Two Vaccines Fail to Protect Against Omicron Infection as Antibodies Fade

The headline everyone is reading this morning is: Pfizer and BioNTech say initial lab studies show a third dose of their Covid-19 vaccine neutralizes the omicron variant.

Sounds good, right? Well not so fast. As seen above, I have provided alternate (and more realistic) headline based on the available data. Pfizer is a publicly traded company, so it’s expected their news release would be the most optimistic version possible.

Pfizer has not published their data yet, not even as a pre-print. But others have, so let’s look at that.

Here is a nice write-up on the first study published late last night.

Study #1

First, small study suggests Omicron is a larger threat to Covid-19 immunity (statnews.com)

Bad news: If you only have two shots of the vaccine, your protection declines to near zero as the antibodies vanish. If you're at or near six months, you might have zero or near zero protection against an Omicron infection.

This was a small study done in South Africa. This study doesn’t involve booster shots because South Africa haven’t really given any out yet.

Good news: They did see that people who have two shots + a prior infection had much more protection against Omicron. Last night people were theorizing that boosters would provide similar protection to a previous infection. This was confirmed early this morning when several more studies were published.

Study #2

This was a study done in Germany.

https://twitter.com/CiesekSandra/status/1468465347519041539

They found that with two shots of Moderna, or two shots of Pfizer, or one shot of Astrazenca + one shot of Pfizer, that protection against Omicron dropped to zero after six months. These results are consistent with the first study.

This study tested a booster shot. They found that after three months, protection against Omicron dropped to 25% compared with 95% against Delta.

Study #3

The Pfizer study. We don’t have the data yet, but the BioNTech CEO said that individuals who received two doses of their vaccine will “most likely not have significant protection against infection.”

Pfizer says a third shot of the vaccine provides similar protection against Omicron that two shots provided against the original strain. Based on the other studies, this appears to be accurate.

HOWEVER

Pfizer did their neutralization study on sera from people one month after being boosted. Given that antibodies start to fade, and the German study found that protection from a third shot drops to 25% after three months, it appears that Pfizer has cherry-picked the perfect time window to run a study on the third shot’s effectiveness against Omicron.

This is dangerous, disingenuous, and I don’t believe these Pfizer results will hold up in the real world, especially as time goes on.

We know that antibodies fade. We now know that less antibodies provides less protection against an Omicron infection. In Israel, a doctor that was boosted with a third shot of Pfizer infected another doctor that was also boosted.

Going forward, it seems safe to assume that even if you’re boosted, your protection against an Omicron infection will fade.

That being said, you should definitely get boosted. The benefits are huge. And most scientists agree that it’s likely being boosted provides additional protection against moderate/severe symptoms regardless of the time passed. Same with two shots. Your immune response is more complex than just antibodies. We don’t have data on the severity yet, but many agree that the vaccines will provide robust protection against it. Even with Omicron.

Takeaway: Two shots plus a booster provides very strong protection against an Omicron infection, but it’s unknown for how long. Protection could drop to 25% after three months.

Companies are scrambling to produce an Omicron-specific vaccine, but it won’t be available until at least March 2022. Even then there won’t be many doses available. BioNTech estimates initial production at 25 to 75 million doses. That’s not nearly enough. So, we must be prepared to deal with Omicron for some time.

It’s still too early to know how bad Omicron will be. People point to the low number of deaths in South Africa and says, “See, it’s not that bad?” But in many countries, the lag time between the first infection and the first death is at least a month. During the initial outbreak in the UK, this was 34 days. It’s still too early to know how bad Omicron is. We’ll know what’s what by the end of the December.

Unfortunately, boosting the entire planet every three months isn’t practical. We’re still going to need to mask up and manufacture oral antivirals.

If you don't have your booster yet and are living an area with an Omicron outbreak, you should be extremely careful. If it’s been more than three months since your second shot, you probably don’t have great protection. The closer you get to six months the closer it is to zero.

Good luck out there. Get vaccinated, get boosted, and don’t forget to follow us on Twitter.