Vaccines That Target Omicron Reportedly in the Works

President Biden attempted to calm Americans and the rest of the world yesterday when he called the Omicron variant of COVID-19 a cause for concern, not panic. In his address, Biden stressed the need for Americans to get booster shots as one way of warding off whatever threat Omicron presents. (Scientists around the world are working feverously to figure that out.)

“If you’re 18 years or over and got fully vaccinated before June the first, go get the booster shot today,” Biden said. “They’re free and they’re available at 80,000 locations coast to coast. A fully vaccinated booster person is the most protected against COVID. Do not wait. Go get your booster if it’s time for you to do so.”

Among those concerned over the emergence of Omicron is one of the makers of a COVID-19 vaccine. Stéphane Bancel, the CEO of Moderna, tells the Financial Times that he worries that the vaccine his company manufactures (which some studies show to be more effective than the Pfizer/BioNTech and Johnson & Johnson vaccines) might not be as effective against Omicron as it has been against the Alpha and Beta strains of COVID-19, the original dominant strains until the Delta variant shoved them aside. The company’s quite capable of creating a vaccine specifically for Omicron; it did so for Delta, but never put the Delta-specific vaccine on the market because the vaccine against Alpha and Beta worked just as well against Delta.

Moderna and Pfizer/BioNTech are currently working on vaccines to target Omicron. And unlike the vaccine made specifically to deal with Delta, Bancel thinks that the Omicron vaccine will most likely be needed. The current vaccine will not be effective enough against Omicron. “I think it’s going to be a material drop,” Bancel tells the Financial Times. “I just don’t know how much because we need to wait for the data. But all the scientists I’ve talked to . . . are like, ‘This is not going to be good.’”

As Kevin Kavanagh, MD, a member of Infection Control Today^®’s Editorial Advisory Board (EAB) wrote yesterday, some 30 mutations in Omicron are on the spike protein. Vaccines strengthen that protein to enable the body to fight off the virus. Making the formula for a new vaccine is a relatively easy and speedy process thanks to mRNA technology. No more long periods of culturing in petri dishes in laboratories; a computer can print out the new formula.

“I’ve been told they can design a new vaccine in three days,” Kavanagh told ICT^® in a Q&A on July 27. “And that’s great news, but you can’t make 300 million doses and get them in arms that quickly, especially when you have half of the country being anti-vaxxers and not wanting to take the vaccine.”

As Kavanagh, Linda Spaulding, RN-BC, CIC, CHEC, CHOP, and another member of ICT^®’s EAB, and other experts have expressed to ICT®, the speed with which COVID-19 attacks continues to catch the health care system off guard. For instance, Bancel tells the Financial Times that experts did not expect to see a variant with as many mutations as Omicron contains for another year or two.

Booster shots could buy the health care system time until a consensus can be reached about what danger Omicron presents and how best to deal with it. The Centers for Disease Control and Prevention (CDC) yesterday updated its guidance on booster shots. The CDC says that “the recent emergence of the Omicron variant (B.1.1.529) further emphasizes the importance of vaccination, boosters, and prevention efforts needed to protect against COVID-19. Early data from South Africa suggest increased transmissibility of the Omicron variant and the potential for immune evasion.”

Even before the emergence of Omicron, there had been an effort to change the definition of being fully vaccinated from receiving 2 doses of a vaccine to receiving 3 doses. That push might become more intense in the face of the waning of the efficacy of 2-dose vaccines and the emergence of Omicron.

But the messaging about boosters has sometimes been confusing, and even before the emergence of Omicron some experts worried that that confusion could cause a fifth wave of COVID-19 in the US. As Kavanagh noted on November 19: “Austria with 65% of its population fully vaccinated and Germany with 68% of its population fully vaccinated are entering a fifth wave of infections.”

Bob Wachter, chairman of the University of California, San Francisco Department of Medicine, tells Axios this morning that vaccine mandates will soon include 3 doses. “If there is some level of immune evasion, but the vaccines continue to have some level of efficacy—which I think is likely—I think the ‘boosters as part of mandate discussion’ moves from a multi-month discussion to a multi-week discussion,” Wachter tells Axios.

But vaccine mandates even without boosters included face some significant opposition. Yesterday, a federal district court issued a temporary injunction for 10 states on a Biden administration effort to mandate that health care workers be vaccinated. There are also ethical and practical considerations concerning vaccine mandates, as ICT^® reported in its October print edition. These are discussion that infection preventionists will most likely be a party to. As we reported: “Infection preventionists and the hospital leadership teams need to communicate with all stakeholders to balance the health of the community and protect the current and future workforce.”