Thank you as always. Question that seems like a bit of a repeat with a new ( ahem) variant: kids 5-11, given that thru just got their shots ( my daughter is just thru her 2 weeks following the second dose) any thoughts / data yet on how protected they are w 2 doses vs three, but maybe some reductions in need based on their immune systems and development generally. ( I know size was not the main issue before)
You were so helpful in the period prevaccine for kids when the world was back and we were not and not it feels like we are back here again, kids not able to be fully vaccinated when others are ( 3 doses) . Im hopeful maybe they need less?!
yes! so the data from the UK showed that those with their second dose within the past 9 weeks have full protection. so 5-11 year olds with two doses are fully protected right now.
When you say kids are "fully protected" do you mean from the perspective of infection likelihood or infection symptom severity?
We just got boosted mid-Nov and our 5-11 kids are now considered fully vaccinated as of this week so trying to figure out if a recently-vaxxed kid is as well off as a boosted adult (like is it the time since last shot or overall # of shots/time that's contributing to the benefit of boosting?)
At this point, based on the available published data, your kids are fully protected in the sense that an additional booster would not augment the immune more than it's at currently. It's producing antibodies at a high rate and will for some period of time, likely longer than an adult's immune system would.
Adding to my comment below - looked at the chart in your post for that UK data, reassuring that real world efficacy looks better than the pseudo virus study I posted below, but even in these data the efficacy drops at 10’weeks, leaving me still wondering about making dose 2 to 3 interval a lot shorter. (Maybe could be 8w after dose 2)
I am very glad to hear the UK data show this! Though I did see some pre-preprint results today showing very low neutralizing antibody activity with even recent double vax against a pseudo virus - especially with Pfizer. Made me wonder if we should be giving boosters much sooner than 6mo out (generally, not specific to or necessarily including pediatrics).
And yes following up, like others are, my main question is what about AFTER 9 weeks. That is, will kids need boosters ? Will they need them sooner than 6 months since shot 2/ previously known full vaccination? And is that being worked on / studied? I see the news about the testing of a three dose regimen for the youngest kids; are they doing the same for 5-11 yos? THANK YOU
Is there any data coming about moderna and it's effectiveness against Omicron? I keep seeing Pfizer data. Is it the assumption that Moderna would be similar in its results?
yes, that is the assumption! we have seen some lab studies with Moderna (saying the same thing as Pfizer) but it will be a while until "real world" vaccine effectiveness of Moderna. This is because Moderna is just not distributed as widely internationally. It's safe to assume the follow similar patterns
When ones says that a variant is more transmissible, more contagious just exactly what does that mean? So with original COVID, it was said that if you spend 15 minutes with someone within 6 ft of each other you can catch it? Then I heard with Delta its more like 7 minutes. So does that mean that with Omicron its more like 2 minutes. Or is it that a person say walking in front of you and is talking to someone next to them, does that mean walking in their path is more likely to catch it where as with Delta is was more unlikely? I don't know why but when I hear this I just don't understand what it means to be more transmissible, more contagious and how? Just trying to figure out what is safe, what isn't. Thank you so much.
In the case of the delta variant, "more transmissible" had to do with several things. First, the variant tended to bind more tightly to the ACE2 receptor sites than earlier variants. Second, the rapidity of binding successfully was appreciably faster than earlier variants. Third, more virus particles were produced per reproductive cycle, placing a larger viral load in play when confronting another individual. In the case of Omicron, all of these are coming into play and we are seeing changes to the receptor binding domain that will influence further how fast the virus binds and how likely it is to resist circulating antibodies from binding to sites that will reduce its ability to infect a given cell.
Appropriate mitigating measures include: full vaccination with booster to increase the amount of circulating immune globulin (antibodies); use of masks in public, especially in enclosed spaces; use of appropriate masks per CDC guidance, and wearing them properly; frequent handwashing; appropriate physical distancing; avoiding social gatherings in enclosed spaces; and, frequent testing using at-home test kits, and reporting results of these to your doctor.
Is there any data showing longevity of antibodies and/or protection following a booster? Some people are already about 3 months out from theirs. What does this mean as they approach the 6 month mark if Omicron is in full swing by then... especially seniors and high risk individuals? Thanks!
data in Israel is showing a 3rd dose wanes too, but not as quickly as the 2 dose series. we are still trying to figure out what this means for long term plans
But, as you've already pointed out, CD8+ T-cells come to the rescue. I'm less concerned about circulating antibody, if we can train the cellular system adequately, as it appears, and if cellular immunity remains active over the long term.
As an FYI, the news today (Dec 14th) is that Oregon has 3 confirmed Omicron cases. You can count me in the "increasing vaccinations due to Omicron" - I wasn't feeling urgency to get the booster, but the data and your summaries gave a big nudge to my conscience. As others have said, thank you for your work in writing these summaries.
I have seen a few headlines about increased hospitalizations for children with Omicron. Is this a too early to tell situation or click bait driven? We do very little and my 2 yo has his trial appointment this week so we are hunkered til then to avoid any germs interfering with that, but I’m wondering if we should start canceling the very few things we have planned for the holidays if actual data is starting to show Omicron is landing this age group in the hospital. We are vaxxed boosted, brothers are vaxxed (9, 6)
I'm curious about this, as well. Our 2yo is the last of us to remain unvaccinated and we're striving to continue protecting her while we await vaccine approval, especially in light that our 6yo is newly fully vaccinated and has been excited to restart a few social activities that we had still avoided up until now.
I think it's still too early in the game to determine if we have more hospitalizations with omicron in kids. None of the data I've seen indicates more kids are being infected or hospitalized with this variant than with earlier variants.
If you got the two doses of Moderna and boosted with Moderna is that thought to be similar to Pfizer? I have seen reports that mixing may give you better boost? I took what I could get very gratefully. Thank you as always for your dedication to science and to the public.
At least one study found a higher humeral immune response with a Moderna boost to either a Pfizer initial and second vaccination, or a single-shot J&J vaccination. A Pfizer booster after Moderna initial was less likely to generate a similar response profile.
doesn't even ~70% efficacy (against infection) with a booster for a variant as infectious as omicron (considered by some to be many times more infectious than delta which was double original covid) mean that even most people with boosters should expect to catch omicron (albeit symptoms should hopefully be extremely mild)?
as a virus gets even more infectious, don't you need higher efficacy to be in a similar situation as before? aka, someone with a booster is many times more susceptible to catching omicron than delta assuming similar community spread (which is inevitable) because efficacy decreased AND omicron is more infectious
if i'm wrong i'd appreciate someone explaining why
Is there any guidance on boosters for those of us who received a 3-dose initial vaccine series due to being immune compromised? Is it still 6 months after the last dose?
(I'm the primary vaccinator for our clinic, and this question comes up now and again. It's confusing since the boosters were approved only a few weeks after the 3rd primary doses were recommended. We have several patients who are still catching up with their 3rd doses, which puts them at late spring/early summer 2022 for their official boosters.)
Thank you for your useful information. I have a question about mutations. If based on its reproductive rate it can be assumed a large portion of the worlds population will be infected with Omicron, won't that provide for a lot of opportunity for mutation? If Omicron's symptoms are truly more mild, does that mean it can't mutate into a variant that is more dangerous. I appreciate any insight on this you may have.
I am not an epidemiologist, so take this with a grain of salt: Yes, more worldwide infections means more opportunity for mutation. Viruses are always mutating, it is just a matter of time and sample size for a mutation to appear that changes the transmissibility or behavior of the virus.
I don't think the severity of Omicron's symptoms have any bearing on what it _could_ become in the future. Evolution is weird and random, it can sometimes get trapped in local "dead ends", and other times it can come up with very novel changes.
This was a great post. Thank you! With the news about the vaccine for children under 5 being pushed back, what you are thinking in terms of their protection. Would two shots, even if they aren't fully effective, not be better than nothing?
As a parent of a 16-month old toddler, and an academic trying to do her job as well, I *really* appreciate your work, and am amazed at how you can keep doing it.
As a fellow parent of under-5 kids, I am sure you are waiting for the vaccine just as impatiently as I am. I also send my toddler to daycare, and even though her teachers are vaccinated and masked, we have had closures in the past few weeks because of positive cases among the kids, who are ineligible for vaccines (and too young to mask.) With the impending Omicron wave, what makes sense for daycare? Should we keep sending our kids to daycare (and that's not even a choice, honestly) or wait it out until the vaccines become available to them? I'm interested in hearing your thoughts on it in light of the new information about Omicron, and any educated guesses on when the vaccine will be available for children under 5. I am terrified of long covid in young children.
My spouse is immunocompromised, we think to due to treatments for giant cell arteritis. She tests with zero antibodies after being boosted with Maderna. Is there a way, or any expectation, that her T cells or other immune system defenses are working? Where might we look for more informaiton for her situation. She feels like a ticking time bomb with the Omicron situation. We have heard of the recent approval of the AstraZeneca monoclona treatment for vulnerable people, and are hopeful for her to receive it soon.
Hi, Katelyn, thanks for the update. News.sky.com in the UK quotes health minister Sajid Javid saying that 200,000 are being infected each day with Omicron, already. I hope more Americans will avail of the world's best vaccines. Please also remember the millions who will need to be vaccinated too: Unicef give a vaccine campaign. It is great news that vaccines can take the sting from this virus's bite. We can hopefully keep each other safe.
When do you predict that hospitals will not be overloaded? This is most concerning to me. Needing to call in the National Guard, worn out health care workers...
Until we see adequate vaccination levels in this country (now needing to approach 90%, if my guess is right) to approximate population immunity for those who cannot be vaccinated for legitimate medical reasons, AND until we can get equitable vaccine distribution out to the entire world and do mass vaccination efforts, we're in a holding pattern. Things will briefly get better and then crash again. I've got a lot of friends in clinical settings who are gasping for breath right now.
i’ve been looking but no data yet with Omicron. BUT we have two studies now showing that JJ+ one dose of mRNA is almost the same neutralizing antibodies as three doses of mRNA. so i would assume that JJ+1 mRNA is highly protective. i’ll keep an eye on the data
Thank you as always. Question that seems like a bit of a repeat with a new ( ahem) variant: kids 5-11, given that thru just got their shots ( my daughter is just thru her 2 weeks following the second dose) any thoughts / data yet on how protected they are w 2 doses vs three, but maybe some reductions in need based on their immune systems and development generally. ( I know size was not the main issue before)
You were so helpful in the period prevaccine for kids when the world was back and we were not and not it feels like we are back here again, kids not able to be fully vaccinated when others are ( 3 doses) . Im hopeful maybe they need less?!
THANK YOU!
yes! so the data from the UK showed that those with their second dose within the past 9 weeks have full protection. so 5-11 year olds with two doses are fully protected right now.
When you say kids are "fully protected" do you mean from the perspective of infection likelihood or infection symptom severity?
We just got boosted mid-Nov and our 5-11 kids are now considered fully vaccinated as of this week so trying to figure out if a recently-vaxxed kid is as well off as a boosted adult (like is it the time since last shot or overall # of shots/time that's contributing to the benefit of boosting?)
At this point, based on the available published data, your kids are fully protected in the sense that an additional booster would not augment the immune more than it's at currently. It's producing antibodies at a high rate and will for some period of time, likely longer than an adult's immune system would.
Adding to my comment below - looked at the chart in your post for that UK data, reassuring that real world efficacy looks better than the pseudo virus study I posted below, but even in these data the efficacy drops at 10’weeks, leaving me still wondering about making dose 2 to 3 interval a lot shorter. (Maybe could be 8w after dose 2)
I am very glad to hear the UK data show this! Though I did see some pre-preprint results today showing very low neutralizing antibody activity with even recent double vax against a pseudo virus - especially with Pfizer. Made me wonder if we should be giving boosters much sooner than 6mo out (generally, not specific to or necessarily including pediatrics).
See tweets 6,7,8 in this thread:
https://twitter.com/balazslab/status/1470726999538745355?s=10
And yes following up, like others are, my main question is what about AFTER 9 weeks. That is, will kids need boosters ? Will they need them sooner than 6 months since shot 2/ previously known full vaccination? And is that being worked on / studied? I see the news about the testing of a three dose regimen for the youngest kids; are they doing the same for 5-11 yos? THANK YOU
Oh that is certainly great news, thanks! And sorry if i missed it!
I will stay tuned to how that protection lasts as we get further out as i assume kids’ boosters would be a ways off ( if endorsed at all)!
Thank you!!
Is there any data coming about moderna and it's effectiveness against Omicron? I keep seeing Pfizer data. Is it the assumption that Moderna would be similar in its results?
yes, that is the assumption! we have seen some lab studies with Moderna (saying the same thing as Pfizer) but it will be a while until "real world" vaccine effectiveness of Moderna. This is because Moderna is just not distributed as widely internationally. It's safe to assume the follow similar patterns
Thank you so much.
When ones says that a variant is more transmissible, more contagious just exactly what does that mean? So with original COVID, it was said that if you spend 15 minutes with someone within 6 ft of each other you can catch it? Then I heard with Delta its more like 7 minutes. So does that mean that with Omicron its more like 2 minutes. Or is it that a person say walking in front of you and is talking to someone next to them, does that mean walking in their path is more likely to catch it where as with Delta is was more unlikely? I don't know why but when I hear this I just don't understand what it means to be more transmissible, more contagious and how? Just trying to figure out what is safe, what isn't. Thank you so much.
In the case of the delta variant, "more transmissible" had to do with several things. First, the variant tended to bind more tightly to the ACE2 receptor sites than earlier variants. Second, the rapidity of binding successfully was appreciably faster than earlier variants. Third, more virus particles were produced per reproductive cycle, placing a larger viral load in play when confronting another individual. In the case of Omicron, all of these are coming into play and we are seeing changes to the receptor binding domain that will influence further how fast the virus binds and how likely it is to resist circulating antibodies from binding to sites that will reduce its ability to infect a given cell.
Appropriate mitigating measures include: full vaccination with booster to increase the amount of circulating immune globulin (antibodies); use of masks in public, especially in enclosed spaces; use of appropriate masks per CDC guidance, and wearing them properly; frequent handwashing; appropriate physical distancing; avoiding social gatherings in enclosed spaces; and, frequent testing using at-home test kits, and reporting results of these to your doctor.
Is there any data showing longevity of antibodies and/or protection following a booster? Some people are already about 3 months out from theirs. What does this mean as they approach the 6 month mark if Omicron is in full swing by then... especially seniors and high risk individuals? Thanks!
data in Israel is showing a 3rd dose wanes too, but not as quickly as the 2 dose series. we are still trying to figure out what this means for long term plans
But, as you've already pointed out, CD8+ T-cells come to the rescue. I'm less concerned about circulating antibody, if we can train the cellular system adequately, as it appears, and if cellular immunity remains active over the long term.
As an FYI, the news today (Dec 14th) is that Oregon has 3 confirmed Omicron cases. You can count me in the "increasing vaccinations due to Omicron" - I wasn't feeling urgency to get the booster, but the data and your summaries gave a big nudge to my conscience. As others have said, thank you for your work in writing these summaries.
I have seen a few headlines about increased hospitalizations for children with Omicron. Is this a too early to tell situation or click bait driven? We do very little and my 2 yo has his trial appointment this week so we are hunkered til then to avoid any germs interfering with that, but I’m wondering if we should start canceling the very few things we have planned for the holidays if actual data is starting to show Omicron is landing this age group in the hospital. We are vaxxed boosted, brothers are vaxxed (9, 6)
I'm curious about this, as well. Our 2yo is the last of us to remain unvaccinated and we're striving to continue protecting her while we await vaccine approval, especially in light that our 6yo is newly fully vaccinated and has been excited to restart a few social activities that we had still avoided up until now.
I think it's still too early in the game to determine if we have more hospitalizations with omicron in kids. None of the data I've seen indicates more kids are being infected or hospitalized with this variant than with earlier variants.
If you got the two doses of Moderna and boosted with Moderna is that thought to be similar to Pfizer? I have seen reports that mixing may give you better boost? I took what I could get very gratefully. Thank you as always for your dedication to science and to the public.
At least one study found a higher humeral immune response with a Moderna boost to either a Pfizer initial and second vaccination, or a single-shot J&J vaccination. A Pfizer booster after Moderna initial was less likely to generate a similar response profile.
doesn't even ~70% efficacy (against infection) with a booster for a variant as infectious as omicron (considered by some to be many times more infectious than delta which was double original covid) mean that even most people with boosters should expect to catch omicron (albeit symptoms should hopefully be extremely mild)?
as a virus gets even more infectious, don't you need higher efficacy to be in a similar situation as before? aka, someone with a booster is many times more susceptible to catching omicron than delta assuming similar community spread (which is inevitable) because efficacy decreased AND omicron is more infectious
if i'm wrong i'd appreciate someone explaining why
Is there any guidance on boosters for those of us who received a 3-dose initial vaccine series due to being immune compromised? Is it still 6 months after the last dose?
So far, the CDC is still saying to boost 6 months after the 3rd/additional primary dose for people with immune-compromising conditions. Reference: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html
(I'm the primary vaccinator for our clinic, and this question comes up now and again. It's confusing since the boosters were approved only a few weeks after the 3rd primary doses were recommended. We have several patients who are still catching up with their 3rd doses, which puts them at late spring/early summer 2022 for their official boosters.)
I’m also very interested in this response … great question!
Thank you for your useful information. I have a question about mutations. If based on its reproductive rate it can be assumed a large portion of the worlds population will be infected with Omicron, won't that provide for a lot of opportunity for mutation? If Omicron's symptoms are truly more mild, does that mean it can't mutate into a variant that is more dangerous. I appreciate any insight on this you may have.
I am not an epidemiologist, so take this with a grain of salt: Yes, more worldwide infections means more opportunity for mutation. Viruses are always mutating, it is just a matter of time and sample size for a mutation to appear that changes the transmissibility or behavior of the virus.
I don't think the severity of Omicron's symptoms have any bearing on what it _could_ become in the future. Evolution is weird and random, it can sometimes get trapped in local "dead ends", and other times it can come up with very novel changes.
This was a great post. Thank you! With the news about the vaccine for children under 5 being pushed back, what you are thinking in terms of their protection. Would two shots, even if they aren't fully effective, not be better than nothing?
Dear Dr. Jetelina,
As a parent of a 16-month old toddler, and an academic trying to do her job as well, I *really* appreciate your work, and am amazed at how you can keep doing it.
As a fellow parent of under-5 kids, I am sure you are waiting for the vaccine just as impatiently as I am. I also send my toddler to daycare, and even though her teachers are vaccinated and masked, we have had closures in the past few weeks because of positive cases among the kids, who are ineligible for vaccines (and too young to mask.) With the impending Omicron wave, what makes sense for daycare? Should we keep sending our kids to daycare (and that's not even a choice, honestly) or wait it out until the vaccines become available to them? I'm interested in hearing your thoughts on it in light of the new information about Omicron, and any educated guesses on when the vaccine will be available for children under 5. I am terrified of long covid in young children.
My spouse is immunocompromised, we think to due to treatments for giant cell arteritis. She tests with zero antibodies after being boosted with Maderna. Is there a way, or any expectation, that her T cells or other immune system defenses are working? Where might we look for more informaiton for her situation. She feels like a ticking time bomb with the Omicron situation. We have heard of the recent approval of the AstraZeneca monoclona treatment for vulnerable people, and are hopeful for her to receive it soon.
Hi, Katelyn, thanks for the update. News.sky.com in the UK quotes health minister Sajid Javid saying that 200,000 are being infected each day with Omicron, already. I hope more Americans will avail of the world's best vaccines. Please also remember the millions who will need to be vaccinated too: Unicef give a vaccine campaign. It is great news that vaccines can take the sting from this virus's bite. We can hopefully keep each other safe.
When do you predict that hospitals will not be overloaded? This is most concerning to me. Needing to call in the National Guard, worn out health care workers...
Until we see adequate vaccination levels in this country (now needing to approach 90%, if my guess is right) to approximate population immunity for those who cannot be vaccinated for legitimate medical reasons, AND until we can get equitable vaccine distribution out to the entire world and do mass vaccination efforts, we're in a holding pattern. Things will briefly get better and then crash again. I've got a lot of friends in clinical settings who are gasping for breath right now.
I don't have much hope that vaccinations will ever increase enough. Maybe treatments, meds, will help take pressure off healthcare people???
Hi! This is great, thank you! Any info on those with one J&J shot and one mRNA shot and how that pairing protects against omicron?
i’ve been looking but no data yet with Omicron. BUT we have two studies now showing that JJ+ one dose of mRNA is almost the same neutralizing antibodies as three doses of mRNA. so i would assume that JJ+1 mRNA is highly protective. i’ll keep an eye on the data
Studies I've seen are similar, so, I concur.
Thanks!