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Prognosis


OMICRON THREAT MAY BE COUNTERED WITH EXTRA DOSE OF VACCINE

By
Jason Gale
and
Naomi Kresge
December 8, 2021, 6:08 AM GMT Updated on December 8, 2021, 3:28 PM GMT
 * Series of tests gives early gauge of immunity against variant
 * Cautious optimism that immune protection loss is not complete

WATCH: Bloomberg Intelligence breaks down the latest findings on the omicron
variant and vaccine efficacy.


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7:08


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The earliest studies on omicron are in and the glimpse they’re providing is
cautiously optimistic: while vaccines like the one made by Pfizer Inc. and
BioNTech SE may be less powerful against the new variant, protection can be
fortified with boosters.

Research from South Africa, Sweden and Germany, as well as from the companies
themselves, shows that omicron does cause a loss of immune protection -- but
potentially not a complete one. 

Pfizer and BioNTech said initial lab studies show a 25-fold reduction in
neutralizing antibody levels versus the variant, compared with the original
strain of the virus, in people who got just two shots. However, boosting with an
additional dose of the vaccine raised antibodies, giving a similar level of the
protective proteins as observed against earlier versions after the standard two
shots, the vaccine partners said Wednesday. 




Publication of their data followed results from a South African study of blood
plasma from people given two doses of the Pfizer-BioNTech shot. These showed a
41-fold drop in levels of virus-blocking antibodies compared with the strain
circulating at the start of the pandemic. 



German researchers backed up South African results, finding as much as a 37-fold
drop in antibodies against omicron versus the delta variant, virologist Sandra
Ciesek said in study results posted early Wednesday on Twitter. A separate study
from Stockholm’s Karolinska Institute was more optimistic, finding the decline
in antibodies against omicron was only slightly worse than for delta, the strain
currently causing most Covid-19 cases worldwide.


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The results offer early, as yet incomplete insight into how potentially damaging
the spread of omicron could be. Antibody levels are only one piece of the immune
system’s response against the virus. So-called “killer” T cells also play an
important role in protection against severe disease, and Pfizer and BioNTech
said they continue to expect a robust response.

Researchers saw reason for hope, even before the companies weighed in. The loss
of immune protection is “robust, but not complete,” said Alex Sigal, head of
research at the Africa Health Research Institute in Durban, who presented the
findings of the first study late Tuesday. “A good booster probably would
decrease your chance of infection, especially infection leading to more severe
disease,” he said. 

The German study by Ciesek’s team at the Institute of Medical Virology at the
University Clinic Frankfurt found no neutralizing antibodies for the omicron
variant in some samples taken six months after double vaccination. The results
have not undergone peer review. However, the data show that boosters will be
needed, Christian Drosten, director of virology at Charite, a university
hospital in Berlin, said on Twitter.



The World Health Organization has warned omicron could fuel surges with “severe
consequences” amid signs that it makes the coronavirus more transmissible.
Still, the jump in cases in South Africa following omicron’s emergence hasn’t
overwhelmed hospitals so far, prompting some cautious optimism that the new
strain may cause mostly mild illness. 




Governments and financial markets are trying to gauge whether the new variant
will have a significant impact on the world’s attempt to move past the pandemic.
Omicron’s rapid spread has raised concern the strain would be sufficiently
immune-evasive to require new vaccines, and hundreds of researchers have been
working around the clock to answer the question. 

Your browser does not support the audio element.
LISTEN: Amesh Adalja, senior scholar at Johns Hokins Center for Health Security,
discusses the omicron variant with Bloomberg’s Nathan Hager.
Source: Bloomberg

“These Karolinska data are reason for optimism,” said Shane Crotty, a professor
in the Center for Infectious Disease and Vaccine Research at San Diego’s La
Jolla Institute for Immunology. “That is pretty close to the best-case scenario
I was considering.”

Levels of neutralizing antibodies are a key marker of immune protection.
Although they naturally decline in the months after an infection or vaccination,
the body’s ability to spring into action to make more effective antibodies if
needed has been shown to improve over time. 

Read More

What We Know About Omicron, the New Virus Variant: QuickTake

Boosters Prevent Covid Better After Six-Month Wait, Doctors Say

Large S. Africa Hospital Group Sees Fewer Severe Covid Cases

“There will be more breakthrough” of vaccine-induced immunity, Sigal said,
adding that fully vaccinated people should get booster shots and those who’ve
been previously infected should get vaccinated. 


PRELIMINARY RESULTS 

The results are preliminary and exact levels of immune escape may change, said
Sigal, whose lab was the first to isolate the beta variant identified in South
Africa in late 2020. He noted that omicron escapes antibody neutralization more
readily than beta, which had been considered the most immune evasive of the
variants of concern detected previously. 



A key question researchers are trying to address is whether existing Covid
vaccines need to be altered to protect against omicron. Pfizer and BioNTech said
an omicron-targeted shot would be ready by March.

Any vaccine changes would require careful consideration, especially since delta
is currently the main driver behind the Covid epidemics and existing shots
provide a sufficient shield against it, Ana-Maria Henao-Restrepo, who co-leads
the WHO’s research and development blueprint for vaccines and innovations during
outbreaks and pandemics, said last week.


MORE DATA

The magnitude of the drop in neutralizing antibodies against omicron could
indicate a need for omicron-matched vaccines, though other considerations may
play a role, said Stephen Goldstein, an evolutionary virologist at the
University of Utah in Salt Lake City. Larger studies looking at neutralizing
antibodies from people immunized with other vaccines are also needed, he said.



“More importantly though will be epidemiological studies looking at the
frequency of reinfections and breakthrough infections, as well as disease
severity in those patients,” Goldstein said. “I am still optimistic that
vaccination or prior infection will provide some measure of protection against
severe disease.”



 


Electron micrograph of an omicron-infected cell showing aggregates of viral
particles with corona shaped spikes on their surface (red box).
Photographer: Prof. John Nicholls/University of Hong Kong


The work in Sigal’s lab involved testing 14 blood plasma samples collected from
a dozen people who had been given a second Pfizer-BioNTech shot about a month
earlier to gauge the concentration of antibodies needed to neutralize, or block,
the live omicrion virus. Levels of neutralizing antibodies against the variant
were significantly higher in a subset of participants who had a bout of Covid
about a year earlier, Sigal said.


HYBRID IMMUNITY

That indicates so-called hybrid immunity generated by natural infection followed
by immunization may provide reasonable protection against omicron. In those who
have never had Covid, this could be emulated by administering three doses of
vaccine, the La Jolla Institute’s Crotty said.



“What many of us want to see is head-to-head comparisons against other variants,
because of the broader experience with them,” he said. Scientists also want to
better understand the significance of the reduction in levels of neutralizing
antibodies against omicron, and to study the antibody responses against omicron
in blood sera from people who have received three doses of either the Pfizer or
Moderna vaccine, Crotty said. 



In the weeks ahead, more clarity will also emerge from studies assessing the T
cell response to omicron, like one being run by the La Jolla Institute’s
Alessandro Sette. 

It’s possible omicron will have a less extreme impact on T cells, the white
blood cell the immune system uses to kill virus-infected cells, said Dan
Barouch, the William Bosworth Castle professor of medicine at Harvard Medical
School and head of Boston’s Beth Israel Deaconess’ Center for Virology and
Vaccine Research. 

— With assistance by Antony Sguazzin, and Robert Langreth

(Updates with Pfizer results from third paragraph)


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