THE DOCTOR IS IN

OP-ED BY DR. ADIL MANZOOR

We haven’t quite defeated the coronavirus yet despite the reduced media attention. Of course, I know hospitalizations and deaths have significantly reduced, but the fact that there are still cases of viruses beating our vaccines means we’re still a way from victory.

Interestingly, experts suggest that we may never be able to eradicate the coronavirus fully, and it would become endemic. This means we may never truly win against the virus, doesn’t it? Well, any move that reduces the chances of the coronavirus evolving into a dangerous variant is a win for me. And one such move is the emergence of omicron-specific vaccine boosters.

You know of Omicron, I’m sure. It’s the last variant that made a mockery of our original vaccines. This variant caused another spike in the cases graph, and more cases mean a higher chance of even more variants evolving.

Before Omicron, Delta was the first major variant that could evade our vaccines. It did so quite well, too. To combat this, we resorted to booster doses. As the name strongly suggests, these booster doses reinvigorated the immunity the vaccine provided. This way, we could curb the spread and severity of the variant.

A few months later, omicron introduced itself and also proved to be vaccine-evading. The BA.4 and BA.5 Omicron subvariants currently account for about 70 percent of new COVID cases in the United States. Now, the plan is to roll out Omicron-specific boosters. These booster doses would go alongside current vaccines that can already prevent serious illnesses and deaths.

Many people, including doctors, had reservations when the FDA broke the news. The argument was that if the current primary vaccine already protects against serious illness, why make an Omicron-specific booster? Here’s why.

The longer a variant is exposed to a vaccine, the higher its chances of evolving to a strain resistant to that vaccine. The same applies to the omicron variant too. We saw it with the original strain of the virus. We saw it with the Delta variant. We cannot afford to take chances with the Omicron variant.

If the Omicron variant evolves, it would almost certainly be into a strain resistant to even our third shots. Then it could also have the much-dreaded perk of easy and rapid transmissibility. We don’t want that.

One bone of contention, though, is whether the Omicron variants circulation now will be the predominant ones come fall, when the boosters are expected to roll out. However, the FDA states that the Omicron-specific boosters would retain the ability of the current vaccines to prevent serious illnesses.

Right now, Pfizer and Moderna are the two companies expected to drop the boosters by fall. According to Pfizer, their booster would be for people who have been fully vaccinated with the Pfizer vaccine. Note that only people who have been fully vaccinated are eligible for the new vaccines.

Studies on the safety and efficacy of the boosters have shown promising results. There haven’t been widespread tests and studies, which is unsurprising at this stage. We are limited to what Moderna and Pfizer are releasing. According to their tests, the Omicron-specific variants can induce levels of neutralizing antibodies up to two times higher than those generated by the companies’ existing vaccines. Note that this is for BA.1 variants.

While that sounds good on paper, it doesn’t tell the full story. We don’t know the exact level of neutralizing antibodies that correlate with disease protection. So, for all we know, increasing antibodies two-fold may not significantly improve protection. Tests are underway for how the booster would react to BA.4 and BA.5, the major problems.

In case you are wondering the age groups the boosters would be available for, we don’t know yet. The CDC will give more detailed reports about the new vaccine boosters in due time. For now, though, get fully vaccinated. Stay safe.

This article was written by Dr. Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.

References

  • https://www.scientificamerican.com/article/omicron-specific-covid-boosters-are-coming/
  • https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-omicron-adapted-covid-19
  • https://www.npr.org/2022/06/30/1109047124/covid-boosters-omicron-fda
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