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Omicron boosters aren’t very effective against mild illness

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A healthcare employee administers a dose of the Pfizer-BioNTech Covid-19 vaccine at a vaccination clinic within the Peabody Institute Library in Peabody, Massachusetts, U.S., on Wednesday, Jan. 26, 2022.

Vanessa Leroy | Bloomberg | Getty Images

The brand new omicron Covid boosters probably aren’t very effective at stopping Covid infections and mild illness, but they’ll likely help keep the elderly and other vulnerable groups out of the hospital this winter, experts say.

The Centers for Disease Control and Prevention, in a real-world study published this week, found the boosters are lower than 50% effective against mild illness across just about all adult age groups compared to people who find themselves unvaccinated.

For seniors, the booster was 19% effective at stopping mild illness when administered as their fourth dose, in comparison with the unvaccinated. It was 23% effective against mild illness when given as their fifth dose.

Though the vaccine’s effectiveness against mild illness was low, individuals who received the boosters were higher off than those that didn’t. The booster increased people’s protection against mild illness by 28% to 56% in comparison with those that only received the old shots, depending on age and once they received their last dose.

The Food and Drug Administration authorized the boosters in late August with the goal of restoring the high levels of protection the vaccines demonstrated in late 2020 and early 2021. At the moment, the shots were greater than 90% effective against infection. But the primary real-world data from the CDC indicates that the boosters aren’t meeting those high expectations.

“The boosters offer you some additional protection but it surely’s not that strong, and you mustn’t depend on it as your sole protective device against infection,” said John Moore, a professor of microbiology and immunology at Weill Cornell Medical College.

Moore said people at higher risk from Covid have every reason to get a booster because it modestly increases protection. But he said common sense measures akin to masking and avoiding large crowds remain vital tools for vulnerable groups for the reason that boosters aren’t highly effective against infection.

The CDC study checked out greater than 360,000 adults with healthy immune systems who tested for Covid at retail pharmacies from September to November when omicron BA.5 was dominant. The participants received either the booster, got two or more doses of the old shots or they were unvaccinated. It then compared those that tested positive for Covid with those that didn’t.

The study didn’t evaluate how well the boosters performed against severe disease, so it’s still unclear whether they’ll provide higher protection against hospitalization than the old shots. The CDC in a press release said it’s going to provide data on more severe outcomes when it becomes available.

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Andrew Pekosz, a virologist at Johns Hopkins University, said the indisputable fact that the shots are providing some protection against infection in an era of highly immune evasive omicron subvariants is a very good sign that they’ll provide strong protection against hospitalization. The vaccines have all the time performed higher against severe disease than mild illness, he said.

“It’s higher than nothing. Actually, it doesn’t kind of show that the protection is incredibly high against infection,” Pekosz said. “I’d expect that you just would then see even greater protection from hospitalization or death.”

Dr. Paul Offit, a member of the FDA’s vaccine advisory committee, said trying to forestall mild illness just isn’t a viable public health strategy since the antibodies that block infection simply wane over time.

“Protection against mild disease just is not that good within the omicron subvariant era. The goal is protecting against severe disease,” said Offit, an infectious disease expert at Kid’s Hospital of Philadelphia who helped develop the rotavirus vaccine.

Dr. Celine Gounder, a senior public health fellow on the Kaiser Family Foundation, said she’s not alarmed by the information. Reducing risk by even a modest amount at the person level can have a big positive effect on public health on the population level.

“For those who can reduce risk among the many elderly by even 30%, even 20%, that is critical when 90% of the COVID deaths are occurring in that group,” Gounder said. “For me, what’s really gonna matter is are you keeping that 65 yr old out of the hospital.”

The boosters, called bivalent vaccines, goal each omicron BA.5 and the unique Covid strain that first emerged in Wuhan, China in 2019. The unique shots, called monovalent vaccines, only include the primary Covid strain.

It’s still unclear how the boosters will perform against more immune evasive omicron subvariants, akin to BQ.1 and BQ.1.1, which are actually dominant within the U.S. Pfizer and Moderna last week said early clinical trial data shows the boosters induce an immune response against these subvariants.

About 11% of those eligible for the brand new booster, or 35 million people, have received it thus far, in response to CDC data. About 30% of seniors have received the shot.

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