Omikron: Why a fourth vaccination is not the solution

Do you need an omicron vaccine booster?

All vaccine manufacturers are currently looking into adapting their vaccines to Omikron. Pfizer has already announced that an omicron vaccine from March will be available. It is questionable whether it is still needed, even if it is supposed to work against other variants.

According to estimates, this process of adapting vaccines to new variants is possible within three months of the appearance of the variant and is comparable to the annual adaptation of the flu vaccine. “To do this, the mRNA sequence is exchanged so that it fits perfectly with the Omikron variant. A missing booster can already lead to diseases, so you shouldn’t wait under any circumstances,” says the vaccine expert Christina Nicolodi.

Also Herwig Kollaritsch, Member of the National Vaccination Board (NIG), emphasizes that one should not wait for new vaccines. “What you will have to consider is the question of whether you are doing booster with variant vaccines. This is no longer such a miracle with the current technologies and they will be available in the foreseeable future. But there is no point in waiting for it.”

For the fourth trick, however, unlike the third, it might pay off to wait, like Ali Ellebedy, Immunologist from Washington University in St. Louis opposite the New York Times Emphasizes: “There is no point in training the immune system against a virus strain that has already disappeared. If you wanted to add another after three doses, I would definitely wait for an omicron-based one.”

However, there are no recommendations for this as there are no studies. Omicron vaccines are simply not yet available, even though they are already in production, according to Pfizer.

Why is it so important to get a third vaccination now?

“The data show that people with three vaccinations are very well positioned. We should make optimal use of this advantage, everyone should get the third vaccination as soon as possible,” says Herwig Kollaritsch. A recent British study shows that people over the age of 65 are very well protected against a severe Omicron course with a booster. Three months after the third vaccination, the protection against hospitalization was around 90 percent, according to the British health authority UKHSA.

For comparison: after only two doses of vaccine, the protection against severe disease with Omikron three months after the vaccination is around 70 percent, after six months it is still 50 percent. Kollaritsch: “The countries that have high vaccination rates have many cases due to Omikron, but relatively few patients in the intensive care unit. That is the crucial point.” The less severe cases relieve the health system.

In Austria currently 43 percent of the population have received the third stitch.

Does it make sense to get vaccinated now at the beginning of the omicron wave?

Yes, says Kollaritsch. “While it is not as if someone who is vaccinated for the first time will be protected from the omicron wave, the pandemic will continue afterwards. We know that the virus has a distinct seasonality – sooner or later it will be it will be necessary to prepare for autumn, “said Kollaritsch. The more people are vaccinated, the lower the risk that new mutations can develop.

When are you protected?

For full, longer-lasting protection, two partial vaccinations and a booster vaccination are necessary (at Johnson & Johnson one vaccination plus one booster), with the interval between the first and second vaccination being three to six weeks. But antibodies are already formed after the first partial vaccination – the protective effect begins about three weeks later. After the second vaccination, it takes around seven days for it to work and for the body to build up sufficient protection.

What should those who have recovered consider?

Anyone who has already tested positive without a previous vaccination should have the first vaccination after about four weeks. The NIG then recommends the second vaccination six months after the first vaccination. What has been new since the end of November is that a third vaccination is recommended after recovery, namely six to nine months after the second.

If you become infected between the first and second vaccination, the NIG recommends that you have the second vaccination four weeks after recovery and the third dose again six to nine months later.

Anyone who has had a breakthrough vaccination after double vaccination should pick up the booster within six to nine months of recovery. “There are very clear recommendations for use here. The longer ago the infection was, the less it is immunologically ‘worth’. Those who have gone through an illness join the vaccination cycle as normal four weeks after recovery,” says Kollaritsch.

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