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What to Know About the New XBB.1.5 Variant


By Jamie Ducharme

January 3, 2023

Source: Time Photo / Image Source: Unsplash, Accuray

Anew variant of the virus that causes COVID-19 is spreading in the U.S., raising concerns about a potential wave of infections and reinfections to start the new year.

The variant, called XBB.1.5, is a descendent of Omicron and a close relative of the XBB variant, which spread widely in Singapore and India this past fall. A December study in the journal Cell demonstrated that XBB is better at evading immune defenses gained from vaccination and prior infection, compared to other variants. This raises the risk of reinfection, a World Health Organization group warned in October—though the group said at the time that XBB does not appear to cause significantly more severe disease than previous strains. Along with its adeptness at getting around immune blockades, XBB.1.5 appears to be highly transmissible, thanks to some key mutations picked up as the virus evolved. These tweaks are stoking concerns about a surge in cases this winter—particularly given low rates of booster uptake and relaxed disease-mitigation measures.

While there is limited research on XBB.1.5 at this point, here’s what we know so far. How widespread is XBB.1.5 in the U.S.? During the week ending Dec. 31, XBB.1.5 accounted for 40.5% of new sequenced COVID-19 cases in the U.S., according to data from the U.S. Centers for Disease Control and Prevention (CDC). It’s currently causing roughly 75% of new cases in the Northeast, which is often a bellwether for the rest of the country.

Nationally representative diagnostic data from Walgreens, a COVID-19 testing provider across the U.S., shows almost 40% of tests are now coming back positive, though it’s not possible to say how many of those infections were due to XBB.1.5. Hospitalizations are also starting to tick upward nationwide, according to CDC data. Do vaccines and treatments work against XBB.1.5? While there isn’t much data on XBB.1.5 yet, research on its relative XBB provides some clues. Research recently published in the New England Journal of Medicine (and based on a small number of people) suggests that while XBB is more immune-evasive than previous versions of the virus, people who have received the updated bivalent booster are better protected against it than those who have not. Just 15% of people in the U.S. ages 5 and older have gotten a bivalent booster, according to the CDC, which means many people are currently not as protected as they could be against the new variant.

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