.

"I'm not saying it won't happen," he said.

CORRECTION (July 7, 2022, 7 a.m. ET): A previous version of this article
misstated which group recommended boosters targeting BA.4 and BA.5. It was the
FDA, not an FDA advisory committee.

Aria Bendix

Aria Bendix is the breaking health reporter for NBC News Digital.



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