WASHINGTON – COVID-19 vaccine boosters will tackle one coronavirus variant at a time, focusing first on a mutation recently identified in South Africa that is alarming scientists, Dr. Anthony Fauci, the nation’s leading infectious disease expert, told McClatchy in an interview.
The “ultimate solution” to the coronavirus pandemic may be a vaccine that protects against all mutations — but work on that project is just beginning, Fauci said.
The chief medical adviser on COVID-19 to President Joe Biden and director of the National Institute of Allergy and Infectious Diseases said that vaccine manufacturers could develop the boosters quickly, and expressed confidence that they could pass regulatory hurdles and reach the public within “months.”
But a longer-term goal — one that could end the cycle of variants, and the pandemic, once and for all — is a universal vaccine that could protect against all types of mutations, Fauci said in an interview Monday evening.
Vaccines for COVID-19 first became available in December, but the new coronavirus continues to mutate, creating the risk that existing vaccines will not be enough to protect Americans and end the pandemic.
The long-term goal, Fauci said, is a vaccine that would work against all mutations of this particular coronavirus, known as SARS-CoV-2. Eventually, a pan-coronavirus vaccine that could protect against all different types of coronaviruses might emerge in the future, he added.
It is a hopeful, but realistic project, Fauci said — and scientists around the country, including in the Army, the National Institutes of Health and in private industry, are already working towards those types of vaccines.
“The long-range goal would be to get a vaccine that would be good against all coronaviruses. But I think the first goal you want is to get a vaccine that’s upgraded enough that whatever mutation occurs with the current SARS-CoV-2 will be covered by the vaccine,” Fauci said.
“That’s the ultimate solution. You don’t even need a pan-coronavirus one — you need a pan-SARS-CoV-2 vaccine first, because that’s the one that continues to mutate,” he said. “We’re going to be upgrading them to match better the mutants.”
‘A very fit virus’
In the short term, Fauci said that Moderna and likely Pfizer — the two companies with vaccines currently available to Americans — are working on a booster shot that would only work against the South African variant, known as B.1.351, which this week was detected for the first time in the United States.
The South African variant appears highly contagious and able to evade the vaccine in some individuals. Those who have already had COVID-19 and recovered also appear highly susceptible to reinfection with the new variant.
“This variant is the one that is the most troublesome since it already is evading many of the monoclonal antibodies that are being used for treatment of COVID-19, and it has diminished by several-fold the efficacy of the antibodies induced by the existing vaccines,” Fauci said.
“It’s a very fit virus,” Fauci said. “People who have been infected with the original virus don’t seem to be protected against reinfection with the South African isolate. In fact, my colleagues in South Africa tell me that it doesn’t protect at all — that if you were infected with the original isolate, there’s no protection.”
By adjusting their vaccine formulas to target the South African variant, Moderna and likely Pfizer hope to stave off an immediate crisis, Fauci said.
“This addresses the immediate problem of B.1.351,” he said. “Looking ahead, it is likely that additional mutants will arise, and so the ‘long game’ approach would be to develop a pan-SARS-Cov-2 also known as a universal SARS-CoV-2 vaccine that would handle all types of mutants of SARS-CoV-2.”
“This is a much longer range project that is just getting started and will likely take a much longer period of time,” he added.
Moderna confirmed that it is working on a booster shot to address the South African variant in an email on Monday night. Pfizer said the nature of its COVID-19 vaccine — which, like the Moderna vaccine, uses a new biotechnology known as messenger RNA — provides it with “flexible technology” to adapt to virus mutations.
“This flexibility includes the ability to alter the RNA sequence in the vaccine to cover new strains of the virus,” Pfizer said in a statement to McClatchy.
The company said it plans to develop booster shots only for variants that have proven an ability to escape the immunity provided by its existing vaccine.
“If one ever were to emerge that is not well covered by the current vaccine, the updated vaccine could be administered as a booster,” Pfizer said.
Optimism for herd immunity
While Fauci has expressed alarm over the South African variant, which was identified for the first time in the United States with three cases in South Carolina and Maryland this week, he was hopeful that modest boosters to the vaccines would not take long to develop and reach the public.
“That should not be very difficult — that could likely be done in a few months, because one of the good things about the mRNA platform technology is that it is very flexible and adaptable,” Fauci said.
“You will not have to do a 30,000 or 44,000-person trial the way you did to show efficacy for the original vaccine,” he said, explaining that data from the monthslong clinical studies could be coupled with new data on the booster shots.
Pfizer noted that the Food and Drug Administration — which would have to authorize any booster shots before they reach the public — is still outlining the process it would take to do so.
“We will need to generate data that gives confidence that any updated vaccine is safe and effective,” the company said. “The updated vaccine to be administered as a booster would be subject to regulatory approval or authorization.”
The most important step that Americans can take to prevent new variants of the virus is to get vaccinated, because the more the virus is allowed to circulate, the more opportunities it has to mutate, Fauci said.
With more vaccine doses and vaccination sites becoming available, and more people being trained to administer them to the public, Fauci expressed some optimism that the emerging variants would not outpace U.S. progress toward a return to some form of normalcy.
Still, once an individual is fully vaccinated, they should not feel as if they have a “free pass” to waive public health guidelines, Fauci said, warning that they may still be able to carry the virus and infect others.
But alongside others who have been vaccinated, it would be reasonable to meet indoors for a meal, he added. “You’ve got to use common sense,” he said. “Yes — there is a degree of protection where, even though the risk is not zero, it’s much less of a risk.”
“We may be able to reach herd immunity by the time we get to the end of the summer, the beginning of the fall,” he said.