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US Is the best strategy against omicron to keep boosting with the original vaccine?

15:42  05 december  2021
15:42  05 december  2021 Source:   nbcnews.com

Omicron Variant: Germany, Czech Republic Report Suspected Cases After U.K. Confirmation

  Omicron Variant: Germany, Czech Republic Report Suspected Cases After U.K. Confirmation Several countries, including the U.S., Japan and Israel, have announced travel restrictions to avoid the mass spread of the latest COVID variant.Germany's Hessian Ministry for Social Affairs and Integration said Saturday that an individual who traveled to Germany from South Africa is suspected to be infected with the Omicron variant.

Federal health officials are urging all vaccinated adults to get their Covid booster shot amid growing alarm over the omicron variant, a heavily mutated coronavirus strain that's already been detected in a handful of states across the U.S. But some vaccine experts worry that numerous booster doses of existing vaccines could make future vaccines, if needed, less effective.

  Is the best strategy against omicron to keep boosting with the original vaccine? © Provided by NBC News

The variant's mutations suggest it may be able to dodge some of the immunity provided by vaccination or natural infection. While federal health officials and drugmakers await highly anticipated lab results to see how much of a threat omicron poses to vaccines, for now, the existing boosters are the best defense against the new strain and the highly transmissible delta variant, Dr. Anthony Fauci, the White House’s chief medical adviser, epidemiologists and immunologists say.

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But what is the best strategy for boosters going forward? And if boosters are needed for years to come, as Pfizer CEO Albert Bourla has suggested, will they need to be modified?

Studies show an extra dose of the current Covid vaccines "increase levels of neutralizing antibodies against all the variants," Fauci, director of the National Institute for Allergy and Infectious Disease, said Friday at the White House Covid-19 Response Team briefing. "There's every reason to believe that if you get vaccinated and boosted that you would have at least some degree of cross-protection, very likely against severe disease, even against the omicron variant."

This week, the health minister of Israel, which started giving out third doses of Pfizer booster shots in summer, said that a fourth booster dose might be necessary if the country's Covid cases continued to climb.

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  Americans face at least 2 weeks of uncertainty as scientists work to answer 3 key questions about the new Omicron variant Americans face at least two weeks of uncertainty before major questions may get answered about the Omicron variant of the coronavirus. © Steve Pfost/Newsday/Getty Images Stony Brook, N.Y.: Robert Baird, of Centereach, New York is given a booster shot as members of the community are administered the COVID-19 vaccination and booster at Stony Brook University Research and Development Park in Stony Brook, New York on Nov. 17, 2021.

Pfizer-BioNTech, Moderna and Johnson & Johnson are working on omicron-specific vaccines to use against the new variant if lab tests show significant declines in protection against severe disease, though it could take months before they're ready to be distributed.

Still, there is discussion among some health experts about whether it is appropriate to use the existing vaccines as boosters against new, emerging strains, as the shots are still formulated to target the original form of the virus identified in late 2019.

“The question is, if you keep priming and boosting with a strain, which is basically to make an immune response against the ancestral strain, will that limit your ability then to make an immune response to a virus, which is very much different than the ancestral?” said Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia.

Offit is describing a phenomenon immunologists call “original antigenic sin” in which the body’s immune system relies on the memory of its first encounter with a virus, sometimes leading to a weaker immune response when it later encounters another version of the virus.

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Vaccines can activate this phenomenon, too, said Offit, also a member of the Food and Drug Administration’s vaccine advisory committee. An example is with the human papillomavirus, or HPV, following the release of an updated vaccine that targeted nine strains of the virus instead of just four in the initial shot, he said.

“If you got HPV4 and then got HPV9, knowing that the four strains in [HPV]4 were also in [HPV]9, you had a very good immune response to the four strains, but you didn’t have as good as an immune response to the other five strains,” he said.

Theoretically, it could apply to Covid, too, Offit said.

He said that some experts have argued it may be better for those not at high risk of severe disease to wait to get a booster until a variant-specific option is available.

He, along with Philip Krause and Marion Gruber, two former FDA officials, wrote an op-ed published Monday in The Washington Post that argued that booster shots should be restricted to those at high risk for severe disease, such as the elderly and those who live or work in high-risk settings, like health care workers. They said the original two doses of the mRNA vaccines are still working for most healthy adults.

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  New Poll Shows That Concern About Omicron Variant Is Split Down Party Lines Democrats were more than twice as likely as Republicans to agree that the Omicron COVID-19 variant "poses a serious risk to all Americans."A poll released on Tuesday by YouGov found that Democrats were much more likely to be concerned about the new variant than Republicans. Although 80 percent of Democrats said they were "somewhat concerned" or "very concerned" about Omicron, only 35 percent of Republicans agreed.

Michael Osterholm, an epidemiologist and former Covid adviser to President Joe Biden, countered that the third dose of mRNA or second dose of J&J should be considered part of the original vaccine's primary series and people should get a booster as soon as eligible. A booster dose “can actually offset the immune evasion we've seen with this particular variant,” Osterholm told MSNBC's Hallie Jackson on Friday.

Ali Ellebedy, an associate professor of pathology and immunology at Washington University School of Medicine in St. Louis, pointed out that for influenza as well, having too many antibodies against previous strains can interfere with vaccinations against other flu variants.

However, he said he rejects the idea that this could happen for Covid, at least right now.

The global population has not accumulated enough baseline antibodies against SARS-CoV-2 "to block any further boosting, which is the case in flu for some people," he said. He also noted influenza vaccines are "poorly immunogenic vaccines," nothing like the mRNA vaccines.

Ellen Foxman, an immunologist at Yale University, said even if boosting with the original vaccine did make future vaccines less effective, it is not "wise" to wait for a variant-specific shot to get a boost. The bottom line, she said, is that there's a life-threatening virus still spreading across the country and current vaccines have been shown to protect against it.

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  Who Discovered the Highly Mutated Omicron Variant, Now Found in More Than a Dozen Countries? The scientific community has praised the efforts of scientists from South Africa, Botswana and Hong Kong for their early detection of the variant of concern.In a press briefing on Tuesday, Dr. Anthony Fauci, chief medical adviser to President Joe Biden and director of the U.S. National Institutes of Allergy and Infectious Diseases, said cases had been confirmed in at least 20 countries and "you're going to expect to see those numbers change rapidly.

Will the existing shot be as good as it was against the original virus? "Maybe or maybe not, but it will probably provide at least some protection against it," she said.

"If we knew that we needed an updated booster and we knew it was going to come out next week, maybe you should wait," she said. "But the truth is, this coronavirus is going around now and it’s mostly the delta variant."

Dr. Peter Hotez agreed, adding that the 30-to-40-fold rise in virus-related antibodies generated by the booster shots may be sufficient against the new strain.

“No matter what, you can’t wait for your booster because delta is still the dominant variant and will be so, I think, for the foreseeable future,” said Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital and dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston.

He added that a variant-specific vaccine may not be needed and that there's a chance that the omicron-specific boosters the drugmakers are developing won't work.

“A slam dunk is not guaranteed,” Hotez said. “Waiting for an omicron-specific booster is a very high-risk strategy.”

John Moore, a professor of microbiology and immunology at the Weill Cornell Medical College, said there are still some unknowns about the uses of the vaccines, and so the “best-boosting strategy” will emerge over time.

“Everyone wants instant answers, but it matters more to get the right answers. That takes time,” he said.

U.S. Finds Mild Omicron Cases; Record Korea Deaths: Virus Update .
Most of the U.S. Covid-19 cases traced to the omicron variant so far have been mild illnesses in people who were vaccinated, according to the U.S. Centers for Disease Control. Vietnam plans to resume some international flights next month, while Korea reported a daily record for virus deaths. After months of warnings that vaccinations would ward off a Covid-19 disaster, the U.S. is hurtling toward a holiday crisis. New York Governor Kathy Hochul ordered all businesses to require masks indoors if they don’t have a vaccine requirement. AstraZeneca Plc will supply Singapore with an antibody drug.

usr: 3
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