6 ms·

mRNA-based Covid-19 vaccine boosters induce immunity against Omicron

42 points by vpj 5y ago

alex_duf 5y ago
>Remarkably, neutralization of Omicron was undetectable in most vaccinated individuals. I'm not sure I understand, are they saying double vaccination had no noticeable effect on Omicron?
- crate_barre 5y ago
  Whoever wrote that sentence can’t write for shit. It’s the most important sentence in that whole document and they fucked it up. You had one job.
- timr 5y ago
  They're saying that it had low effect on immediate neutralization of the virus (sterilizing immunity). You're still well-protected against severe disease. Far too much fear-mongering has happened based on confusion about what different studies are measuring. Measures of "neutralization titer" are pretty much pointless, outside of a lab -- they're a model for immunity with no demonstrated relevance to real-world outcomes. Studies involving "symptomatic disease" are trying to measure the chance you might get any symptoms at all -- a very low bar. Even the sniffles count here. This is where most of the pro-booster studies have focused, and it's a pretty lame endpoint, unless you continue to harbor the delusion that "zero covid" is a thing that is possible (it is not). Basically, if you get infected after two doses, you might get cold-like symptoms, unless you're either severely immunocompromised (e.g. on immune suppressants, AIDS, in the middle of a bone marrow transplant, etc.) or so old that your immune system is failing anyway.
  - alex_duf 5y ago
    Thanks, I hadn't made that distinction between immediate and long term protection. The immune system is pretty complicated.
- JumpCrisscross 5y ago
  > are they saying double vaccination had no noticeable effect on Omicron? Practically, yes. See Figure 2. Recent vax (< 3 mos.) and distant vax (6 to 12 mos.) neutralization is between the first two eighth ticks for omicron. (Distant vax + infection is a bit less effective than distant vax with the wild type variant, which should put to bed the nonsense around prior infection being equivalent to innoculation.) We need an updated vaccine and/or to refresh the vaccination requirement to including boosters.
  - scotty79 5y ago
    Check out this paper https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v... Last page specifically. I think the problem with comparing immunity from infection and vaccination is mostly due to how quickly both fade out with time.
- ChrisMarshallNY 5y ago
  I read it as they were surprised that regular vaccinations had no effect on Omicron, but that [recent] boosters did (although to a limited extent). That seems to jive with what I have seen on the ground, around here (New York). Dozens of friends and acquaintances are sick. None, severely. I am quarantined through Christmas weekend. Tests (at least accurate ones) are rare as hen’s teeth. The home test kits seem to be absolutely worthless. I have not talked to one single person that got a positive from a home test (some were clearly symptomatic, when they took the test, and still came up negative).
  - HamburgerEmoji 5y ago
  - Causality1 5y ago
    My concern is for the other symptoms of covid that could compound. Taking your vaccinations and boosters will generally keep you out of the hospital, but what of the other consequences? Cardiomyopathy, damage to smell and taste, and cognitive impairment could all be cumulative. What happens if they are and we're subjected to decades of repeated damage?
    - ChrisMarshallNY 5y ago
      These are valid concerns. It appears that COVID is a blood disease, as opposed to a pulmonary disease. I know a 19-year-old girl that had a stroke, as a result of COVID. I was talking to an acquaintance that is a mortician, a few months ago, and he said they could always tell the people that died of COVID, because their blood had a different consistency.
      - schnebbau 5y ago
        Well that's interesting because I was also talking to an acquaintance that is a mortician, a few months ago, and he said that anecdotes like this contain absolutely no valuable data at all and only help to sow misinformation.
- 0x008 5y ago
  Other papers show that they have no noticeable effect on how the virus can reproduce, however the T-immune cell response to already infected cells is still good, meaning you most likely won’t go to the hospital if you get omicron and your 2nd dose is not too long ago.
ubercore 5y ago
> Remarkably, neutralization of Omicron was undetectable in most vaccinated individuals. Living in a country (Norway) where boosters are being slowly trickled out, this was disappointing to read.
cloudengineer94 5y ago
Boosters are gonna be the norm moving forward, I highly recommend people to check out TWIV (This Week In Virology) Podcast it has a lot of information based on real data and studies coming out. Link - https://www.youtube.com/watch?v=VkhN4rC19RI https://www.youtube.com/watch?v=VkhN4rC19RI
- chana_masala 5y ago
  The norm? I'm highly skeptical. Why isn't there more focus on preventative measures? Even with the Measles vaccine we know to give vitamin A for treating measles.
  - cloudengineer94 5y ago
    Here in Europe we already going with preventative measures however if the vaccines have a drop off it's normal to be going for boosters moving forward at least for folks with age 50 and above.
hnplj 5y ago
cortexio 5y ago
gnfargbl 5y ago
See also https://www.medrxiv.org/content/10.1101/2021.12.14.21267615v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.14.21267615v..., which suggests (Figure 1) that two doses of AstraZeneca does nothing to prevent symptomatic Omicron, but that an mRNA booster pulls effectiveness up to somewhere near 75%.
morrisda 5y ago
mipsi 5y ago
So what's the difference between a booster and a recent vax (<2 months)?
- tdrdt 5y ago
  There is no difference between what is injected. It's more like a retraining program. It's almost like the difference between short and long term memory. One shot will turn on short term memory after a week or two. Repeating shots will turn on long term memory. But what I personally think is interesting is that a natural infection works longer and broader after just one 'dose'. It is amazing how complitacted the immuunsysteem is. And I also think this is the reason we should be careful with giving healthy young people the vaccins.
- ricardobeat 5y ago
  As large as it could be. Recent vaccination gives you basically no protection at all. The graph at the end summarizes it: https://imgur.com/a/XfQstP6 https://imgur.com/a/XfQstP6
  - timr 5y ago
    This is completely incorrect. As the sibling comment notes, antibody titer against a pseudovirus (synthetic virus containing spike protein; what this figure shows) is a proxy for immunity, and nobody has ever shown that it bears any practical significance at all. Antibody levels go down over time. If they didn't, your blood would be peanut butter. Antibody levels for absolute neutralization of a synthetic virus in a dish? I have no idea what that means. It's something people look at because it's easy to look at in a dish. In contrast, a recent paper from JHU and the NIH shows that people who were previously infected have T-Cell responses to spike protein that are almost completely unaffected by mutations in Omicron: https://www.biorxiv.org/content/10.1101/2021.12.06.471446v1 https://www.biorxiv.org/content/10.1101/2021.12.06.471446v1 In short, there's excellent data showing that long-term immunity to Omicron is robust after exposure to prior strains.
    - tambourine_man 5y ago
roenxi 5y ago
Seems a bit weird, it'll be fun to find out what the mechanism for this effect is. It seems strange that 2 doses does nearly nothing, then 3 doses suddenly causes the body to figure out Omicron. Something interesting is that the Omicron mutation seems to very much be about vaccine escape, natural immunity through prior infection offers some protection (linked paper, figure 2C). It isn't totally out off the question that something about the sort of people who get boosters is skewing these results. Table S1 (last page) suggests there are a lot of healthcare workers in the booster sample, maybe they are also people who's immune system is also getting primed from exposure to real coronavirus.
- fcurts 5y ago
  Many vaccines require three shots. A key difference is that the timespan between second and third (booster) shot is much longer than that between first and second shot.
- F30 5y ago
  It's a matter of antibody levels. Antibody binding is worse for Omicron, so you need more of them. Booster shots provide you with such increased antibody levels. Are they still gonna be high enough after a few months? Good question. Afaict, nobody knows yet. (And this of course leaves aside the whole matter of T-cell immunity still providing protection against severe disease.)
  - roenxi 5y ago
    It looks like there might be more factors at play here than that. Natural immunity does a lot better than being only vaccinated, which suggests there is some sort of issues related to quality as well as quantity of antibodies.
  - orra 5y ago
    > And this of course leaves aside the whole matter of T-cell immunity still providing protection against severe disease. Quite. But it’s hard to quantify so we don’t bother.
walterbell 5y ago
Dec 20, https://www.euronews.com/next/2021/12/20/omicron-3-vaccine-doses-are-not-enough-to-stop-the-new-covid-variant-warns-biontech-ceo https://www.euronews.com/next/2021/12/20/omicron-3-vaccine-d... > COVID-19 vaccines will not be enough to withstand the Omicron variant, warned the CEO of BioNTech, the German company behind the mRNA vaccine produced with Pfizer. "We must be aware that even triple-vaccinated are likely to transmit the disease…It is obvious we are far from 95 per cent effectiveness that we obtained against the initial virus."
jimmyearlcarter 5y ago
bko 5y ago
Serious question: does anyone have a plausible end game mapped out? No one bothers talking about what's going to happen 1, 2, 5, 10 years from now. There's no talk about herd immunity or anything besides the immediate concern of getting the last holdouts vaccinated. Places like NYC have 90+% vaccination rate and a lot of political effort is being put on that last 10% hold out, but then what? Is vaccine as a bi-annual service really practical? Is a better vaccine going to come out? Is it just going to mutate into a dud? https://www1.nyc.gov/site/doh/covid/covid-19-data-vaccines.page https://www1.nyc.gov/site/doh/covid/covid-19-data-vaccines.p...
- toper-centage 5y ago
  I suppose its impossible to make a 5 year plan when the game is changing month after month. With countries having 50% vaccination rate, there's always place to brew new variants that might or not be resistant to vaccines and medicine.
  - lambdaba 5y ago
    Is there any reason to believe being vaccinated means you're less of a breeding ground for variants? Surely it's not 100%, and if it's not, new variants will always come, including gradually evading vaccines, no?
    - orra 5y ago
      Mutations evolve in infected people. Vaccines reduce infection, both directly and via reduced spread. Hence fewer mutations. But muations happen all the time. Is a particular mutation viable, does it spread, then outcompete? Thankfully emperical evidence shows thr neutralizing antibodies response, due to vaccination, reduces spread of COVID.
      - deleted 5y ago
        [deleted]
      - deleted 5y ago
        [deleted]
inb4_cancelled 5y ago
So, the relationship between the number of doses and omicron immunity is highly non-linear and pretty unintuitive? (Recent vax vs recent booster) The anti-vax community is going to love this.
cruelty2 5y ago
skinkestek 5y ago
I'm vaccinated myself and think that is smart but friends with some people who'd probably consider death before covid vaccines. According to them there is a good deal of things one can do to reduce risk of severe infections. Personally I have started taking extra vitamin D in addition to the one I get from cod liver oil. It sounds smart and it seems science supports it and I don't have to buy into the rest of what I think is kind of crazy. (to be perfectly clear, I'm vaccinated and I recommend it. Vaccines have small and uncertain side effects. Viruses have large and much more certain effects.)
- gnfargbl 5y ago
  Taking vitamin D is great and recommended for pretty much everyone, but the evidence for it being an effective prophylaxis against Covid-19 just isn't there[1]. By all means take it for general health reasons (I do too!) but don't expect it to provide you any specific protection. [1] https://www.nice.org.uk/guidance/ng187/evidence/evidence-reviews-for-the-use-of-vitamin-d-supplementation-as-prevention-and-treatment-of-covid19-pdf-8957587789 https://www.nice.org.uk/guidance/ng187/evidence/evidence-rev...
  - skinkestek 5y ago
    Ok, I guess you are right. Let me rephrase it: if one also has a vitamin D deficit the chances of getting seriously ill increases significantly. Would that be correct? (Same is AFAIK true for being overweight but unlike increasing vitamin D levels which takes days or weeks, getting down to a healthy weight in a healthy way is a months long process.)
    - gnfargbl 5y ago
      I'm not sure. https://nutritionj.biomedcentral.com/articles/10.1186/s12937-021-00744-y https://nutritionj.biomedcentral.com/articles/10.1186/s12937... says that isn't the case, but I have no idea how reliable that journal is. Overall, there is a weight of evidence in favour of vaccines (especially mRNA vaccines) being effective, and very little evidence for the various options that the antivax crowd like to put up as alternatives.
hnplj 5y ago
kristofferR 5y ago
Why is there almost no talk about updating the vaccines? Isn't that supposed to be very easy with mRNA technology? I get that it would take several months to roll out, and that the old pre-alpha boosters are a good stop gap in the meantime, but it seems like it would make much more sense to have effective Omicron vaccines as soon as possible instead of more and more of less and less effective vaccines.

42 points by vpj 5y ago

>Remarkably, neutralization of Omicron was undetectable in most vaccinated individuals. I'm not sure I understand, are they saying double vaccination had no noticeable effect on Omicron?

crate_barre 5y ago
Whoever wrote that sentence can’t write for shit. It’s the most important sentence in that whole document and they fucked it up. You had one job.
timr 5y ago
They're saying that it had low effect on immediate neutralization of the virus (sterilizing immunity). You're still well-protected against severe disease. Far too much fear-mongering has happened based on confusion about what different studies are measuring. Measures of "neutralization titer" are pretty much pointless, outside of a lab -- they're a model for immunity with no demonstrated relevance to real-world outcomes. Studies involving "symptomatic disease" are trying to measure the chance you might get any symptoms at all -- a very low bar. Even the sniffles count here. This is where most of the pro-booster studies have focused, and it's a pretty lame endpoint, unless you continue to harbor the delusion that "zero covid" is a thing that is possible (it is not). Basically, if you get infected after two doses, you might get cold-like symptoms, unless you're either severely immunocompromised (e.g. on immune suppressants, AIDS, in the middle of a bone marrow transplant, etc.) or so old that your immune system is failing anyway.
- alex_duf 5y ago
  Thanks, I hadn't made that distinction between immediate and long term protection. The immune system is pretty complicated.
JumpCrisscross 5y ago
> are they saying double vaccination had no noticeable effect on Omicron? Practically, yes. See Figure 2. Recent vax (< 3 mos.) and distant vax (6 to 12 mos.) neutralization is between the first two eighth ticks for omicron. (Distant vax + infection is a bit less effective than distant vax with the wild type variant, which should put to bed the nonsense around prior infection being equivalent to innoculation.) We need an updated vaccine and/or to refresh the vaccination requirement to including boosters.
- scotty79 5y ago
  Check out this paper https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v... Last page specifically. I think the problem with comparing immunity from infection and vaccination is mostly due to how quickly both fade out with time.
ChrisMarshallNY 5y ago
I read it as they were surprised that regular vaccinations had no effect on Omicron, but that [recent] boosters did (although to a limited extent). That seems to jive with what I have seen on the ground, around here (New York). Dozens of friends and acquaintances are sick. None, severely. I am quarantined through Christmas weekend. Tests (at least accurate ones) are rare as hen’s teeth. The home test kits seem to be absolutely worthless. I have not talked to one single person that got a positive from a home test (some were clearly symptomatic, when they took the test, and still came up negative).
- HamburgerEmoji 5y ago
- Causality1 5y ago
  My concern is for the other symptoms of covid that could compound. Taking your vaccinations and boosters will generally keep you out of the hospital, but what of the other consequences? Cardiomyopathy, damage to smell and taste, and cognitive impairment could all be cumulative. What happens if they are and we're subjected to decades of repeated damage?
  - ChrisMarshallNY 5y ago
    These are valid concerns. It appears that COVID is a blood disease, as opposed to a pulmonary disease. I know a 19-year-old girl that had a stroke, as a result of COVID. I was talking to an acquaintance that is a mortician, a few months ago, and he said they could always tell the people that died of COVID, because their blood had a different consistency.
    - schnebbau 5y ago
      Well that's interesting because I was also talking to an acquaintance that is a mortician, a few months ago, and he said that anecdotes like this contain absolutely no valuable data at all and only help to sow misinformation.
0x008 5y ago
Other papers show that they have no noticeable effect on how the virus can reproduce, however the T-immune cell response to already infected cells is still good, meaning you most likely won’t go to the hospital if you get omicron and your 2nd dose is not too long ago.

ubercore 5y ago

> Remarkably, neutralization of Omicron was undetectable in most vaccinated individuals. Living in a country (Norway) where boosters are being slowly trickled out, this was disappointing to read.

cloudengineer94 5y ago

Boosters are gonna be the norm moving forward, I highly recommend people to check out TWIV (This Week In Virology) Podcast it has a lot of information based on real data and studies coming out. Link - https://www.youtube.com/watch?v=VkhN4rC19RI https://www.youtube.com/watch?v=VkhN4rC19RI

chana_masala 5y ago
The norm? I'm highly skeptical. Why isn't there more focus on preventative measures? Even with the Measles vaccine we know to give vitamin A for treating measles.
- cloudengineer94 5y ago
  Here in Europe we already going with preventative measures however if the vaccines have a drop off it's normal to be going for boosters moving forward at least for folks with age 50 and above.

hnplj 5y ago

cortexio 5y ago

gnfargbl 5y ago

See also https://www.medrxiv.org/content/10.1101/2021.12.14.21267615v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.14.21267615v..., which suggests (Figure 1) that two doses of AstraZeneca does nothing to prevent symptomatic Omicron, but that an mRNA booster pulls effectiveness up to somewhere near 75%.

morrisda 5y ago

mipsi 5y ago

So what's the difference between a booster and a recent vax (<2 months)?

tdrdt 5y ago
There is no difference between what is injected. It's more like a retraining program. It's almost like the difference between short and long term memory. One shot will turn on short term memory after a week or two. Repeating shots will turn on long term memory. But what I personally think is interesting is that a natural infection works longer and broader after just one 'dose'. It is amazing how complitacted the immuunsysteem is. And I also think this is the reason we should be careful with giving healthy young people the vaccins.
ricardobeat 5y ago
As large as it could be. Recent vaccination gives you basically no protection at all. The graph at the end summarizes it: https://imgur.com/a/XfQstP6 https://imgur.com/a/XfQstP6
- timr 5y ago
  This is completely incorrect. As the sibling comment notes, antibody titer against a pseudovirus (synthetic virus containing spike protein; what this figure shows) is a proxy for immunity, and nobody has ever shown that it bears any practical significance at all. Antibody levels go down over time. If they didn't, your blood would be peanut butter. Antibody levels for absolute neutralization of a synthetic virus in a dish? I have no idea what that means. It's something people look at because it's easy to look at in a dish. In contrast, a recent paper from JHU and the NIH shows that people who were previously infected have T-Cell responses to spike protein that are almost completely unaffected by mutations in Omicron: https://www.biorxiv.org/content/10.1101/2021.12.06.471446v1 https://www.biorxiv.org/content/10.1101/2021.12.06.471446v1 In short, there's excellent data showing that long-term immunity to Omicron is robust after exposure to prior strains.
  - tambourine_man 5y ago

roenxi 5y ago

Seems a bit weird, it'll be fun to find out what the mechanism for this effect is. It seems strange that 2 doses does nearly nothing, then 3 doses suddenly causes the body to figure out Omicron. Something interesting is that the Omicron mutation seems to very much be about vaccine escape, natural immunity through prior infection offers some protection (linked paper, figure 2C). It isn't totally out off the question that something about the sort of people who get boosters is skewing these results. Table S1 (last page) suggests there are a lot of healthcare workers in the booster sample, maybe they are also people who's immune system is also getting primed from exposure to real coronavirus.

fcurts 5y ago
Many vaccines require three shots. A key difference is that the timespan between second and third (booster) shot is much longer than that between first and second shot.
F30 5y ago
It's a matter of antibody levels. Antibody binding is worse for Omicron, so you need more of them. Booster shots provide you with such increased antibody levels. Are they still gonna be high enough after a few months? Good question. Afaict, nobody knows yet. (And this of course leaves aside the whole matter of T-cell immunity still providing protection against severe disease.)
- roenxi 5y ago
  It looks like there might be more factors at play here than that. Natural immunity does a lot better than being only vaccinated, which suggests there is some sort of issues related to quality as well as quantity of antibodies.
- orra 5y ago
  > And this of course leaves aside the whole matter of T-cell immunity still providing protection against severe disease. Quite. But it’s hard to quantify so we don’t bother.

walterbell 5y ago

Dec 20, https://www.euronews.com/next/2021/12/20/omicron-3-vaccine-doses-are-not-enough-to-stop-the-new-covid-variant-warns-biontech-ceo https://www.euronews.com/next/2021/12/20/omicron-3-vaccine-d... > COVID-19 vaccines will not be enough to withstand the Omicron variant, warned the CEO of BioNTech, the German company behind the mRNA vaccine produced with Pfizer. "We must be aware that even triple-vaccinated are likely to transmit the disease…It is obvious we are far from 95 per cent effectiveness that we obtained against the initial virus."

jimmyearlcarter 5y ago

bko 5y ago

Serious question: does anyone have a plausible end game mapped out? No one bothers talking about what's going to happen 1, 2, 5, 10 years from now. There's no talk about herd immunity or anything besides the immediate concern of getting the last holdouts vaccinated. Places like NYC have 90+% vaccination rate and a lot of political effort is being put on that last 10% hold out, but then what? Is vaccine as a bi-annual service really practical? Is a better vaccine going to come out? Is it just going to mutate into a dud? https://www1.nyc.gov/site/doh/covid/covid-19-data-vaccines.page https://www1.nyc.gov/site/doh/covid/covid-19-data-vaccines.p...

toper-centage 5y ago
I suppose its impossible to make a 5 year plan when the game is changing month after month. With countries having 50% vaccination rate, there's always place to brew new variants that might or not be resistant to vaccines and medicine.
- lambdaba 5y ago
  Is there any reason to believe being vaccinated means you're less of a breeding ground for variants? Surely it's not 100%, and if it's not, new variants will always come, including gradually evading vaccines, no?
  - orra 5y ago
    Mutations evolve in infected people. Vaccines reduce infection, both directly and via reduced spread. Hence fewer mutations. But muations happen all the time. Is a particular mutation viable, does it spread, then outcompete? Thankfully emperical evidence shows thr neutralizing antibodies response, due to vaccination, reduces spread of COVID.
    - deleted 5y ago
      [deleted]
    - deleted 5y ago
      [deleted]

inb4_cancelled 5y ago

So, the relationship between the number of doses and omicron immunity is highly non-linear and pretty unintuitive? (Recent vax vs recent booster) The anti-vax community is going to love this.

cruelty2 5y ago

skinkestek 5y ago

I'm vaccinated myself and think that is smart but friends with some people who'd probably consider death before covid vaccines. According to them there is a good deal of things one can do to reduce risk of severe infections. Personally I have started taking extra vitamin D in addition to the one I get from cod liver oil. It sounds smart and it seems science supports it and I don't have to buy into the rest of what I think is kind of crazy. (to be perfectly clear, I'm vaccinated and I recommend it. Vaccines have small and uncertain side effects. Viruses have large and much more certain effects.)

gnfargbl 5y ago
Taking vitamin D is great and recommended for pretty much everyone, but the evidence for it being an effective prophylaxis against Covid-19 just isn't there[1]. By all means take it for general health reasons (I do too!) but don't expect it to provide you any specific protection. [1] https://www.nice.org.uk/guidance/ng187/evidence/evidence-reviews-for-the-use-of-vitamin-d-supplementation-as-prevention-and-treatment-of-covid19-pdf-8957587789 https://www.nice.org.uk/guidance/ng187/evidence/evidence-rev...
- skinkestek 5y ago
  Ok, I guess you are right. Let me rephrase it: if one also has a vitamin D deficit the chances of getting seriously ill increases significantly. Would that be correct? (Same is AFAIK true for being overweight but unlike increasing vitamin D levels which takes days or weeks, getting down to a healthy weight in a healthy way is a months long process.)
  - gnfargbl 5y ago
    I'm not sure. https://nutritionj.biomedcentral.com/articles/10.1186/s12937-021-00744-y https://nutritionj.biomedcentral.com/articles/10.1186/s12937... says that isn't the case, but I have no idea how reliable that journal is. Overall, there is a weight of evidence in favour of vaccines (especially mRNA vaccines) being effective, and very little evidence for the various options that the antivax crowd like to put up as alternatives.

hnplj 5y ago

kristofferR 5y ago

Why is there almost no talk about updating the vaccines? Isn't that supposed to be very easy with mRNA technology? I get that it would take several months to roll out, and that the old pre-alpha boosters are a good stop gap in the meantime, but it seems like it would make much more sense to have effective Omicron vaccines as soon as possible instead of more and more of less and less effective vaccines.