Omicron encourages a quick rethinking of boosters among scientists

As last week, many public health experts strongly opposed the Biden administration’s campaign to deploy booster shots of the coronavirus vaccine to all American adults. There was little scientific evidence to support the additional doses for most people, the researchers said.

The Omicron variant changed it all.

Scientists are still not sure if the virus is easy to spread or if it is less vulnerable to the body’s immune response. However, with dozens of new mutations, this variant is likely to circumvent vaccine protection to some extent.

Booster shots can clearly increase antibody levels, strengthen the body’s defenses against infection, and help offset the benefits that Omicron has gained through evolution.

Many experts who opposed boosters now believe that Shot may provide the best protection against new varieties. The extra dose can slow the spread, at least by purchasing time for the vaccine manufacturer to develop an Omicron-specific formulation as needed.

“Based on what we know about the potential for antigenic escape, I make mistakes on the part of the booster giver,” said Dr. Celine Gounder, an infectious disease specialist at the Bellevue Hospital Center. Opposed to the booster effect of the Biden administration..

The administration is not waiting for a scientific consensus.Warning to a preliminary report on Omicron, Centers for Disease Control and Prevention officials said on Monday that all American adults Must receive booster shots..

The first confirmed Omicron infection in the United States was reported Wednesday in San Francisco, a traveler returning from South Africa to California on 22 November. The individual was completely vaccinated but did not receive boost immunization and showed mild symptoms, which were said to be improving.

The first Omicron variant identified in southern Africa has been found in at least 20 countries, and the World Health Organization warns that the risk posed by the virus is “very high.” After news of the epidemic of variants in South Africa, countries around the world have reduced air travel to and from South Africa.

Omicron has more than 50 gene mutations, more than 30 of which are in viral spikes, proteins on the surface. Vaccines train the body’s immune defenses to target and attack these spikes.

So far, experts like Dr. Gonder have said that vaccines against delta mutant infections appear to be less effective, yet protect most people from serious illness, hospitalization, and death. I was insisting. They said booster doses should only be recommended for adults over the age of 65 and those in long-term care facilities and those with weak immunity.

If Delta is the only threat, boosters will not yet be guaranteed, Dr. Gonder and other researchers said. But Omicron may be a more formidable enemy.

John Moore, a virologist at Weill Cornell Medicine in New York, said:

“I want to see more data, but there is no harm in increasing protection.”

Even before Omicron arrived, some experts have come to boosters for all adults as the US case has turned up again in the last few weeks.

Dr. Camille Cotton, an infectious disease specialist at the Massachusetts General Hospital and an advisor to the CDC, said:

“Now, more than ever, it’s the best time to get vaccinated or boosted for people who haven’t been vaccinated yet,” she said.

Dr. Cotton’s first hesitation was partly rooted in a lack of research on the safety of booster shots in young adults.Specific given Rare heart problems It was not clear that the benefits outweighed the risks in young men after receiving a second dose of the mRNA vaccine.

However, the data currently available eased her concerns, she said — she even urged her college son to receive booster immunization.

“Oh yeah, I’ve changed,” she said. “When it comes to risks and benefits, it’s a really good idea to get a booster effect for qualified people.”

Greater support for boosters among scientists will eventually It complicates efforts to deliver a limited supply of coronavirus vaccines to poor countries. The World Health Organization states that in the months long before Omicron’s appearance, demands for additional doses in developed countries were depriving poor countries of the first dose desperately needed.

Despite WHO’s designation of Omicron as a high risk, the organization has not changed its position regarding boosters.

“There is currently no evidence to suggest that increasing the overall population will increase the protection of healthy individuals against hospitalization and death,” said Dr. Mike Ryan, director of WHO. .. Said at a press conference on Wednesday.

He and other scientists say that the unchecked spread of coronavirus through a largely unvaccinated population like Africa is likely to cause mutations like Omicron.

Not all experts are lined up to support booster shots.

Dr. Paul Offit, Head of Vaccines, is based on the misconception that antibodies are a central aspect of immunity and overlook the importance of other parts of the immune system in preventing severe illness and death. He said he was promoting additional doses. Advisor to the Education Center and Food and Drug Administration of the Children’s Hospital of Philadelphia.

He said he would be more worried if a large number of vaccinated people infected with the Omicron variant were hospitalized. However, limited evidence to date suggests that the vaccine still prevents serious illness, he said.

“It’s always true. It’s true for the first three variants, and it can be true here as well,” he said. “If we set our goal as protection from mild illness, we will boost until the day of death.”

Even if Omicron turns out to be resistant to the vaccine, additional shots of the original vaccine may not be the best solution, Dr. Ofitt said. Of this pandemic to be vaccinated with unvaccinated. “

But waiting may not be an option.

If laboratory tests show that Omicron is avoiding the vaccine, the manufacturer says it is ready to adjust the new version. The process takes at least several months and may require a booster dose of the current vaccine to continue suppressing the mutant.

Even if the antibodies stimulated by these shots are not as effective at dodging Omicron as they were against previous mutants, they can be compensated for by increasing the amount alone, Dr. Gonder said.

“By increasing the number, you can disable some of the lesser ones,” she said.

If necessary, multiple boosters should be given at the right time, first with the current vaccine and then with the Omicron-specific version, so that certain immune cells do not become unresponsive to vaccination. There is, Dr. Moore said.

“This is where everything gets complicated-certainly, no one should sit here in the doctrine,” he said. “We are working in a low-information environment where the results can be extremely serious.”