Understanding COVID-19 Variants and Vaccinations
Dr. Sarah Brovender provides answers to the most frequently asked questions about COVID-19 variants and discusses the benefits of getting vaccinated.
Featured Speaker:
Sarah Brovender, MD
Sarah Brovender, MD is an Emergency Medicine Attending Physician. Transcription:
Understanding COVID-19 Variants and Vaccinations
Caitlin Whyte: We're two years into this pandemic now, and it's still pretty difficult to keep up with the mask mandates, vaccine boosters and all the new variants of COVID that keep popping up. So today, we are chatting with emergency medicine attending physician, Dr. Sarah Brovender. She will answer some of the most frequently asked questions about COVID-19 variants and discuss the benefits of getting vaccinated.
This is Jamaica Hospital Med Talk. I'm your host, Caitlin Whyte. All right, to start us off here, doctor, just what is a variant? We've heard so much about variants in the news. Can you break that down for us?
Dr. Sarah Brovender: Yeah. So just sort of very simply, it's just a small change in the virus. Basically, the way that a virus replicates is it uses the human cells to reproduce their genetic code. Anytime that a little mistake is made or there's a slight change in the way that the genetic code is made, whether it's intentional or unintentional, you'll have a new version of the virus. The way that that is going to continue on in the environment is if it's beneficial for the virus. So these little changes can be nothing, they can mean nothing, but if they allow the virus to become more infectious or evade certain treatments that we have and be more likely to persist and then that's sort of what's become these variants of concern.
Caitlin Whyte: Gotcha. Gotcha. So can you provide a little more information about why the COVID virus has mutated? I mean, is this common? Is this abnormal?
Dr. Sarah Brovender: Yeah, very common. You know, all viruses mutate, you know, the flu or HIV, like common viruses that we've heard about much longer than COVID also mutate. And it's similar to like human evolution, how anything that's beneficial for development will stick. So like I said, if it allows the virus to infect more hosts, that's going to stick and that's going to get more spread more widespread.
Caitlin Whyte: Great. So now that we know a bit about why variants happen, can you tell us about some of the COVID variants that have emerged?
Dr. Sarah Brovender: So there've been lots of variants and most of those did not become variants of concern, which is how the CDC sort of breaks up how much attention they need to give to different variants. Currently, the only ones that are variants of concern are Delta and Omicron. Basically, what's a variant of concern is something that is more infectious or more likely to evade, you know, either vaccines or whatever other treatments we have. And so that's sort of, like I said, how variants come to be. That's why the others didn't really last as long or become as widespread. And that's why they're not necessarily variants of concern. And who knows what's going to happen with the next one?
Caitlin Whyte: Well, let's talk about protection. What is the most effective way to get that protection from the virus and the recent variants?
Dr. Sarah Brovender: So for viruses, it's always going to be vaccines, that's COVID, non-COVID. Sometimes people don't really realize this, but we actually don't have treatments for viruses. Antibiotics and stuff are for bacterial diseases. So viruses don't really have a treatment. The things that we do help the body fight off the disease, but it doesn't directly cure you from the virus. So the best way for all viruses, including COVID is vaccines. Even viruses that aren't really causing disease can lay dormant in your cells for years and years and years. So the best way to protect yourself against getting a virus is before you even get it, so to get the vaccine early and now we have all the different boosters to improve your immunity.
Caitlin Whyte: Well, you mentioned the vaccine, so let's get into that next. What is the efficacy of the vaccines? You know, I am triple vaxxed, but I still got COVID. And then I have unvaccinated friends and, of course, they've got COVID. I mean, how does all this work together? What are the vaccines doing?
Dr. Sarah Brovender: So I will say just in my personal experience, vaccinated versus unvaccinated patients are, yes, both coming in with COVID, both coming in with potentially breakthrough infections. But the only people that I've seen really, really, really sick from COVID recently are the unvaccinated people by and large. So we need some sort of immunity, sometimes that's through prior infections, sometimes that's through vaccines and that again applies to multiple COVID and other infections. But the vaccine helps us create antibodies so that if we come in contact with the virus, we have a stronger protection against developing severe disease. So even if it doesn't prevent all infections, it at least prevents severe disease.
As I said that most people that I'm seeing that are really sick are unvaccinated, the exception to that and this is one of the reasons why vaccines are so important is the immunocompromise. So people that have cancer or are transplant patients that are on immunosuppressing medications or, for whatever reason, their immune system is not strong enough. Sometimes that's intentional if they're on immunosuppressive medications or unintentional, if they're on chemo or something like that. And so these are people that, even if they get the vaccine, they're not going to mount an immune response from the vaccine and that's expected, that's normal. And so herd immunity is this idea that if enough people get vaccinated and the people who can't mount a response won't have as many opportunities to come in contact with the disease.
So again, this is something that is not just COVID specific. This is every virus that we have vaccines for rely on this concept of herd immunity. And, you know, just because nothing's a hundred percent. So, you know, you create a vaccine, you knows it's not going to work in a hundred percent of people. But if enough people have it, have the vaccine and have the immunity, that helps many of the people who get the vaccine, but are not going to be able to mount an immune response.
Caitlin Whyte: So now, a lot of people are in that third stage of getting boosters. Why are boosters important and how do they offer more protection or better protection?
Dr. Sarah Brovender: So there's a lot of evidence out there that the antibodies that we have from prior infections or from vaccines wane. And that again is typical. You know, we get a flu shot every year. You got a tetanus shot every 10 years. Your childhood vaccines are done in multiple shots. Again, none of this is atypical. This is all to be expected. With COVID, which is changing so quickly and so new with these different variants, sometimes the specific antibodies that the vaccines target are what changes, and that's kind of what happened with Omicron, is a specific part of the virus that was targeted with the vaccine is the part that changed for Omicron, which is probably how it became so widespread anyway, because again, it evaded our prevention techniques.
So there is some question, you know, as you said, triple vaxxed, got COVID that is happening. Now, there's some research being done into Omicron specific vaccines. But regardless, some immunity is still better than no immunity. And having antibodies that maybe aren't as strong towards Omicron are still going to prevent against severe disease, which is really the worst case scenario. So that's really what we're trying to avoid anyway.
Caitlin Whyte: So as of this taping, January 26th, what are the current recommendations for boosters when it comes to age, timing, after other shots? What are the factors right now?
Dr. Sarah Brovender: So right now, it's pretty much recommended pretty much everyone who's vaccinated to get a booster, because as I said, immunity does wane after a certain period of time and that is typical. So Pfizer is the most widespread, so everyone 12 and older five months after your vaccine series. For Moderna, it's only approved for 18 and older, but it's the same timeframe. And then Johnson & Johnson is a shorter timeframe because it's only the one shot, so two months, but again, still 18 and older.
Another thing is it's okay to mix and match. So if you've got the Moderna vaccine and you've got a Pfizer booster, that's fine. You know, you should get whatever you have available to you because that's what's going to give you protection for both getting this disease and spreading this disease. And that's, I feel, like the most important thing right now. Probably most people have gotten COVID, but we want to stop the spread.
Caitlin Whyte: No, absolutely. Well, doctor, we covered a lot in a short amount of time. But as we wrap up here, is there anything else we didn't touch on? Anything else you want listeners to know about COVID-19, variants, boosters, anything we covered this episode?
Dr. Sarah Brovender: I think just take-home point, get vaccinated. I think a lot of people think, "Oh, well, I'm young, I'm healthy. You know, I'm not going to get severe COVID. It's not a big deal. But it's not just for you. It's not just about you. Getting vaccinated may protect a, you know, teenager with leukemia or a parent undergoing chemo or things like that that you don't even think about or don't even realize, that these people that you interact with every day, that because you and I are vaccinated and you, even if you've got to have a decreased viral load and you could potentially save someone else's life. So it's bigger than just, "Well, I probably won't get severe COVID," and so I would recommend everyone to get vaccinated.
Caitlin Whyte: Well, I know you're busy, doctor, so thank you so much for taking the time to keep us up-to-date on COVID and its variants. For more information or to make an appointment with a doctor at Jamaica Hospital, please call (718) 206-6000. That's (718) 206-6000. Or visit us online at jamaicahospital.org. This has been Jamaica Hospital Med Talk. I am your host, Caitlin Whyte. Be well and get vaccinated.
All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed in this podcast.
Understanding COVID-19 Variants and Vaccinations
Caitlin Whyte: We're two years into this pandemic now, and it's still pretty difficult to keep up with the mask mandates, vaccine boosters and all the new variants of COVID that keep popping up. So today, we are chatting with emergency medicine attending physician, Dr. Sarah Brovender. She will answer some of the most frequently asked questions about COVID-19 variants and discuss the benefits of getting vaccinated.
This is Jamaica Hospital Med Talk. I'm your host, Caitlin Whyte. All right, to start us off here, doctor, just what is a variant? We've heard so much about variants in the news. Can you break that down for us?
Dr. Sarah Brovender: Yeah. So just sort of very simply, it's just a small change in the virus. Basically, the way that a virus replicates is it uses the human cells to reproduce their genetic code. Anytime that a little mistake is made or there's a slight change in the way that the genetic code is made, whether it's intentional or unintentional, you'll have a new version of the virus. The way that that is going to continue on in the environment is if it's beneficial for the virus. So these little changes can be nothing, they can mean nothing, but if they allow the virus to become more infectious or evade certain treatments that we have and be more likely to persist and then that's sort of what's become these variants of concern.
Caitlin Whyte: Gotcha. Gotcha. So can you provide a little more information about why the COVID virus has mutated? I mean, is this common? Is this abnormal?
Dr. Sarah Brovender: Yeah, very common. You know, all viruses mutate, you know, the flu or HIV, like common viruses that we've heard about much longer than COVID also mutate. And it's similar to like human evolution, how anything that's beneficial for development will stick. So like I said, if it allows the virus to infect more hosts, that's going to stick and that's going to get more spread more widespread.
Caitlin Whyte: Great. So now that we know a bit about why variants happen, can you tell us about some of the COVID variants that have emerged?
Dr. Sarah Brovender: So there've been lots of variants and most of those did not become variants of concern, which is how the CDC sort of breaks up how much attention they need to give to different variants. Currently, the only ones that are variants of concern are Delta and Omicron. Basically, what's a variant of concern is something that is more infectious or more likely to evade, you know, either vaccines or whatever other treatments we have. And so that's sort of, like I said, how variants come to be. That's why the others didn't really last as long or become as widespread. And that's why they're not necessarily variants of concern. And who knows what's going to happen with the next one?
Caitlin Whyte: Well, let's talk about protection. What is the most effective way to get that protection from the virus and the recent variants?
Dr. Sarah Brovender: So for viruses, it's always going to be vaccines, that's COVID, non-COVID. Sometimes people don't really realize this, but we actually don't have treatments for viruses. Antibiotics and stuff are for bacterial diseases. So viruses don't really have a treatment. The things that we do help the body fight off the disease, but it doesn't directly cure you from the virus. So the best way for all viruses, including COVID is vaccines. Even viruses that aren't really causing disease can lay dormant in your cells for years and years and years. So the best way to protect yourself against getting a virus is before you even get it, so to get the vaccine early and now we have all the different boosters to improve your immunity.
Caitlin Whyte: Well, you mentioned the vaccine, so let's get into that next. What is the efficacy of the vaccines? You know, I am triple vaxxed, but I still got COVID. And then I have unvaccinated friends and, of course, they've got COVID. I mean, how does all this work together? What are the vaccines doing?
Dr. Sarah Brovender: So I will say just in my personal experience, vaccinated versus unvaccinated patients are, yes, both coming in with COVID, both coming in with potentially breakthrough infections. But the only people that I've seen really, really, really sick from COVID recently are the unvaccinated people by and large. So we need some sort of immunity, sometimes that's through prior infections, sometimes that's through vaccines and that again applies to multiple COVID and other infections. But the vaccine helps us create antibodies so that if we come in contact with the virus, we have a stronger protection against developing severe disease. So even if it doesn't prevent all infections, it at least prevents severe disease.
As I said that most people that I'm seeing that are really sick are unvaccinated, the exception to that and this is one of the reasons why vaccines are so important is the immunocompromise. So people that have cancer or are transplant patients that are on immunosuppressing medications or, for whatever reason, their immune system is not strong enough. Sometimes that's intentional if they're on immunosuppressive medications or unintentional, if they're on chemo or something like that. And so these are people that, even if they get the vaccine, they're not going to mount an immune response from the vaccine and that's expected, that's normal. And so herd immunity is this idea that if enough people get vaccinated and the people who can't mount a response won't have as many opportunities to come in contact with the disease.
So again, this is something that is not just COVID specific. This is every virus that we have vaccines for rely on this concept of herd immunity. And, you know, just because nothing's a hundred percent. So, you know, you create a vaccine, you knows it's not going to work in a hundred percent of people. But if enough people have it, have the vaccine and have the immunity, that helps many of the people who get the vaccine, but are not going to be able to mount an immune response.
Caitlin Whyte: So now, a lot of people are in that third stage of getting boosters. Why are boosters important and how do they offer more protection or better protection?
Dr. Sarah Brovender: So there's a lot of evidence out there that the antibodies that we have from prior infections or from vaccines wane. And that again is typical. You know, we get a flu shot every year. You got a tetanus shot every 10 years. Your childhood vaccines are done in multiple shots. Again, none of this is atypical. This is all to be expected. With COVID, which is changing so quickly and so new with these different variants, sometimes the specific antibodies that the vaccines target are what changes, and that's kind of what happened with Omicron, is a specific part of the virus that was targeted with the vaccine is the part that changed for Omicron, which is probably how it became so widespread anyway, because again, it evaded our prevention techniques.
So there is some question, you know, as you said, triple vaxxed, got COVID that is happening. Now, there's some research being done into Omicron specific vaccines. But regardless, some immunity is still better than no immunity. And having antibodies that maybe aren't as strong towards Omicron are still going to prevent against severe disease, which is really the worst case scenario. So that's really what we're trying to avoid anyway.
Caitlin Whyte: So as of this taping, January 26th, what are the current recommendations for boosters when it comes to age, timing, after other shots? What are the factors right now?
Dr. Sarah Brovender: So right now, it's pretty much recommended pretty much everyone who's vaccinated to get a booster, because as I said, immunity does wane after a certain period of time and that is typical. So Pfizer is the most widespread, so everyone 12 and older five months after your vaccine series. For Moderna, it's only approved for 18 and older, but it's the same timeframe. And then Johnson & Johnson is a shorter timeframe because it's only the one shot, so two months, but again, still 18 and older.
Another thing is it's okay to mix and match. So if you've got the Moderna vaccine and you've got a Pfizer booster, that's fine. You know, you should get whatever you have available to you because that's what's going to give you protection for both getting this disease and spreading this disease. And that's, I feel, like the most important thing right now. Probably most people have gotten COVID, but we want to stop the spread.
Caitlin Whyte: No, absolutely. Well, doctor, we covered a lot in a short amount of time. But as we wrap up here, is there anything else we didn't touch on? Anything else you want listeners to know about COVID-19, variants, boosters, anything we covered this episode?
Dr. Sarah Brovender: I think just take-home point, get vaccinated. I think a lot of people think, "Oh, well, I'm young, I'm healthy. You know, I'm not going to get severe COVID. It's not a big deal. But it's not just for you. It's not just about you. Getting vaccinated may protect a, you know, teenager with leukemia or a parent undergoing chemo or things like that that you don't even think about or don't even realize, that these people that you interact with every day, that because you and I are vaccinated and you, even if you've got to have a decreased viral load and you could potentially save someone else's life. So it's bigger than just, "Well, I probably won't get severe COVID," and so I would recommend everyone to get vaccinated.
Caitlin Whyte: Well, I know you're busy, doctor, so thank you so much for taking the time to keep us up-to-date on COVID and its variants. For more information or to make an appointment with a doctor at Jamaica Hospital, please call (718) 206-6000. That's (718) 206-6000. Or visit us online at jamaicahospital.org. This has been Jamaica Hospital Med Talk. I am your host, Caitlin Whyte. Be well and get vaccinated.
All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed in this podcast.