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BQ.1.1 is among the most immune-evasive COVID variants yet. It’s coming in hot in the U.S.

Omicron spawn BQ.1 and its offspring—the highly immune-evasive BQ.1.1—are coming in hot in the U.S.

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BQ.1.1 is surging in New York, considered by experts to be a "bellwether" state due to its volume of incoming international travelers and robust sequencing capabilities. It's also rising in European countries like Germany, where Oktoberfest celebrations may have served as super-spreader events.

Along with XBB—a combination of two Omicron strains spiking in Singapore and Bangladesh—BQ.1.1 is thought to be the most immune-evasive new variant, according to Dr. Eric Topol, a professor of molecular medicine at Scripps Research and founder and director of the Scripps Research Translational Institute.

BQ.1.1's extreme immune evasiveness "sets it up to be the principal driver of the next U.S. wave in the weeks ahead," Topol tweeted Friday.

On Thursday, he told Fortune that scientists won't know to what extent it challenge vaccines, if it does, until it reaches 30%-50% of cases somewhere.

"It's not going to wipe out vaccine efficacy, but it could but a dent in protection against hospitalizations and death," he said.

BQ.1.1 is already known to escape antibody immunity, rendering useless monoclonal antibody treatments used in high-risk individuals with COVID. According to a study last month out of Peking University’s Biomedical Pioneering Innovation Center in China, BQ.1.1 escapes immunity from Bebtelovimab, the last monoclonal antibody drug effective on all variants, as well as Evusheld, which works on some. Along with variants CA.1 and XBB, BQ.1.1 could lead to more severe symptoms, the authors wrote.

BQ.1.1 is one of two variants, including XBB, Topol says should be granted new Greek letter names, like Pi or Rho, because they differ enough from BA.5, the strain they derived from. He also said he would have assigned a Greek letter to BA.5, which was significantly distinct from ancestors BA.1 and BA.2.

The good news, if there is any, about BQ.1 and BQ.1.1 is that new Omicron boosters will "almost certainly" provide "some" protection against them because they were designed to tackle close relative BA.5, Fauci told CBS on Friday.