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Pirola variant shows value of boosters

Preliminary data from three separate research teams suggest the latest anxiety-inducing Covid variant is not quite the threat many had feared. BA.2.86 — or what some armchair epidemiologists have dubbed “Pirola” — does seem capable of escaping some of our prior immunity, but we are not left defenseless.

Even better, data suggests the updated boosters, which are matched to a previous variant known as XBB, could still offer decent protection against the new edition.

That is hugely reassuring.

But it does not mean we can ignore this late-summer bump in Covid cases or skip the updated boosters. Instead, it should serve as a reminder that the virus isn’t quite done with us yet. New variants will continue to appear, and our increasingly limited tracking of the virus could make us slow to react to whatever descendant comes next. (In case you are wondering what happened to Eris, the other recent variant, it is still circulating, but the World Health Organisation has said it is likely no worse than other variants we have seen.)

Infectious disease experts start to sweat when a new variant emerges with lots of changes in the spike protein, the now-familiar knobby feature on the surface of the virus that allows it to pierce our cells. So despite only a few cases of BA.2.86 identified in recent weeks, the 30 or so mutations in its spike protein grabbed scientists’ attention.

Moreover, the variant suddenly showed up in wastewater samples in nearly a dozen countries, suggesting it had been quietly spreading at a time when the world is doing much less Covid monitoring.

To understand the potential problem posed by a new variant, researchers need to understand three things: whether it can spread more quickly, infect people more easily or evade our existing immunity. When all three collide, there is a real danger of fresh waves of hospital admissions and deaths. And with little data to go on, some predicted BA.2.86 presented enough of a problem to cause another Omicron-like event.

Thankfully, the first studies of the variant suggest things are not quite that dire.

A team led by Dan Barouch, director of the Centre for Virology and Vaccine Research at Beth Israel Deaconess Medical Centre, examined plasma samples from 66 people with a mix of exposures to vaccines and variants. Some had received the bivalent booster distributed last autumn, while others had not, and each group included some people who had been recently infected by XBB.

The researchers made two key discoveries. The first is that everyone developed neutralising antibodies against BA.2.86, and they were not any lower — and in fact were in most cases higher — than those generated against the already-circulating variants. In other words, the new variant does not seem to be as immune-evasive as many had worried. “That was somewhat unexpected and welcome news,” Barouch says.

And people who were infected with XBB generated substantially higher antibodies against all circulating variants, including BA.2.86. That bodes well for the boosters matched to XBB that are expected to arrive this month. Moderna said this week that its updated booster induced an 8.7-fold increase in antibodies against the strain, and was similarly effective against other circulating variants.

Two other as-yet-unpublished analyses support a similar narrative: BA.2.86 does evade some of our prior immunity, but it is not as bad as some had feared, and the updated boosters could prop up that protection.

Although the result is a happy one, it is still a bit of a head-scratcher: if BA.2.86 has so many new mutations, should it not be more immune evasive? Barouch’s hypothesis is that BA.2.86 descended from BA.2, the Omicron subvariant that became dominant in spring 2022 yet was not very good at evading immunity. While protection wobbled as it evolved, some amount of coverage remains.

To be sure, we are not out of the woods. One worry is that BA.2.86 could further mutate — or worse, combine with something XBB-like to take on scary new dimensions. And, of course, something entirely different could crop up. Scientists no longer have the funding or support to track the virus as closely as they did earlier in the pandemic, making it harder to detect something before it becomes a problem.

And hospital admissions have been ticking up from their historic lows for almost two months. We know many of the more serious cases are in older, more vulnerable people. The new data provides yet another motivation for people in those groups to get their updated booster as soon as they are available to ramp up their protection.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, healthcare and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, healthcare and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News

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Published September 07, 2023 at 8:00 am (Updated September 06, 2023 at 3:40 pm)

Pirola variant shows value of boosters

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