The latest variant report from the Hawaii Department of Health shows emerging new subvariants are gaining ground in the state, similar to national trends.

Omicron subvariant BA.5, which the new bivalent boosters targets, still remains dominant, making up 88% of new COVID-19 cases in Hawaii for the two-week period ending Sept. 24 compared with 91% in the previous reporting period.

New omicron subvariants, such as BA.4.6 and BF.7, meanwhile, are growing in proportion, and together represented 10% of variants circulating in the state.

“Fortunately, both BA.4.6 and BF.7 are offshoots of Omicron and the new bivalent boosters provide increased protection against them,” DOH spokesman Brooks Baehr said in a statement.

Subvariant BF.7, a descendant of BA.5, has beenflagged as a variant of concern by the United Kingdom Health Security Agency, due to rising cases in Europe.

Others detected and listed in the report that epidemiologists are watching include more immune-evasive subvariants such as BA.2.75.2, a descendant of BA.2.75, along with BQ.1, a sublineage of BA.5. DOH confirmed that the BA.2.75.2 and BQ.1 strains included in its latest variant report were detected for the first time in Hawaii.

One study called BA.2.75.2 “the most neutralisation resistant variant evaluated to date.” Another Lancet report found BA.2.75.2 to have “profound immune escape” and resistance to treatments such as Evusheld and Sotrovimab monoclonal antibodies, as well as significant growth advantage in the U.S.

“While BA.2.75.2 and BQ.1 are also subvariants in the Omicron lineage, they have mutations that suggest an increased ability to escape immunity from vaccination and previous infection,” Baehr said. “DOH is closely monitoring these subvariants.”

The U.S. Food and Drug Administration earlier this month updated its fact sheet for Evusheld to warn users of the increased risk of developing COVID when exposed to variants not neutralized by the treatment used to help protect immunocompromised individuals.