By my calendar it looks like the local Omicron surge started the week of December 20th. It has not peaked yet that I can tell. The good news is that most of the cases that I have seen in boosted individuals have been mild. Some people at higher risk for progression have cancelled their infusions of monoclonal antibodies because they are substantially recovered by the time that they are available. Still hospital cases are climbing and the vast majority (80%) are unvaccinated. The following article shows that the most effective way of not getting Covid 19 is to be vaccinated and boosted.
January 7, 2022
Third Dose of COVID-19 mRNA Vaccine Is Critical to Increase Neutralizing Antibodies Against Omicron
George Sakoulas, MD, reviewing
A booster dose of BNT162b or mRNA-1273 vaccine enhanced cross-reactive antibody responses sufficient to neutralize the Omicron variant.
The three vaccines available in the U.S. have been successful in inducing humoral and cellular immunity sufficient to neutralize SARS-CoV-2 and significantly reduce severe COVID-19. However, the Omicron variant harbors 36 spike protein mutations that attenuate vaccine-driven immunity. Garcia-Beltran et al. measured neutralization potency of sera from 239 recipients of BNT162b, mRNA-1273, or Ad26.COV2.S (Johnson & Johnson) against wild-type, Delta, and Omicron genetically engineered SARS-CoV-2 pseudoviruses. Sixty-three participants had received a third dose of mRNA vaccine.
Consistent with prior studies, recipients of the primary mRNA vaccine series demonstrated significantly higher titers against wild-type virus than did Ad26.COV2.S recipients. While neutralization was decreased relative to wild type for recipients of all vaccine types (and Delta neutralization was absent in most individuals >6 months after the primary vaccine series), Omicron neutralization was absent in all primary vaccine recipients, even those recently vaccinated. Prior vaccine recipients who had also convalesced from prior COVID-19 infection did retain some detectable Omicron neutralization. Most notably, serum from recent mRNA vaccine booster recipients exhibited potent Omicron neutralization; in particular, such serum showed higher SARS-CoV-2 neutralization titers (via higher anti-spike antibody levels) as well as broader humoral responses cross-reacting against Omicron. In tissue culture studies, Delta was two-fold more efficient at infecting cells than wild-type and Omicron was two-fold more efficient than Delta.
These experiments suggest that the rapid spread of Omicron is driven by more efficient infection of cells and immune escape. While a two-dose mRNA series resulted in high neutralizing antibody titers against wild-type SARS-CoV-2 with minimal decline against Delta, a booster dose now appears necessary to elicit comparable levels against Omicron and should be encouraged 6 months after the primary vaccine series.
Garcia-Beltran WF et al. mRNA-based COVID-19 vaccine boosters induce neutralizing immunity against SARS-CoV-2 Omicron variant. Cell 2021 Dec 23; [e-pub]. (https://doi.org/10.1016/j.cell.2021.12.033)
Now comes word of an even more effective vaccine against Omicron and future variants which may be released in March by Pfizer.
Pfizer is racing ahead with plans to manufacture 50 million to 100 million doses of a new omicron-specific version of its coronavirus vaccine, a reflection of rising concerns that current vaccine formulations may need to be tweaked for the new threat.
Pfizer also is testing hybrid combinations of vaccine to target multiple coronavirus forms, as well as larger doses.
The omicron-specific doses will be created “at risk,” CEO Albert Bourla said Monday, meaning that if they are not needed, Pfizer will absorb the costs. The company has climbed to the lead in global vaccine production with 3 billion doses in 2021 and is planning to produce up to 4 billion doses in 2022.
If it turns out to be necessary to roll out an omicron-targeting vaccine, Pfizer will be ready, Bourla said.
“In terms of manufacturing, we have so big of a capacity built right now, that it won’t be an issue to switch immediately,” Bourla said at the conference.
Rapid development and manufacturing changes are made possible by the new mRNA vaccine technology deployed by Moderna and Pfizer, with German partner BioNTech. The companies have said it takes about 90 days from genetic sequencing of a new threat to producing a new lipid nanoparticle vaccine containing the updated mRNA payload, which is an extraordinarily fast time frame for vaccine development.
Pfizer on Monday announced a licensing deal with a San Diego company, Codex DNA, that has a synthetic DNA manufacturing process that should cut the development time even further, to just 60 days, Bourla said.
Moderna is also testing different vaccine formulations, including a hybrid shot that would combine a flu vaccine and a coronavirus vaccine, Moderna CEO Stéphane Bancel said at the biotech conference. Moderna is striving to have a combination shot available by the fall, in preparation for a likely coronavirus surge next winter, he said.
The demand for boosters and, potentially, variant-targeting vaccines and hybrids is causing alarm among global health authorities, who say the greater volumes and new versions will be reserved by wealthy nations and further delay the time Africa and other developing countries get their populations substantially vaccinated.