Booster against Omicron
Three extensive new studies from the US Centers for Disease Control and Prevention highlight getting a booster shot to provide the best protection against the Omicron coronavirus variant.
This is the first real-life data to examine the effect of boosters against Omicron, which now accounts for more than 99% of coronavirus cases in the United States. The studies released Friday raise whether people with just two vaccine doses should still be considered fully vaccinated.
“I think we have to redefine fully vaccinated as three doses,” said Dr. William Schaffner, a longtime CDC vaccine adviser who was not involved with the studies.
Omicron cases dip in the US overall, but the wave is far from over in many parts.
The studies have an enormous scope, involving millions of cases, hundreds of thousands of visits to emergency departments and urgent care centers, and tens of thousands of hospitalizations among adults.
Getting boosted was 90�effective at preventing hospitalizations during December and January when Omicron was the dominant variant, according to a CDC study looked at nearly 88,000 hospitalizations across ten states.
In comparison, getting two shots were 57�effective when at least six months past the second shot.
According to the study, getting boosted was 82�effective at preventing visits to emergency rooms and urgent care centers, which looked at more than 200,000 visits in 10 states.
What’s next with Omicron and the pandemic?
In comparison, getting two shots was only 38�effective at preventing those visits when it had been at least six months past the second shot.
“I think the third dose gives you the solid, the very best protection,” Schaffner said.
That study was published Friday in the CDC’s Morbidity and Mortality Weekly Report. A second study, also published in Friday’s MMWR, concluded that people with three shots were less likely to get infected with Omicron. Looking at data from 25 state and local health departments, the CDC researchers found that there were 149 cases per 100,000 people on average each week among those who were boosted. Those who had only two doses were 255 cases per 100,000 people.
A third study, published in the medical journal JAMA, showed that having a booster helped prevent people from becoming ill with Omicron. That study of just over 13,000 US Omicron cases found that the odds of developing asymptomatic infection were 66% lower for boosted people than those who had only received two shots.
All three studies found that unvaccinated people faced the highest risks of becoming sick with Covid-19.
- The CDC currently says a person is considered fully vaccinated after receiving their primary Covid-19 vaccines — two weeks after receiving their second dose of an mRNA vaccine or two weeks after their first dose of the Johnson & Johnson vaccine.
- Booster doses are recommended for everyone age 12 and older five months after their primary vaccination series.
According to CDC data, less than half of those eligible to receive booster shots have gotten one, and only about a quarter of the total US population is fully vaccinated and boosted. - Nearly 20% of the US population eligible to be vaccinated — those age five and older — has not received any dose of the Covid-19 vaccine.
- The Omicron surge has driven Covid-19 cases and hospitalizations to record highs in the United States. This week, however, officials have started to call out very early signs that the wave is peaking — or at least plateauing — in parts of the Northeast.
But case rates are still higher in this region than any other, and experts say it will be weeks before any change can be declared a trend.
ACCORDING TO DATA FROM JOHNS HOPKINS UNIVERSITY, the US overall is reporting an average of more than 786,000 Covid-19 cases each day, double what it was two weeks ago.
19 states have fewer than 15% of ICU beds left as health care staffing shortages complicate care
Yet, seven states have seen case rates level out, changing less than 10% week-to-week: New Jersey, Maryland, Ohio, Georgia, New York, Kansas, and Mississippi. And in Washington, DC, they’re down 19% from last week. But only in DC has this been a pattern for more than a week.
- On Tuesday, New York Gov. Kathy Hochul said that recent case trends are “a glimmer of hope.” She specifically noted an apparent plateau in average daily case rates in New York City.
- The New York City health department’s data tracker indicates that while the test positivity rate is “stable,” case trends are “increasing,” as are hospitalizations and deaths. Also, data for the most recent ten days is considered incomplete.
- “We remain squarely within our Omicron wave in New York City, whether looking at cases, hospitalizations, or deaths due to COVID-19,” according to the city’s health department. “
Although there are preliminary signs that the level of cases may be plateauing, we need to continue following the data closely in the coming days to discern the trend.”
Biden says his administration will make free high-quality face masks available to all Americans.
- In a briefing Tuesday, Philadelphia Health Commissioner Dr. Cheryl Bettigole said that judging from a collection of metrics, the city “may be at peak right now.”
- Data from the city shows that the test positivity rate dropped for the first time in months, from 45% positive in the last week of December to 36% in the first week of January.
- But she noted that the trends remain in flux.
“The thing about watching things like this is you’re watching a graph, you’re doing your best to project, and there’s no certainty to any of this,” she said. “I think we’re going to see it wiggle over the next few days, and then it’s just a question of whether we can hold it together and manage not to expose ourselves.”
Not a clear trend yet
There are a few reasons it’s hard to declare what longer-term trends in case rates will be in real-time, Dr. Andrew Pavia, an epidemiologist and infectious disease doctor with the University of Utah, told CNN.
Shortfalls in testing are one complicating factor.
Biden vowed to fix testing. But he didn’t plan for Omicron.
“Testing resources are challenged in many places, and there may be a plateau simply because there is not much more capacity for PCR tests,” he said. Many home tests are not counted in the officially reported figures either.
The most recent days of reporting are often an undercount as data catches up, but this may be wildly exaggerated as the health care system is pushed to the brink.
“Overwhelmed and understaffed health departments could be falling behind in reporting,” he said.
Pavia also notes that there is day-to-day fluctuation as significant testing events or certain superspreader events could bring in many cases at one specific time.
“Consistency over a long enough period to determine a true trend is key,” he said. “The bottom line is that we need several more days of data before we can exhale in those jurisdictions.”
Home Covid-19 tests must be paid for by health insurers starting Saturday.
In New Jersey, average daily cases have dropped slightly in recent days. However, weekly tallies are still up about 6% compared to a week ago, according to data from Johns Hopkins University.
“We’ve had two days of a slight downturn, so we’re looking at a silver lining,” New Jersey Health Commissioner Judith Persichilli said. “That’s why I keep telling everybody it’s a prediction. Omicron is a funny variant that shoots way up and then, for example, in South Africa, came down just as quickly. We can only hope that that occurs.”
New Jersey state epidemiologist Dr. Christina Tan said that the Northeast region might see cases peak before other parts of the US.
Pavia agrees that the patterns will shift from place to place.
“The duration of the spike is likely to be different in different places, related to the speed of spread, superspreader events, vaccination and immunity levels, and the apparent rates will be influenced by testing capacity,” he said.
And states lagging in the timeliness and completeness of their reporting make it challenging to compare them.
A quick rise and fall?
Some models predict the United States could reach a Covid-19 case peak in the coming weeks. And trends from South Africa would indicate a drop that happens nearly as quickly as the rise.
But the situation in South Africa could be different than in the US for several reasons, including that a larger share of the South African population had prior infections and a more significant percentage of the US is vaccinated and boosted, Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said last week.
“I do think in places that we are seeing this steep incline, that we may well see also a precipitous decline,” she said. “But we’re also a much bigger country than South Africa, so it may very well be that we see this ice pick-shape, but that it travels across the country.”
And while there are indications that Omicron causes less severe disease than Delta, the sheer number of cases will likely lead to a wave of hospitalizations and deaths.
Hospitalizations have already reached a record high, with more than 151,000 people hospitalized with Covid-19 and near-record numbers in ICUs, too, according to the US Department of Health and Human Services.
And after weeks of holding steady, deaths have also started to increase sharply. Nearly 1,800 people are dying of Covid-19 each day, up almost 50% from a week earlier, according to JHU data.
“Let’s hope it is the peak, not a false summit, as we say in the mountains,” Pavia said.
