COVID-19 - Facts and Information Only Topic

[Hapless Bills Fan]

There is a really cool video here explaining part of the Pfizer mRNA vaccine manufacturing process

 

https://www.cnn.com/2021/04/01/health/pfizer-covid-vaccine-efficacy-six-months-bn/index.html

 

 

[Hapless Bills Fan]

https://www.usnews.com/news/health-news/articles/2021-04-13/cdc-fda-recommend-pause-of-johnson-johnson-coronavirus-vaccine-over-blood-clot-concerns

 

The number of events in the above link is 6 per 6.8 million doses, or 0.88 per million. 

 

There appears to be debate on what the background rate is for this disorder, called vaccine-induced immune thrombotic thrombocytopenia (VITT).  One source in the EU said the background rate was 0.6 per million, which would put this somewhat over background.

 

There is confusion about number of events because some are publishing total blood clot side effects while some are publishing numbers only for VITT.   Normal people get blood clots in the normal course of life and a number of widely-used medications have blood clots as a side effect including birth control pills.  Covid itself also has a high rate of causing blood clot disorders. 

This is a specific blood-clotting syndrome involving low platelets.  The anti-coagulant Heparin has a similar rare side-effect.

 

[Edit: the Astra-Zeneca vaccine appears to have 4-10 in 1 million of the same disorder or ~10x the incidence]

 

 

 

 

[Hapless Bills Fan]

BeastMode interviews Dr Fauci.  This is totally classic

 

 

 

I 💓 Marshawn

[Hapless Bills Fan]

1) FDA approves Pfizer vaccine for 12-15 yr olds

https://www.npr.org/sections/coronavirus-live-updates/2021/05/10/993591902/hold-fda-oks-pfizer-covid-19-vaccine-for-12-15-age-group

 

There are 3 essential steps:

1. FDA EUA

2. ACIP meeting / review & recommendations

3. CDC Director approval & publishing of guidance in the MMWR.

 

2) CDC met and reviewed data yesterday, recommended it

https://www.khou.com/article/news/health/coronavirus/vaccine/cdc-advisory-committee-may-12-to-discuss-pfizer-vaccine-ages-12-to-15/507-7d3fa638-5dc3-435e-a94b-ad1cda43dc2f

 

3) 12-15 yr olds can now be vaccinated with Pfizer vaccine

 

Find appointments at Walgreens, CVS, Walmart, Sams, and health department clinics using the Pfizer vaccine near you:

https://www.vaccines.gov/search/
https://www.vaccinespotter.org/
 

https://www.wsj.com/articles/how-to-get-a-covid-19-vaccine-a-state-by-state-guide-11611703769

Or call your physician and ask for help finding an appointment.

 

 

[Hapless Bills Fan]

The new variant popularly called "Delta" (officially B.1.617.2, first noted in India) is now >90% of the cases tested in UK.

Here's gouge on vaccine effectiveness from Public Health Scotland and Public Health England.

 

Conclusion:  After 2 doses of either vaccine there were only modest differences in vaccine effectiveness with the B.1.617.2 variant. Absolute differences in vaccine effectiveness were more marked with dose 1. This would support maximising vaccine uptake with two doses among vulnerable groups.

 

(click to enlarge)

References:

Preprint (Public Health England)

Lancet (Public Health Scotland)

Popular Article based on these data

 

Note on vaccination programs in UK: vaccines used are Astrazeneca/Oxford (most common) or Pfizer.  In order to vaccinate more people quickly, it has been public health policy to administer only one dose to as many people as possible, then circle back to get most vulnerable first.

 

Based upon their similarity in many other studies, it would be predicted that 2 doses of Moderna vaccine would provide similar protection to 2 doses of Pfizer vaccine; it would likewise be predicted that 1 dose of J&J vaccine would provide similar protection to 1 dose of Astrazeneca vaccine.

 

No hard data I could find yet with regard to protection against Delta compared to infection with original virus.

There are data showing a previous infection with Covid-19 provided protection against the variants circulating in US through February, 2021

 

 

 

 

 

 

[HappyDays]

38 minutes ago, JaCrispy said:

Well, to be fair, covid did not specifically kill that many people...if you noticed on the data charts, all other causes of death went significantly down over the passed year

 

I mean this is simply not true. One measure researchers use is "excess mortality," which tracks how many people died in a given year compared to how many people should have died based on mortality rates over the last 5 years. If covid was not actually as deadly as scientists claim, we would expect mortality rates to stay the same. Instead researchers find that mortality rates increased significantly during the pandemic.

 

https://www.medpagetoday.com/infectiousdisease/covid19/91910

 

Quote

No harder measure of the coronavirus pandemic's toll exists: death from any cause rose 23% nationwide in 2020.

That meant 522,368 excess deaths from March through the end of 2020 compared with a projection from the prior 5 years, Steven Woolf, MD, MPH, of Virginia Commonwealth University School of Medicine in Richmond, and colleagues reported in JAMA.

It's well above the unofficial tally of COVID-19 deaths, which reached about 339,000 deaths by the end of 2020. COVID directly accounted for about 72% of the excess mortality, Woolf's group found.

 

https://www.cebm.net/covid-19/excess-mortality-across-countries-in-2020/

 

According to that link, mortality in the US was 12.9% higher than expected in 2020. Keep in mind the pandemic didn't really begin until March so in just 10 months we saw that level of difference.

 

https://ourworldindata.org/grapher/excess-mortality-p-scores?country=~USA

 

This chart shows excess mortality in the USA on a weekly basis. You can use the slider at the bottom to change the end date. Notice that excess morality rises sharply right when the pandemic first began in 2020, starts declining at the time most states instituted social restrictions, rises again as certain states removed those restrictions before peaking in January of this year at 51% excess mortality, then drops sharply at the same time the vaccine rollout began earlier this year.

 

You can believe whatever you want but you can't hide from the data.

Edited June 26, 2021 by HappyDays

[Hapless Bills Fan]

1 hour ago, Weatherman said:

False positives are a thing I can attest.  Also wondering if the vaccine can cause a false positive soon after you’ve been vaccinated.  So many questions not many verified answers.  

 

No.  It is impossible for any of the current vaccines to cause a false positive on a diagnostic test for covid-19 disease. 

 

https://www.gavi.org/vaccineswork/can-you-test-positive-covid-19-test-after-getting-vaccine

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html

https://www.goodrx.com/blog/testing-positive-for-covid-after-getting-vaccinated/
https://www.nebraskamed.com/COVID/you-asked-we-answered-will-the-vaccine-make-you-test-positive

https://www.forbes.com/sites/coronavirusfrontlines/2021/02/26/could-vaccination-cause-me-to-test-positive-for-covid-19/

 

There Is No "not many verified answers" on this point.  It's not possible and any reputable medical source will tell you so.

 

The only way you would test positive is if you actually got infected with covid between being vaccinated and developing full immunity, or if there was a lab SNAFU causing a false positive PCR test.

 

 

[Doc Brown]

2 hours ago, JaCrispy said:

Well, to be fair, covid did not specifically kill that many people...if you noticed on the data charts, all other causes of death went significantly down over the passed year- not because they were suddenly cured, but because any one who died with covid was listed as dying from covid- a “slight of hand” that the establishment used to, likely, make it seem worse than it was...Also, we know that hospitals were monetarily incentivized to list covid as cause of death...the more covid casualties, the more money received from the gove\ment...Fear is a hell of a drug...👍

 

There was a 15.9% increase in the death rate in the US in 2020 compared to 2019 after three straight years of decline. 

[Hapless Bills Fan]

3 hours ago, El Guapo said:

I wonder how many that tested positive were vaccinated. We’ve seen it happen at our office already. She wasn’t having any symptoms, but they tested her before a medical procedure and she was positive. 

 

Studies suggest that with regard to the original Covid-19 strain and Alpha ("UK" strain, the mRNA vaccines are 90% effective at preventing any infection, including asymptomatic infection.

https://www.cdc.gov/media/releases/2021/p0607-mrna-reduce-risks.html

This means that if 100 unvaccinated people are infected with Covid, you would predict 10 equally-exposed vaccinated people would be infected with Covid (a tenfold reduction in relative risk of any infection, including asymptomatic infection).

 

On the other hand, against the more contagious Delta ("Indian") variant (see post above), recent data from UK Health suggest that the mRNA vaccines are 80% effective at preventing infection.   This means that if 100 unvaccinated people are infected with Covid, you would predict 20 equally-exposed vaccinated people would be infected with Covid (a 5-fold reduction in relative risk of any infection, including asymptomatic infection).

 

Applied to the 13 infected members of the NC State "Cinderella" team, these data suggest 1 or 2 of the infected players could have been vaccinated.

[Hapless Bills Fan]

https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/covid-19-cases-by-vaccination-status/

 

 

 

[Hapless Bills Fan]

Clearest graphic I've found showing the real impact of vaccination on Covid in the UK;

Infection rates rise, but deaths do not

 

The vertical axis is days since the "wave" started

1 = 9/8/20 for 2nd wave on L

1 = 5/14/21 for 3rd wave on R

 

Data are from the UK Public Health service, are linked in the original graph, and I spot verified.

Source is Newstatesman, High factual, Left-biased.  Citing only because data are sourced, and verifiable.

 

UK is one of the most highly vaccinated countries in the world, but much of the population has had only ONE DOSE, which turns out not to be very effective against asymptomatic or mild infection vs. Delta. (see above post for sources)

 

Data data from Public Health UK suggest younger people are more likely to be "S-gene positive" (infected with Delta), so this may change as more elders are infected.  Same data suggest a fully-vaccinated >80 yr old has ~= risk to unvaccinated 50 yr old, which is why there is still a substantial death rate among vaccinated elders.

 

 

 

Source: BBC

[Coach Tuesday]

1 hour ago, 4merper4mer said:

Is that a documented mathematical truth or simply a belief?  Not a shot at you, just wondering if it is documented somewhere with numbers or if it is simply anecdotal.  
 

What about people who had the virus in the past?  Do their natural immunities count them as vaccinated even if they’ve had no shot?  Do they spread it more easily than someone vaxxed?

 

If these answers are unknown, it seems very odd to have unequal rules for different groups of people.  
 

Rules should be made based on logic, not feelings or panic.  If there are logical reasons, these reasons should be explained.

 

https://www.cidrap.umn.edu/news-perspective/2021/08/study-ties-covid-vaccines-lower-transmission-rates

 

(Mods, pls. remove if not appropriate to link to a study/article.)

 

Edit: Please note that this study, while excellent, took place between February and May in Netherlands where "Alpha" or "UK Strain" was dominant

[PTS]

On 8/24/2021 at 9:38 AM, Hapless Bills Fan said:

 

No such studies are coming out.  See above.  Possible, yes.  "Just as possible" no.  This is ranging into general Covid discussion and should not be continued.

 

What the NFL is probably going to do, is resume testing of vaccinated individuals at a more frequent interval than 1x in 14 days, and resume universal masking indoors except when distanced for eating.  This will probably not occur until at least one team has an outbreak, however.

 

"No such studies are coming out?" You serious? Let's throw out some blatant misinformation and then say this discussion should not be continued? Every day there are more and more studies, data, stories that state everyone is spreading COVID variants, vaxxed or not. Simple Google search will show that form leading medical institutions.

 

https://publichealth.jhu.edu/2021/new-data-on-covid-19-transmission-by-vaccinated-individuals

 

Quote

THE NEW DATA SAYS THAT A FULLY VACCINATED PERSON WHO EXPERIENCES A BREAKTHROUGH INFECTION CAN SPREAD THE VIRUS JUST AS MUCH AS AN UNVACCINATED PERSON.

----------------------------------------------------------------------------------------------------------------------------------------------------

Hapless sez:

OK let's Do This Thing and break this down.

 

The original statement was that vaccinated people are just as likely to transmit Covid as unvaccinated people. 

As far as I know, that is still considered to be incorrect, and the study referenced in the link is being misinterpreted.

 

There are two parts to considering how likely a person is to transmit Covid:

1) how likely they are to get an infection in the first place - makes sense, right, if you're not infected you can't transmit it?

2) whether any infection they get is as likely to be transmitted - this is believed to be related to the viral titer carried by an infected person

 

Let's get this out of the way right up front: No responsible scientist or public health official anywhere, EVER, claimed that vaccines would completely prevent covid (as some have said was claimed).  The best effectiveness claimed was 94-95% against symptomatic disease, ~92% against any infection.  The other claim is higher protection against severe infection/hospitalization, which is still true.

 

With the UK variant "Alpha",

1) Public Health UK published peer-reviewed studies showing the Pfizer vaccine (for example) was 92% effective at preventing infection, meaning a vaccinated person was 12x less likely to be infected at all. 

2) In addition, a CDC study of healthcare workers showed that vaccinated people carried substantially lower viral titer, and the study quoted by the UMN article @Coach Tuesday linked showed that the "attack rate" (secondary infections) of a vaccinated, infected person was ~3x lower (11%). 

 

So the OVERALL chance of a vaccinated person transmitting covid "Alpha" was infection rate * attack rate:(1-.92)* (.11) or 0.0088,  less than 1% - relative to an unvaccinated person (1)*(.31) or 31%.  These data were the basis for the current NFL rules, estimating a vaccinated person is about 35x less likely to be infected then transmit Covid after a close contact.

 

That was Then, This is now.

 

With the "Delta" variant which is now responsible for estimated >90% of new cases in the US, the basic reproduction rate (number of people infected by an infected person in the absence of vaccines or other mitigation like masks) is higher - Ro of 5-6 for Delta vs 2-3 for Alpha.  The best published data I've seen on vaccine effectiveness against Delta, is again, from Public Health UK.  (Israel claims have been quoted in the press, but I can't find published studies with details of data set, data collection etc).

1) Public Health UK published peer-reviewed studies showing the Pfizer vaccine (for example) was 78% effective at preventing infection, meaning a vaccinated person was 4.5x less likely to be infected at all. 

2) I have not yet seen data on attack rates for Delta yet, but data have shown that a vaccinated, infected person and an unvaccinated, infected person are carrying the same titer.  So let's make a reasonable assumption here and say that they're equally likely to infect someone else.  The attack rate for "Alpha" for an unvaccinated person was given in the UMN article as 31%.  If we combine this with an Ro ~2x higher, that means potentially an attack rate of ~60%.

 

So the overall chance of a vaccinated person transmitting covid "Delta" may be (1-.78)*(.6) or 13% relative to an unvaccinated person (1)*(.6) or 60%.  The same NFL rules may not work when a vaccinated person is only about 5x less likely to be infected then transmit Covid.  And it may, in an NFL facility, be higher chance of transmission, because many players chose to be vaccinated with J&J, for which we lack good data on effectiveness vs. any infection for Delta as yet.

 

Two take-home points:

 1) the NFL rules about vaccinated people being tested 1x every 14 days, not masking, and not being quarantined upon exposure seem relatively reasonable if a vaccinated person has less than 1% chance to transmit covid

2) but now, if a vaccinated person has about ~13% chance to transmit covid, things look different epidemiologically. 

 

The rules probably need to change, and soon, to maintain a reasonable level of protection for unvaccinated players.

 

Hope this clarifies a bunch of stuff and if questions/corrections/better data Hit Me in PM - I'm not an epidemiologist and sometimes I slip up.  Thanks!

 

 

 

 

 

 

 

[Hapless Bills Fan]

Update of the best US study on vaccine effectiveness in the "real world" (vs clinical trial), initially published by the CDC in April.

Summary: https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e4.htm

Full paper: https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7034e4-H.pdf

 

They studied vaccinated and unvaccinated health care workers - first responders, healthcare workers, and other patient-facing essential workers.

Every study participant was tested every week, in order to identify all infections, not just symptomatic infections.

 

Previously, from December through April, they had found the vaccines were 90% effective in preventing any infection (symptomatic or asymptomatic)

 

They now extended the study to August 2021 and determined "Delta variant predominant weeks"  They found the vaccines were 66% effective in preventing any infection (symptomatic or asymptomatic) during "Delta variant predominant weeks", which were also weeks in which a longer time had elapsed since vaccination

 

They found a decreasing effect of vaccination by binning the participants into <120 or >150 days since vaccination, but the effect was not "statistically significant" given the small numbers of Covid cases in each group.

 

Click to embiggen this table:

 

I think a point that jumps out to anyone, is that there were 5x as many vaccinated as unvaccinated study participants - 2,352 vs 488 (a lot of the initial unvaccinated group apparently dropped out, possibly to get vaxxed).

 

But, the number of covid infections were comparable (24 vs 19), in 5x as many vaccinated study participants.  That right there says the vaccine is still reduces the chance of getting any infection of Delta variant Covid (including an asymptomatic infection) by ~5x, before any numbers gagiggery was performed.  KISS, baby, KISS.

 

The adjusted VE of 66% is a 3x reduction, lower because they adjusted for "local virus circulation, study location, and occupation" - the point is they aren't jiggering the raw data to make their results look better, in fact they're making them look worse.  [The reason to do jiggering is because the vaccinated and unvaccinated study participants may not be evenly distributed over each study site or within each occupation, and obviously if more unvaccinated participants live in a community with high community infection while more vaccinated participants live in a community with lower community infection, it would bias the resultsl  Same for occupation.  It's a sign of a carefully done study.]

 

Another finding was that during the Delta-variant predominant weeks, 94.7% of the infections in unvaccinated people were symptomatic (remember, they are testing every week so as to catch all infections).  75% of the infections in vaccinated people were symptomatic, meaning 25% of them were asymptomatic.  I don't think you need to be a "genius in France" (or maths) to figure out that if asymptomatic infections can be transmitted and if it takes as little as 4-5 days from exposure to become infectious, testing every 2 weeks is gonna miss some asymptomatic, infectious people.

 

OK, that's all I got.  Questions -> PM me.  (Be nice)

 

 

 

 

 

 

 

 

 

 

[Hapless Bills Fan]

Published, peer-reviewed study of Pfizer/BioNTech vaccine safety from Israel.  Hot off the press (August 25, 2021)

https://www.nejm.org/doi/full/10.1056/NEJMoa2110475

This is the first country-wide, same population same time study of vaccination side effects vs. Covid-19 disease side effects.

 

The study matched 880,000 unvaccinated patients infected with Sars-CoV2 and 880,000 patients vaccinated with the Pfizer vaccine, which is the only vaccine used in Israel.

 

Everyone in the vaccine arm of the study was vaccinated before May 24, 2021.

 

Quote

We used data from the largest health care organization in Israel to evaluate the safety of the BNT162b2 mRNA vaccine. For each potential adverse event, in a population of persons with no previous diagnosis of that event, we individually matched vaccinated persons to unvaccinated persons according to sociodemographic and clinical variables.

 

This graph is pretty compelling:

 

Seems clear and compelling that the rates of kidney injury, cardiac arrhythmias, blood clots (deep vein thrombosis and pulmonary embolism), myocarditis, and pericardits are much higher in the unvaccinated group.

 

The two principle higher risks of the vaccinated group were lympadenopathy, which means temporary swollen lymph glands (a common side effect of many vaccinations; for example, women in US have been advised to delay their mammograms for a month after receiving a covid-19 vaccine to avoid false positive results, but after a month, it's fine and in the meantime, they go about their normal lives) and...... herpes zoster infection  - I did NOT see that one coming.  The risk was 16 per 100,000 (0.016%). For some context, the risk of injury from skydiving is estimated at 0.3% to 0.7%, so you're about 18x more likely to get hurt skydiving (mostly ankles) than to get

 

The risk of pericarditis and myocarditis is 5.5x higher from a natural covid-19 vaccination than from the Pfizer covid-19 vaccine - despite the fact that the latter has been getting all the press.  The risk from vaccination was an excess 3 per 100,000 or 0.003%

 

[Hapless Bills Fan]

With all the talk about boosters, people who got the J&J shot are wondering "what about me?"

 

https://www.facebook.com/permalink.php?story_fbid=372783124503333&id=100053149454347

 

"Your Local Epidemiologist" does a great job collating the data to date, what we do and don't know.

[Hapless Bills Fan]

Thought our Canadian friends would like this information from YLE.  Click to Embiggen.

 

The most cogent information is that Any Combination of Two Doses of an FDA approved/authorized or WHO-listed vaccine will be recognized as "Fully Vaccinated", along with 1 dose of J&J.

 

 

CDC Info on Air Travel to the US

https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html

 

CDC information on International Travel

https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel/index.html

 

Hope this helps any of our Canadian brethren planning to attend a game at Highmark.

[Hapless Bills Fan]

PSA: How to Obtain Monoclonal Antibody Therapy

 

https://combatcovid.hhs.gov/i-have-covid-19-now/monoclonal-antibodies-high-risk-covid-19-positive-patients

 

Quote

If you’ve tested positive for COVID-19, one of the first questions you may have is, What can I do to reduce the risk of getting sicker? The good news is, there are treatments that may reduce that risk. Depending on your age, health history, and how long you’ve had symptoms of COVID-19, you may qualify for a promising form of treatment for the disease. It’s called monoclonal antibody (mAb) treatment.

 

Some early evidence suggests that mAb treatment can reduce the amount of the SARS-CoV-2 virus (the virus that causes COVID-19) in a person's system. This amount is known as viral load. Having a lower viral load means you may have milder symptoms thereby decreasing the likelihood of you needing to stay in the hospital.

 

mAb treatment may help people who:

Have a positive COVID-19 test, and had symptoms for 10 days or less

Are at high risk of getting more serious symptoms

 

 

How to know if you qualify?  You need not be "very high risk", just be over 65 or have one or more known risk factors:

https://combatcovid.hhs.gov/i-have-covid-19/how-do-i-know-if-im-high-risk

 

Have symptoms, but no healthcare provider? Call the Combat COVID Monoclonal Antibodies Call Center at 1-877-332-6585.

 

This tool may or may not be useful to find locations which offer this treatment near you:

 

https://protect-public.hhs.gov/pages/therapeutics-distribution

 

Fundamentally, your primary care physician should help you obtain this treatment, but if you don't have one, there's a toll-free number to call and a website showing locations that have received shipments.

 

Note that the monoclonal therapies are believed to be most helpful if they are started EARLY (within 10 days) and before one becomes seriously ill.

 

Some people in this area (Missouri) have obtained referrals to outpatient infusion centers through an Urgent Care visit.

 

[Hapless Bills Fan]

Omicron.  This is one of the best summaries I've seen to date:

 

https://yourlocalepidemiologist.substack.com/p/omicron-update-nov-27

 

Omicron has been declared a "Variant of Concern" by WHO because it has a large number of mutations to the Spike protein and appears to be more transmissible

-The Spike protein is the protein that studs the outside of the virus and binds to the cellular receptor that allows the protein entry into our cells

-The Spike protein is (not coincidentally) the target of vaccines (vaccines target what the body sees, and that's the protein studding the outside of the intact virus)

 

However, there is a whole lot of surmise and not a lot of hard data yet

-We don't yet know if or to what degree vaccines will still be protective

-Or whether/to what degree it's more transmissible

-Or whether it will be more or less virulant

 

Quote

4. We still have no scientific updates on Omicron’s impact on immunity escape or transmissibility. If you’re hearing anything right now (even if it’s the British PM) it’s purely speculation. Hypotheses are important to discuss, but not the solid evidence we need. Getting answers takes time because good science takes time. I give it a week or two until the evidence starts rolling in.

 

Quote

5. We’re seeing a lot of cases but not a lot of severe disease. Yesterday, Dr. Rudo Mathivha, head of the ICU at an Omicron epicenter hospital said that among their patients:

“About 65% are not vaccinated and most of the rest are only half-vaccinated”.

This is incredibly encouraging news. This may be a sign that our vaccines continue to protect against severe disease and death. I cannot stress enough, though, that this is preliminary evidence. We need to know a few more things:

Is this because of a small sample size? Maybe Omicron just hasn’t spread enough in South Africa to see hospitalizations rise.

Is this because of lag time? Population-level hospitalization trends lag cases trends by 3-4 weeks.

Is this because of the population? Populations will respond differently to infections. What may be happening in South Africa may not be representative of what will happen elsewhere.

 

NY Times coverage:

https://www.nytimes.com/2021/11/26/health/omicron-variant-vaccines.html

Quote

Independent scientists agreed that Omicron warranted urgent attention, but also pointed out that it would take more research to determine the extent of the threat. Although some variants of concern, like Delta, have lived up to initial worries, others have had a limited impact.

 

“Epidemiologists are trying to say, ‘Easy, tiger,’” said William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “This could be bad. This could be very bad. But we don’t know enough to roll that tape forward.”

 

Quote

Dr. Hanage and other researchers said that vaccines will most likely protect against Omicron, but further studies are needed to determine how much of the shots’ effectiveness may be reduced.

 

Quote

The researchers found more than 30 mutations on a protein, called spike, on the surface of the coronavirus. The spike protein is the chief target of antibodies that the immune system produces to fight a Covid-19 infection. So many mutations raised concerns that Omicron’s spike might be able to evade antibodies produced by either a previous infection or a vaccine.

 

Quote

Some earlier variants, such as Beta and Mu, had evolved a strong ability to evade immune defenses. But they never became a serious threat to the world because they proved to be poor at transmitting.

 

Some mutations in Omicron suggest that it may indeed transmit well. Three mutations alter a region of the spike protein called the furin cleavage site, which is already known to help the spike protein attach more effectively to cells.

 

I have some questions about the data from South Africa that I'm not going to comment on; things will sort out in a week or two.

 

 

[Hapless Bills Fan]

OK, we have our first data on Omicron.  First of all, lab study from South Africa.  This is a peer-reviewed, accepted publication from a lab that has been in the forefront

 

https://secureservercdn.net/50.62.198.70/1mx.c5c.myftpupload.com/wp-content/uploads/2021/12/MEDRXIV-2021-267417v2-Sigal.pdf

 

Quote

The emergence of the SARS-CoV-2 Omicron variant, first identified in South Africa, may compromise
the ability of vaccine and previous infection (1) elicited immunity to protect against new infection.
Here we investigated whether Omicron escapes antibody neutralization elicited by the Pfizer
BNT162b2 mRNA vaccine in people who were vaccinated only or vaccinated and previously infected.
We also investigated whether the virus still requires binding to the ACE2 receptor to infect cells. We
isolated and sequence confirmed live Omicron virus from an infected person in South Africa. We
then compared neutralization of this virus relative to an ancestral SARS-CoV-2 strain with the D614G
mutation. Neutralization was by blood plasma from South African BNT162b2 vaccinated individuals.
We observed that Omicron still required the ACE2 receptor to infect but had extensive escape of
Pfizer elicited neutralization. However, 5 out of 6 of the previously infected, Pfizer vaccinated
individuals, all of them with high neutralization of D614G virus, showed residual neutralization at
levels expected to confer protection from infection and severe disease (2). While vaccine
effectiveness against Omicron is still to be determined, these data support the notion that high
neutralization capacity elicited by a combination of infection and vaccination, and possibly by
boosting, could maintain reasonable effectiveness against Omicron. If neutralization capacity is
lower or wanes with time, protection against infection is likely to be low. However, protection
against severe disease, requiring lower neutralization levels and involving T cell immunity, would
likely be maintained

 

Bottom line: both immunity from previous infection and immunity from vaccination have decreased effectiveness against Omicron, as shown by testing for neutralizing antibodies.  Vaccination PLUS previous infection maintains higher protection.

 

Bear in mind: antibodies are only one arm of the adaptive immune system, and may not be the most important aspect of immune response to prevent severe disease.  As the authors note "protection against severe disease, requiring lower neutralizaton levels and involving T cell immunity, would likely be maintained"

 

This is from Pfizer/BioNTech about vaccination and Omicron (the overall facts are likely to be true, but the numbers may be more favorable than an independent study):

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-provide-update-omicron-variant

 

-two doses of Pfizer vaccine are 25x less protective against Omicron (note that above, real life SA study said 40x)

-"According to the companies’ preliminary data, a third dose provides a similar level of neutralizing antibodies to Omicron as is observed after two doses against wild-type and other variants that emerged before Omicron. These antibody levels are associated with high efficacy against both the wild-type virus and these variants. A third dose also strongly increases CD8+ T cell levels against multiple spike protein epitopes which are considered to correlate with the protection against severe disease. Compared to the wild-type virus, the vast majority of these epitopes remain unchanged in the Omicron spike variant."

 

This would be consistent with the South African data that 2 doses of vaccine PLUS a prior infection provided good protection, saying 2 doses plus a booster provide good infection.

 

It is not unknown for vaccines to require 3 or 4 doses to provide consistent protection - for example, many childhood vaccines have a 3 or 4 dose series and a booster is recommended in the teenage years.  Years ago, when I was vaccinated against Hepatitis B with the original vaccine as a condition of my employment and they took blood and checked for antibodies 3 weeks after each shot, it took me five (5) doses to seroconvert.