The Centers for Disease Control and Prevention (CDC) has confirmed the detection of the new COVID-19 variant NB.1.8.1 in multiple locations across the United States. This variant has been linked to a significant increase in cases in China.
“CDC is aware of reported cases of COVID-19 NB.1.8.1 in China and is in regular contact with international partners,” a CDC spokesperson stated last week. The agency noted that the number of U.S. sequences reported for NB.1.8.1 is currently too low to be included in its variant estimate dashboard. However, increased hospitalizations observed internationally have raised concerns about the variant’s characteristics.
According to experts, the symptoms associated with NB.1.8.1 are “broadly similar to those seen in earlier strains of the virus,” as stated by Subhash Verma, a professor of microbiology and immunology at the University of Nevada, Reno School of Medicine. Commonly reported symptoms include respiratory issues such as cough and sore throat, alongside systemic effects like fever and fatigue.
Regarding the severity of the new variant, Verma indicated that “data suggests that NB.1.8.1 does not lead to more severe illness compared to previous variants, although it appears to have a growth advantage, suggesting it may spread more easily. In other words, it is more transmissible.” Authorities in Hong Kong, where the variant is a descendant of the XDV lineage, have also found no evidence of increased severity. Dr. Amy Edwards, a pediatric infectious disease specialist at Case Western Reserve University School of Medicine, corroborated this, citing preliminary lab evidence suggesting the variant binds more tightly to human cells, enhancing transmission but not necessarily the severity of infection. The rise in hospitalizations in regions experiencing surges appears to align with typical summer trends rather than indicating increased virulence of NB.1.8.1.
Despite the variant’s high transmissibility, the Trump administration is planning to limit access to the 2025 COVID booster vaccine to specific populations. The Food and Drug Administration (FDA) announced last week that it will continue to approve updated COVID-19 vaccines for seniors and individuals with underlying medical conditions, including pregnancy and diabetes. However, broader approval for wider use will require vaccine manufacturers to conduct significant new clinical trials, potentially restricting access for many Americans without these conditions this fall.
Verma cautioned that these restrictions could have considerable public health implications. “Although over 100 million Americans are still expected to qualify under these criteria, the administration’s decision introduces new barriers for the broader population,” he explained. Concerns include potential delays in booster access for lower-risk groups due to the new clinical trial requirement, which might discourage vaccination. The policy could also create confusion and reduce vaccination rates due to uncertainty about eligibility and insurance coverage, especially with high-cost manufacturers potentially charging more for the vaccines.
Dr. Edwards noted the ambiguity in the updated recommendations, particularly regarding the definition of “pre-existing conditions.” Uncertainty also remains about the specific variants that will be included in this year’s vaccine and the parameters for allowed vaccine trials.
The new COVID-19 vaccination framework was established under the FDA’s new leadership, appointed by Health and Human Services Secretary Robert F. Kennedy Jr., who has publicly expressed skepticism about vaccines. Dr. Céline Gounder, a CBS News medical contributor and public health editor-at-large for KFF Health News, criticized the decision, stating that it would lead to reduced vaccine access despite earlier assurances of transparency and continued availability.
With questions surrounding vaccine access, Dr. Edwards emphasized the importance of alternative prevention strategies, including good cough and sneeze etiquette, thorough handwashing, and staying home when unwell. Mask-wearing is also recommended in crowded settings or for individuals feeling slightly under the weather to prevent the spread of respiratory viruses, including COVID-19. Authorities in Hong Kong have already begun advising residents to wear masks on public transportation and in crowded areas as cases of the new variant have increased.
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