Booster against Omicron
Three extensive new US Centers for Disease Control and Prevention studies emphasize the importance of 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 the question of 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, thousands of visits to emergency departments and urgent care centers, and tens of thousands of hospitalizations among adults.
A CDC study examining nearly 88,000 hospitalizations across 10 states found that boosting was 90% effective at preventing hospitalizations during December and January when Omicron was the dominant variant.
In comparison, getting two shots was 57 effective 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. The study examined 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, 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 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 aged 12 and older five months after their primary vaccination.
According to CDC data, less than half of those eligible for booster shots have gotten one, and only about a quarter of the 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 a 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 identify very early signs that the wave is peaking—or at least plateauing—in parts of the Northeast.
However, 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 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 healthcare 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. In Washington, DC, they’re down 19% from last week. But this pattern has only been present in DC for over a week.
- On Tuesday, New York Gov. Kathy Hochul said recent case trends are “a glimmer of hope.” She 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, hospitalizations, and deaths are “increasing. ” Also, data for the last ten days are 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 plateau, we need to follow 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, based on 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.
- However, 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
Dr. Andrew Pavia, an epidemiologist and infectious disease doctor at the University of Utah, told CNN there are a few reasons it’s difficult to declare the longer-term trends in case of rates in real-time.
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 healthcare system is pushed to the brink.
“Overwhelmed and understaffed health departments could be falling behind in reporting,” he said.
Pavia also notes day-to-day fluctuation as significant testing events or certain superspreader events could bring 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 recent days, average daily cases in New Jersey have dropped slightly. However, according to data from Johns Hopkins University, weekly tallies are still up about 6% compared to a week ago.
“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 cases might peak in the Northeast region before other parts of the US.
Pavia agrees that the patterns will shift from place to place.
“Tspikeiduration 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.
However, Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said last week that the situation in South Africa could be different from that in the US for several reasons, including that a larger share of the South African population had prior infections and a larger percentage of the US population is vaccinated and boosted.
“I do think in places where we see this steep incline, we may also see 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 shape, but 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.
According to the US Department of Health and Human Services, hospitalizations have already reached a record high, with more than 151,000 people hospitalized with COVID-19 and near-record numbers in ICUs.
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.
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