Understanding the COVID-19 FLiRT Variants

Virologists are closely monitoring several COVID-19 variants, known as FLiRT variants, due to their shared mutations. Here’s what you need to know about these developments.

FLiRT Variants Overview
At the end of March 2024, the KP.2 variant accounted for approximately 4% of COVID-19 infections in the U.S., while the JN.1 strain was responsible for over 50%. By early May, KP.2 had surged to about 28% of infections, surpassing JN.1 as the dominant variant.

FLiRT variants, including KP.2 and JN.1.7, have independently acquired the same set of mutations through convergent evolution. These mutations occur at specific positions in the spike protein, particularly positions 456, 346, and 572, enhancing the virus’s ability to bind to cells and evade antibodies.

Impact of Mutations
The mutations at positions 456 and 346 help the virus evade neutralizing antibodies but can reduce its binding efficiency to cells. However, the mutation at position 572 compensates for this by improving the virus’s binding ability, facilitating infection.

Immunity and Vaccine Effectiveness
A previous infection with JN.1 likely provides strong protection against FLiRT variants due to minimal differences. Vaccines based on the XBB.1.5 variant generate some cross-reactive antibodies against JN.1. However, immunity wanes over time, and the efficacy against newer variants is still being studied.

In February, the CDC recommended an additional dose of the current COVID vaccine for adults 65 and older. The guidance for summer vaccinations remains uncertain.

Potential Summer Surge
A summer wave driven by FLiRT variants is possible, though the scale of infections, hospitalizations, and deaths is expected to be lower compared to earlier in the pandemic. The most vulnerable populations remain the elderly, immunocompromised, and those with underlying health conditions.

Vaccine Formulation for Fall
The WHO has recommended using the JN.1 lineage for the fall 2024 vaccine formulation. The FDA will finalize its recommendation in early June, aiming to match the circulating variants as closely as possible.

Symptoms and Transmission
Symptoms of FLiRT variants are similar to previous strains, typically milder due to stronger population immunity. The period of infectiousness remains consistent, with individuals being contagious one to two days before and a few days after symptom onset.

Antiviral Effectiveness
Antivirals like Paxlovid, molnupiravir, and remdesivir remain effective against FLiRT variants. Ongoing testing ensures these treatments continue to work against emerging variants.

Protection Measures
Monitor local case rates and take precautions, such as wearing masks and ensuring good ventilation, especially when traveling or in areas with rising infections. Keep COVID tests at home for quick testing if symptoms develop, and follow CDC guidelines to prevent spreading the virus, particularly around high-risk individuals.

Understanding these developments helps in making informed decisions about vaccination and protective measures to stay safe as we navigate the evolving COVID-19 landscape.

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