Should we postpone getting a booster due to Omicron, till there are Omicron-specific boosters?

ChristianKl

Should we postpone getting a booster due to Omicron, till there are Omicron-specific boosters? — LessWrong

33

[ Question ]

Should we postpone getting a booster due to Omicron, till there are Omicron-specific boosters?

by ChristianKl

4th Dec 2021

1 min read

5 18

33

Wai Dai writes over in the comments at Omicron Variant Post #1: We’re F***ed, It’s Never Over:

From your linked paper https://www.cell.com/trends/immunology/fulltext/S1471-4906(21)00177-0: [Wai Dai's quote from the paper in italics]
Experience from the IAV field indicates that multiple serial exposures to variant IAV strains might imprint (focus) the immune response to a narrow array of well-conserved viral epitopes relative to emerging subsequent strains and this might eventually reduce vaccine effectiveness. Randomizing multiple cohorts over time to either serial or partial immunization might also yield important neutralization data, although powering such studies for efficacy would be challenging. Larger observational studies of cohorts receiving serial immunizations might therefore also prove useful.
This suggests that it may be a good idea to avoid getting a booster now (with the ancestral spike protein) and wait for an Omicron-specific booster instead. (Use other precautions to avoid infection in the meantime.)

Given that this is an important question for many of us, I consider it useful to have the conversation on the top level instead of only in the comments of the other thread.

Covid-19

Personal Blog

33

New Answer

New Comment

5 Answers sorted by
top scoring

Zvi

Dec 04, 2021

270

At current pace you have 1-2 months before the peak, and the booster takes a week to work. There's basically no chance as a non-prioritized person you'll be able to get an Omicron booster in that time frame.

[-]rchplg5y70

This seems right, but also interested in whether boosters might be net-harmful v.s. nothing.

Does original antigenic sin also mean that e.g. your body would have a harder time fighting off omicron if infected, because rather than developing new antibodies it would just keep trying to deploy the old ones?

If we have data that boosters reduce severity for omicron, that would seem to answer this. But do we?

1rchplg5y

I have not looked into much, but saw what looks like more evidence that boosters do help: https://mobile.twitter.com/DataDrivenMD/status/1469448926562455555 Again, I did not look into much detail - so feel free to look at zvi's newer post with some updated data - but overall weight seems in favor of booster more than when I made this comment.

1Nicole Ross5y

Very interested in this question as well.

[-]Wei Dai5y50

Thanks, I've seen a number of experts suggest that people get booster shots ASAP, but without any explicit reasoning attached. To push back a bit on this, it looks like Omicron will soon become the dominant variant almost everywhere, so subsequent variants will probably branch off it. So it might be worth taking additional precautions during the Omicron peak, and then get an Omicron-specific booster when it comes out to be better protected against future Omicron-branch variants. As mentioned in another comment, I'm waiting for some additional data to come out before making this decision.

7rossry5y

I don't think you're wrong, but it is worth noting that Omicron itself violated this guess; it is defended from the original strain, not any other Greek-lettered variant.

1cistrane5y

But note the R0 for Omicron. It seems to be able blow the competition away in any location it establishes.

4rossry5y

I'm sorry -- I don't understand how your comment responds to mine. I pointed to the fact that Omicron outcompeting Delta without being descended from Delta indicated that a successor to Omicron could perhaps not be descended from Omicron. In particular, I agree with you that Omicron will become the dominant variant almost everywhere. One minor detail: It is implausible that Omicron's competitive advantage is primarily derived from an increased R0 (that would give it a higher R0 than measles); rather, its observed fitness against the competition is more easily explained by some measure of immunity evasion (which won't be measured in increased R0).

4ChristianKl5y

There's also the question of whether this is very important and warrents unconvential action in which case making your own vaccines with Stöcker's formula and actually using the Omicron spike protein might be warrented.

1[comment deleted]5y

JoeBloggs

Dec 04, 2021

I wonder if it may make sense for some to even forgo Omicron and wild-type strain boosting altogether. If Omicron looks as though it's becoming dominant and it continues to look as though illness is mild (and you are sufficiently low risk) maybe it's best to wait and reserve boosting with an "upgrade" for a strain which is perhaps more virulent down the road. Seeing as this virus is highly mutable, premature and perhaps excessive serial boosting may be unwise per the cited article.

RedMan

Dec 04, 2021

Unfortunately radvac won't be valid when it comes to vaxpass type policies.

https://radvac.org/press-release/

Summary: We predict the extensive variation of Omicron will reduce the effectiveness of Spike-based vaccines, and substantially reduce the effectiveness of RBD-based vaccines and antibody therapeutics (other than GSK sotrovimab), yet have little impact on RaDVaC vaccines.

[-]ChristianKl5y20

Unfortunately radvac won't be valid when it comes to vaxpass type policies.

It's possible to take RaDVaC for the actual protection and then take the offiically recommended vaccine to get your vaxpass.

gareth

Dec 04, 2021*

I’m not an immunologist so can’t talk of the efficacy of various vaccine strategies which seem unclear at the moment, but I ask myself - what is the opportunity cost of not getting a booster now? If we assume that omicron boosters will be available in (at best) 3-4 months, and then given to elderly or immunocompromised people first, the chance of me getting an omicron booster in the next 6 months is low. Weigh that against the chance of getting omicron covid in the next 6 months. Looking at the data, we can already establish that omicron is more contagious and looking at increases in infection rates in Europe over the last few weeks along with the fact that omicron will (probably) soon become the dominant strain, I’ll take a small increase in immunity now over a potentially larger one in 6 months when the omicron wave may be over. That’s just my risk calculation though - I got moderna booster yesterday. YMMV

[-]ChristianKl5y50

The open hypothesis is that getting the booster against the alpha-spike-protein might increase the "original antigenic sin" dynamics and reduce the effect of the Omicron booster.

1[comment deleted]5y

Wei Dai

Dec 04, 2021

My current thinking is to wait at least a couple of weeks, for data to come out regarding how effective current 2-shot vaccines are against Omicron, and how much the current boosters help on top of that.

Rendering 3/8 comments, sorted by

top scoring

(show all) Click to highlight new comments since: Today at 4:25 PM

[-]cdrini5y10

Please fix the formatting of the post ; as is, it looks like "This suggests" is a quote from the paper! You likely need a new line to break out of the quote. Also the url to the paper doesn't work because of the ":" at the end ; could you add a space before the ":"?

[-]ChristianKl5y30

I fixed the link and made it clear that I italized the amount coming form the original paper. I'm not sure whether the software allows other ways to mark double quotes.

[-]cdrini5y10

Ah, nevermind about the quote ; it seems like you're quoting the quote of a quote.

Moderation Log

33

[ Question ]

Should we postpone getting a booster due to Omicron, till there are Omicron-specific boosters?

33

33

5 Answers sorted by top scoring

Dec 04, 2021

Dec 04, 2021

Dec 04, 2021

Dec 04, 2021*

Dec 04, 2021

33

5 Answers sorted by
top scoring