BILLIONboth FDA and CDC approved Vaccines against covid-19 last week. The promise of the mRNA vaccine technology platform has always been that we can update them quickly. Ultimately, we may have gained an advantage over SARS-COV-2 because the updated vaccine formulation is consistent with the currently circulating strain BA.5 (and strain BA.4.6 developed). slow-growing) without another transmission variant of interest.
However, we are concerned that the CDC may once again miss the boat with its recommendations for timing to know when most American adults should receive this booster. Follow the Advisory Committee on Immunization Practices (ACIP) meeting on September 1The CDC states that adults who have completed their primary series of vaccines are eligible for a booster shot if it is received at least two months since their previous vaccine. They advised the who has recently had an infection wait 3 months before being boosted.
However, such a short period is not optimal if we are aiming for strong protection in the long fall/winter and can also be counterproductive. The CDC should recommend a 6-month interval between a booster shot or previous infection and a new updated vaccine for healthy adults for two main reasons: up-to-date immunology research, and the recognition that millions of Americans had a post-vaccination infection with Omicron variants this year and thus had strong current protection against BA.5 reinfection.
We were before appeal on CDC to extend the recommended interval between main doses of both mRNA vaccines to 8 weeks primarily on basis of immunological studies exhibited higher antibody responses, amplified T cells and enhanced memory B cells with longer intervals between doses.
Recent studies in the Omicron variant period further demonstrated the benefit of prolonged intervals between doses in increasing both neutralizing antibodies and mnemonic B cells. A supply booster antibody protection for at least 6 months According to a recent study. Another study demonstrated that antibody levels are stable 6-9 months post-vaccination of study participants with and without prior infection.
Memory B cells were even stronger after vaccination – demonstrating sustained reactivity against all variants including Omicron for at least 9-10 months after the 2-dose series; with an additional positive response to the 3rd booster dose. One additional research showed that memory B cells continued to mature for about 6 months, after vaccination or infection. B-cell immunity — as well as Immune T cells for the COVID vaccine–provide protection against serious illness and did not lead to high hospitalization rates as BA.5 became dominant this summer.
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One of the purposes of the Omicron-specific vaccine is to boost antibodies and prevent minor infections. Thus, a stable antibody level at the 6-month mark would signal the ideal time to boost with the BA.4/5 concentrate vaccine because low pre-boost antibody levels actually correlate with increase many times strengthen later. In other words – high levels of circulating antibodies from a short period booster may limit the ability of another enhancer to provide additional protection. Again Recent research by NIH also showed similar concern after a recent infection, but even more severe: booster shots 2 months after recent infection actually reduced the effective response of B cells.
Millions of people infected with Omicron
One recent research at JAMA showed that 56% of those infected with the Omicron variant were unaware of the infection. And the actual number of daily infections this past summer far exceeded the official table based on the scale of unreported rapid antigen testing at home. Additionally, millions of Americans have received their third and fourth doses of the vaccine in the past few months.
The benefit of this level of population immunity can be extrapolated from a recent studies outside of Portugal this suggests, in contrast to previous concerns about BA.5 reinfection, that a previous BA.1/2 infection provides up to 75.3% protection against BA reinfection .5. This is suitable for Qatar Studies showed 79.7% protection against reinfection.
All of this data means that there is a large amount of active population-level immunity to COVID-19 in the United States that is likely to protect against serious illness. Our booster strategy should recognize this existing immunity and seek to build on it in a way that extends this shot’s protection through the winter. Repeated boosting at short intervals or boosting too soon after post-vaccination infection limits the response of the neutralizing antibody and slows the expansion of memory B cells.
Following expert input, CDC officially updated its guidance in February 2022 to recommend extended dosing intervals for the main vaccine series, but lags significantly behind with their partners in Canada, Europe and India where this 8-week period applies. Furthermore, prolonging the vaccination interval does not widely advertised. CDC now has the opportunity to apply these principles of immunology to updated Omicron boosters and make them work better.
The Canadian National Advisory Committee on Immunization, was ahead of the curve, officially recommended Last week, the updated bivalent vaccine will be given at 6 months intervals after the previous vaccination or infection.
In a recent survey by CDC, 72% of those polled will “definitely” or “probably” get an updated booster. Interest in an updated booster is important because only half of them qualify Americans received the first recommended booster dose, and only 34% of those over 50 years of age received a second booster. That’s why it’s important that we get recommendations on the right timing for this updated Omicron booster, the first update in the mRNA vaccine since they were launched in January 2021.
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