Good news, although it’s naturally being spun by some vax skeptics as part of a con. “Aha. Of course they want us to get another $hot.”
If instead the company had come out and said that the booster doesn’t work, the reaction would be, “Aha. Of course they want us to get an updated Omicron $hot.”
The skeptics can take their chances with natural immunity. For the rest of us, three doses produces enough neutralizing antibodies in lab studies to provide as much protection against Omicron as two doses provided against the original Wuhan strain of the virus. Which, I’m guessing, means that Pfizer won’t end up producing an Omicron-specific vaccine after all. There are costs to doing that, scientific and financial. If the current formula works after three doses, why tinker with it?
The real news here is that two doses might suffice to protect people from severe illness after being infected with Omicron. Given that the variant appears to produce milder symptoms than Delta to begin with, those who’ve had two doses but are ambivalent about getting a third might be okay with what they have.
Sera from individuals who received two doses of the current COVID-19 vaccine did exhibit, on average, more than a 25-fold reduction in neutralization titers against the Omicron variant compared to wild-type, indicating that two doses of BNT162b2 may not be sufficient to protect against infection with the Omicron variant. However, as the vast majority of epitopes targeted by vaccine-induced T cells are not affected by the mutations in Omicron, the companies believe that vaccinated individuals may still be protected against severe forms of the disease and are closely monitoring real world effectiveness against Omicron, globally.
A more robust protection may be achieved by a third dose as data from additional studies of the companies indicate that a booster with the current COVID-19 vaccine from Pfizer and BioNTech increases the antibody titers by 25-fold. According to the companies’ preliminary data, a third dose provides a similar level of neutralizing antibodies to Omicron as is observed after two doses against wild-type and other variants that emerged before Omicron. These antibody levels are associated with high efficacy against both the wild-type virus and these variants. A third dose also strongly increases CD8+ T cell levels against multiple spike protein epitopes which are considered to correlate with the protection against severe disease. Compared to the wild-type virus, the vast majority of these epitopes remain unchanged in the Omicron spike variant.
In graph form:
Pfizer-BioNtech data on omicron neutralization — showing that 2 doses vs. booster – along with beta/delta pic.twitter.com/YUaAsUOqIh
— carolyn johnson (@Carolynyjohnson) December 8, 2021
You’re much better protected against infection and severe illness from Omicron if you’ve had three shots but you might be protected from severe illness if you’ve had two. Logically, that points away from developing an updated vaccine and towards telling the public, “Get a booster ASAP or take your chances and hope for the best.” Which is the message that’s circulating among relevant authorities this morning:
The new data from Pfizer on vaccine effectiveness against Omicron is encouraging. This reinforces what my medical advisors have been emphasizing: that boosters give you the highest protection yet.
Anyone who is eligible and has not been boosted should go get a booster today.
— President Biden (@POTUS) December 8, 2021
— Disclose.tv (@disclosetv) December 8, 2021
There are three catches with Pfizer’s results, though. The first is that this was a lab study, testing blood taken from vaccinated people against the variant in vitro. That gives scientists a sense of how effective antibodies will be inside the body but they’ll need actual clinical trials to know that for sure.
The second catch is that the blood they used to run the study was taken from people who’d only recently received their second or third doses:
Briefing on Pfizer/biontech neutralisation studies has begun. 19 or 20 seras (why don’t they know which?!)
— Tom Whipple (@whippletom) December 8, 2021
How well protected are you from Omicron if you were boosted three months ago, say? Presumably your antibody levels have already begun to wane by now.
The third catch is that Pfizer’s study is just one of four that appeared overnight testing how well antibodies produced by its vaccine fare against Omicron. I wrote about another from South Africa last evening that showed neutralizing antibodies were 40-fold less effective against the variant after two doses. Notably, that South African study used a live version of Omicron; Pfizer’s study used a “pseudovirus” that they engineered in the lab to mimic Omicron.
Of the four studies testing Pfizer’s vaccine against the variant, the ones using the actual virus show a much steeper drop in antibodies’ ability to neutralize Omicron than the ones using a pseudovirus do.
Updated table of Omicron neuts studies with @Pfizer results (which did the worst job in terms of reporting raw data). Strong discrepancy between studies with live vs pseudo. pic.twitter.com/InQuWMAm4l
— Yaniv Erlich (@erlichya) December 8, 2021
Note the Ciesek study in particular, which found a roughly 30-fold loss in neutralizing protection *even among the boosted* when antibodies were pitted against the live Omicron virus. That’s a lot different from Pfizer’s encouraging data using the pseudovirus.
One more lab, similar results—though worse than the other two. 2X not enough. Booster helped, but not restored, waned quickly. Previous infection also not enough. (Note all labs are working with small samples & methods vary—epi data will provide clarity). https://t.co/lO7XDnhcJ0
— zeynep tufekci (@zeynep) December 8, 2021
So maybe a new Omicron-specific vaccine isn’t off the table after all.
Here’s Scott Gottlieb, a Pfizer board member, emphasizing that even two doses will provide some protection.
“Across all these studies we’re seeing that protection offered by 2 doses is significantly diminished. It’s not going to be lost. There is some indication that there is residual protection against infection,” says @ScottGottliebMD on the #omicron neutralization studies. pic.twitter.com/u3HOjI20Oj
— Squawk Box (@SquawkCNBC) December 8, 2021
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