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Can the Covid Vaccine Protect Me

Against Virus Variants?
Vaccines do a good job of protecting us from coronavirus, but fear
and confusion about the rise of variants have muddled the
message. Here are answers to common questions.

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By Tara Parker-Pope

April 15, 2021

The news about coronavirus variants can sound like a horror

movie, with references to a “double-mutant” virus, “vaccine-
evading” variants and even an “Eek” mutation. One headline
warned ominously: “The devil is already here.”

While it’s true that the virus variants are a significant public health
concern, the unrelenting focus on each new variant has created
undue alarm and a false impression that vaccines don’t protect us
against the various variants that continue to emerge.

“I use the term ‘scariants,’” said Dr. Eric Topol, professor of

molecular medicine at Scripps Research in La Jolla, Calif., referring
to much of the media coverage of the variants. “Even my wife was
saying, ‘What about this double mutant?’ It drives me nuts. People
are scared unnecessarily. If you’re fully vaccinated, two weeks post
dose, you shouldn’t have to worry about variants at all.”

Viruses are constantly changing, and new variants have been

emerging and circulating around the world throughout the
pandemic. Some mutations don’t matter, but others can make
things much worse by creating a variant that spreads faster or
makes people sicker. While the rise of more infectious variants has
caused cases of Covid-19 to surge around the world, the risk is
primarily to the unvaccinated, for whom there is great concern.
While vaccination efforts are well underway in the United States
and many other developed countries, huge swaths of the world’s
population remain vulnerable, with some countries yet to report
having administered a single dose.

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But for the vaccinated, the outlook is much more hopeful. While it’s
true that the vaccines have different success rates against different
variants, the perception that they don’t work against variants at all
is incorrect. In fact, the available vaccines have worked
remarkably well so far, not just at preventing infection but, most
important, at preventing serious illness and hospitalization, even
as new variants circulate around the globe.

The variants are “all the more reason to get vaccinated,” said Dr.
Anthony S. Fauci, the nation’s top infectious disease specialist.
“The bottom line is the vaccines we are using very well protect
against the most dominant variant we have right now, and to
varying degrees protect against serious disease among several of
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lot scarier than it is. In addition, the fact that two vaccines have Pregnancy

achieved about 95 percent efficacy has created unrealistic Europe Plunders

expectations about what it takes for a vaccine to perform well. Paris for Talent, and
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Here are answers to common questions about the variants and the
vaccines being used to stop Covid-19.

Which variant am I most likely to encounter in the

United States?
The variant called B.1.1.7, which was first identified in Britain, is
now the most common source of new infections in the United
States. This highly contagious variant is also fueling the spread of
the virus in Europe and has been found in 114 countries. A mutation
allows this version of the virus to more effectively attach to cells.
Carriers may also shed much higher levels of virus and stay
infectious longer.

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The main concern about B.1.1.7 is that it is highly infectious and

spreads quickly among the unvaccinated, potentially
overwhelming hospitals in areas where cases are surging.

Do the vaccines work against B.1.1.7?

All of the major vaccines in use — Pfizer-BioNTech, Moderna,
Johnson & Johnson, AstraZeneca, Sputnik and Novavax — have
been shown to be effective against B.1.1.7. We know this from a
variety of studies and indicators. First, scientists have used the
blood of vaccinated patients to study how well vaccine antibodies
bind to a variant in a test tube. The vaccines have all performed
relatively well against B.1.1.7. There’s also clinical trial data,
particularly from Johnson & Johnson and AstraZeneca (which is
the most widely used vaccine around the world), that shows they
are highly effective against both preventing infection and serious
illness in areas where B.1.1.7 is circulating. And in Israel, for
instance, where 80 percent of the eligible population is vaccinated
(all with the Pfizer shot), case counts are plummeting, even as
schools, restaurants and workplaces open up, suggesting that
vaccines are tamping down new infections, including those caused
by variants.

If the vaccines are working, why do I keep hearing

about “breakthrough” cases?
No vaccine is foolproof, and even though the Covid vaccines are
highly protective, sometimes vaccinated people still get infected.
But breakthrough cases of vaccinated people are very rare, even as
variants are fueling a surge in case counts. And the vaccines
clearly prevent severe illness and hospitalization in the few
vaccinated patients who do get infected.

So what’s the risk of getting infected after vaccination? Nobody

knows for sure, but we have some clues. During the Moderna trial,
for instance, only 11 patients out of 15,210 who were vaccinated got
infected. Both Pfizer and Moderna now are doing more detailed
studies of breakthrough cases among vaccinated trial participants,
and should be releasing that data soon.

The Coronavirus Outbreak ›

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new wave.

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says.

Two real-world studies of vaccinated health care workers, who

have a much higher risk of virus exposure than the rest of us, offer
hopeful signs. One study found that just four out of 8,121 fully
vaccinated employees at the University of Texas Southwestern
Medical Center in Dallas became infected. The other found that
only seven out of 14,990 workers at UC San Diego Health and the
David Geffen School of Medicine at the University of California,
Los Angeles, tested positive two or more weeks after receiving a
second dose of either the Pfizer-BioNTech or Moderna vaccines.
Both reports were published in the New England Journal of
Medicine, and are a sign that even as cases were surging in the
United States, breakthrough cases were uncommon, even among
individuals who were often exposed to sick patients. Most
important, patients who were infected after vaccination had mild
symptoms. Some people had no symptoms at all, and were
discovered only through testing in studies or as part of their
unrelated medical care.

Researchers are still studying whether the variants eventually

might increase the number of breakthrough cases or if vaccine
antibodies begin to wane over time. So far, data from Moderna
show the vaccine still remains 90 percent effective after at least six
months. Pfizer has reported similar results.

A recent study of 149 people in Israel who became infected after

vaccination with the Pfizer vaccine suggested that a variant first
identified in South Africa was more likely to cause breakthrough
infections. However, those eight infections occurred between days
seven and 13 following the second dose. “We didn’t see any South
Africa variant 14 days after the second dose,” said Adi Stern, the
study’s senior author, a professor at the Shmunis School of
Biomedicine and Cancer Research, Tel Aviv University. “It was a
small sample size, but it’s very possible that two weeks after the
second dose, maybe the protection level goes up and that blocks
the South Africa variant completely. It gives us more room for
optimism.”

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For now, the variants don’t appear to be increasing the rate of

infection in vaccinated people, but that could change as more data
are collected. Read more about breakthrough cases here.

Are there other variants we should be worried about?

The C.D.C. is tracking more than a dozen variants, but only a few
qualify as “variants of concern,” which is a public health
designation to identify variants that could be more transmissible or
have other qualities that make them more of a risk. The main
additional variants everyone is talking about right now are the
B.1.351, which was first detected in South Africa, and the P.1, which
was first identified in Brazil. While there are other variants
(including two “California” variants, B.1.427 and B.1.429, and a New
York variant, B.1.526), for now, it seems that the South Africa and
Brazil variants (which as of late March together accounted for
about 2 percent of cases in the United States) are causing the most
concern. While a new variant can emerge at any time, existing
variants also compete with each other for dominance. One
interesting new development: In countries like the United States
where B.1.1.7 is dominant, some of the other variants seem to be
getting crowded out, making them less of a worry.

Is it true that the variants first identified in South

Africa and Brazil can “evade” the vaccines?
There is a concern that the B.1.351 and the P.1 are better at dodging
vaccine antibodies than other variants. But that doesn’t mean the
vaccines don’t work at all. It just means the level of protection you
get from the vaccines against these variants could be lower than
when the shots were studied against early forms of the virus.
Among the variants, the B.1.351 may pose the biggest challenge so
far. It has a key mutation — called E484K, and often shortened to
“Eek” — that can help the virus evade some, but probably not all,
antibodies.

What You Need to Know About the Johnson & Johnson Vaccine
Pause in the U.S.
On April 13, 2021, U.S. health agencies called for an immediate pause in
the use of Johnson & Johnson’s single-dose Covid-19 vaccine after six
recipients in the United States developed a rare disorder involving blood
clots within one to three weeks of vaccination.

All 50 states, Washington, D.C. and Puerto Rico temporarily halted or

recommended providers pause the use of the vaccine. The U.S. military,
federally run vaccination sites and a host of private companies, including
CVS, Walgreens, Rite Aid, Walmart and Publix, also paused the injections.

Fewer than one in a million Johnson & Johnson vaccinations are now under
investigation. If there is indeed SEE MORE
a risk of blood clots from the vaccine —
which has yet to be determined — that risk is extremely low. The risk of
getting Covid-19 in the United States is far higher.
Remember that there’s a lot of “cushion” provided by this current
The pause could complicate the nation’s vaccination efforts at a time when
cropmany
of vaccines,
states are so even if aa surge
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in new caseseffective
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to address
variant, it appears
vaccine hesitancy. that it’s still going to do a good job of protecting
you Johnson
from serious illness.
& Johnson has also decided to delay the rollout of its vaccine in
Europe amid concerns over rare blood clots, dealing another blow to
Europe’s inoculation push. South Africa, devastated by a more contagious
How much protection will the vaccines give me
virus variant that emerged there, suspended use of the vaccine as well.
against the variant first seen in South Africa?
Australia announced it would not purchase any doses.

We don’t yet have precise estimates of vaccine effectiveness

against B.1.351, which may be the most challenging variant so far.
But studies show that the various vaccines still lower overall risk
for infection and help prevent severe disease. A large study of
Johnson & Johnson’s one-dose vaccine in South Africa found it was
about 85 percent effective at preventing severe disease, and
lowered risk for mild to moderate disease by 64 percent.
(Distribution of the Johnson & Johnson vaccine has been paused as
health officials investigate safety concerns.) The AstraZeneca
vaccine did not do much to protect against mild illness caused by
B.1.351, but scientists said they believed the vaccine might protect
against more severe cases, based on the immune responses
detected in blood samples from people who were given it. There’s
less definitive research for the Pfizer and Moderna vaccines
against the variant, but it’s believed that these two-dose vaccines
could reduce risk of infection against the variant by about 60
percent to 70 percent and still are highly effective at preventing
severe disease and hospitalization.

“From everything we know today, there is still protection from the

vaccines against the South Africa variant,” said Dr. Stern.

Should I still worry that the vaccines are less effective

against some variants?
Part of the problem is that we misinterpret what efficacy really
means. When someone hears the term “70 percent efficacy,” for
instance, they might wrongly conclude that it means 30 percent of
vaccinated people would get sick. That’s not the case. Even if a
vaccine loses some ground to a variant, a large portion of people
are still protected, and only a fraction of vaccinated people will get
infected. Here’s why.

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To understand efficacy, consider the data from the Pfizer clinical

trials. In the unvaccinated group of 21,728, a total of 162 people got
infected. But in the vaccinated group of 21,720, only eight people
became infected. That’s what is referred to as 95 percent efficacy. It
doesn’t mean that 5 percent of the participants (or 1,086 of them)
got sick. It means 95 percent fewer vaccinated people got infected
compared to the unvaccinated group.

Now imagine a hypothetical scenario with a vaccine that is 70

percent effective against a more challenging variant. Under the
same conditions of the clinical trial, vaccination would still protect
21,672 people in the group, and just 48 vaccinated people — less
than one percent — would become infected, compared to 162 in the
unvaccinated group. Even though overall efficacy was lower, only a
fraction of vaccinated people in this scenario would get infected,
most likely with only mild illness.

While far more research is needed to fully understand how

variants might dodge some (but not all) vaccine antibodies, public
health experts note that an estimate of 50 percent to 70 percent
efficacy against a challenging variant would still be considered an
adequate level of protection.

“Seventy percent is extremely high,” said Dr. Stern. “Basically

what this means is that it’s even more important to get vaccinated.
If you have 95 percent efficacy, you can create some form of herd
immunity with less people. With 70 percent efficacy, it’s even more
important to get vaccinated to protect others.”

Am I going to need a booster shot?

Vaccine makers already are working on developing booster shots
that will target the variants, but it’s not clear how soon they might
be needed. “In time, you’re going to see a recommendation for a
booster,” said Dr. Peter J. Hotez, dean of the National School of
Tropical Medicine at Baylor College of Medicine in Houston. “That
booster will elevate everybody’s antibodies and increase durability.
The booster will probably be configured to target the South African
and Brazil variants.”

Given all these unknowns about the variants,

shouldn’t I just stay home even after I’m vaccinated?
Even amid the rise of variants, vaccines will significantly lower
your risk for infection and will protect you from serious illness and
hospitalization. People who are vaccinated can socialize,
unmasked, with other vaccinated people. While vaccinated people
still need to follow local health guidelines about wearing a mask
and gathering in groups to protect the unvaccinated, vaccinated
people can travel, get their hair and nails done, or go to work
without worrying. And vaccinated grandparents can hug their
unvaccinated grandchildren. Because there are still some
outstanding questions about the risk of vaccinated people carrying
the virus, a vaccinated person is still advised to wear a mask in
public to protect the unvaccinated — although those guidelines
may be updated soon.

“The vaccines protect you, so go get vaccinated — that’s the

message,” said Dr. Fauci. “If you’re around other vaccinated
people, you shouldn’t worry about it at all. Zero.”

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