If You've Never Had COVID Are You More Susceptible to Variants?

By this point, nearly everyone knows someone who has had COVID-19. As of July, 82% of Americans have been infected with the coronavirus at least once, according to a report from the Institute of Health Metrics and Evaluation.

Yet there's a small group of people who still have not gotten COVID. These individuals range from people who keep their distance from others and isolate themselves at home, to those who don't wear masks on planes, or who attend crowded parties and weddings and have still never gotten sick.

The thing about COVID, however, is that it's constantly evolving and new variants continue to emerge regularly. Case in point, the now-dominant BA.5 variant has proven to be more contagious than its predecessors and more resistant to vaccination.

All of which begs the question—are COVID virgins, who do not have the benefit of the increased immunity that often results from a previous COVID infection, more susceptible to variants?

Here's a closer look at why some people still have not gotten COVID yet and whether these individuals may be more vulnerable as new variants continue to emerge.

How Have Some People Managed to Avoid COVID?

There's a variety of explanations for why some people have managed to escape getting a virus as contagious as COVID-19. One of the most widespread theories is that these individuals probably have had the virus but simply did not know it.

This rationale behind this line of thinking is research suggesting that about 40% of COVID-19 infections are asymptomatic. Infections among children and young adults are particularly likely to be underrepresented as studies show this group of individuals are more likely to show no symptoms when infected. And those who had very mild symptoms, may have simply shrugged it off, thinking they were experiencing a random cold or an off-day.

What's more, if you felt tired or had a runny nose that resolved quickly, testing was probably not even a consideration.

"Most likely, people do not know they've been infected," Scott Roberts, MD, an infectious disease specialist and associate medical director of infection prevention at Yale Medicine, told Health. "Studies that check antibodies against COVID support this theory as these people show antibodies when you do those tests compared to the number who've actually reported infection."

Another explanation for the lack of infection among some is the extreme precautions being taken to shield against the virus. Some COVID virgins are not lucky but ‌have made efforts to mask up indoors at all times, avoid large gatherings, and stay up to date on vaccinations, Dr. Roberts added. And when they ‌meet with friends and families, these COVID 'virgins' may have encouraged people to get tested beforehand.

What Role Do Genes Play?

Yet another factor that's being explored is the role genes may play. Roberts says there are some people with HIV who are known as elite controllers and these individuals have genes that prevent the virus from spreading and infecting other cells. While not confirmed, scientists are not ruling out the possibility that something similar could happen with COVID.

"It is possible that people have genes or something that makes their immune system function in a different manner. Maybe they don't have the receptors the virus strongly binds to enter a cell," theorizes Robert.

The National Institute of Health is currently supporting work studying the role of genetics in a person's COVID-19 risk. Researchers have not yet found the holy grail of genes that makes individuals immune to COVID, but they have shown evidence that a person's genes can sway a person's course of infection.

Not all scientists support this theory, however, citing the lack of evidence so far.

"There's no reason to think that's necessarily a real thing that can happen," Andrew Handel, MD, a doctor of pediatric infectious diseases at Stony Brook Medicine, told Health. "So far there's been no reports, no findings, and no studies showing that anyone is innately immune to it without ever having had it before."

Are COVID 'Virgins' More Susceptible to Variants?

There are now different tiers of protection against COVID, said Dr. Roberts. Individuals with the highest level of protection are those who have been vaccinated and infected. A step behind are vaccinated individuals who have not been infected. Trailing further behind are those who have been infected but not vaccinated, or not fully vaccinated. At the very bottom of this ranking are individuals who have never been vaccinated or infected, they have the lowest immunity.

But still there's no guarantee that COVID virgins who lack the immunity bump from natural infection would end up severely ill from a variant. At this point there are many questions that scientists still don't have answers to, said Dr. Roberts, including just how much immunity an individual receives from having contracted the COVID-19 virus.

Research suggests naturally acquired antibodies help provide cross-immunity against prior coronavirus strains in vaccinated people. However, in unvaccinated individuals antibodies do not provide the same broad protection against non-Omicron variants. Another study reported that recovering from an Omicron infection is 76% more protective against reinfection from BA.4 and BA.5 variants.

There's also questions surrounding the type of immunity an individual might get from having been infected. Since the COVID virus has mutated so much, it can bypass antibodies, Dr. Roberts explained.

"Natural infection does more than antibodies vaccines give you. Other aspects of the immune system, such as T-cell response and innate immune responses, may act differently in a natural infection than in a vaccine," said Dr. Roberts.

Still, experts caution that this doesn't mean individuals should purposely try to get sick. There is always a risk of long COVID, regardless of the severity of your infection. Nearly one in five adults in the US who've recovered from COVID developed long COVID. Dr. Roberts says there's also no guarantee that contracting the virus would even provide immunity for a future and unknown variant.

What Comes Next?

Scientists say the COVID virus could become endemic by 2024, meaning the virus is constantly circulating but at predictable levels. However, that doesn't mean it's a good idea to let your guard down or to deliberately try and get COVID-19 to build immunity.

"It's going to be how we treat the flu that causes 40,000 to 60,000 deaths per year. And we've accepted that as a society and decided to live with the flu. But in the hospital we see people, including some young and healthy, die from the flu," said Dr. Roberts. "It's a dangerous mindset to think 'It's here to stay so I might as well get infected'."

If you have not been infected, here are some tips from Dr. Roberts and Dr. Handel to help keep you— and others—from getting COVID.

Do:

• Get vaccinated
• Stay up to date on boosters
• Wear masks indoors
• Maintain physical distance from people not in your immediate circle
• Open a window for better ventilation when indoors with others
• Regularly test to prevent spreading the virus to others
• Keep track of COVID-19 levels in your community

Don't:

• Go out and intentionally get COVID
• Go to COVID parties
• Wear your mask on your chin or below your nose
• Attend crowded spaces or areas with low ventilation

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.