mRNA-based Covid-19 vaccine boosters induce immunity against Omicron

I suppose its impossible to make a 5 year plan when the game is changing month after month. With countries having 50% vaccination rate, there's always place to brew new variants that might or not be resistant to vaccines and medicine.

A better question might be why would the political class ever want an exit strategy for something that gives them perpetual emergency powers?

In my mind the end game is either a natural mutation into something that isn't that big of a deal or a technology exmachnia.

Something like a vaccine agaisnt all coronaviruses or perhaps some other clever solution no one has thought of.

The longer this goes on the more Manhattan project we're going to get about it.

How long any of that takes I don't even have guesses for anymore.

The pill just got approved so once manufacturing ramps up we should be good to go because they don’t target the spikes.

The real issue is variants arising in other parts of the world where healthcare access is not great.

I don't think we're going anywhere until we have a real cure. You can have 10 vaccinations but if your immune system is shite they are not gonna amount to anything. And half of the world is still unvaccinated so even with our boosters we're not gonna end variants.

Omicron is basically the common cold when it comes to symptoms and deaths. Could be the real "vaccine".

Or our reality is forever changed unless one revolutionary treatment that is cheap, OTC, and reduce the death rate down to below 1%.

Otherwise, what end game are we talking about?

The end-game is not so much that the virus adapts (which can happen but mutations are not that easily predicable) but that our immune systems become adapted. We can see this already. Previously infected and/or vaccinated people can get omicron but it will be very mild disease. Next year there will be another variant and people will get sniffles again. Next year another variant that could easily cause severe disease to immuno-naive person but for those who already got 2-3 vaccinations plus mild omicron or whatever it will be just sniffles again.

That's how most cold viruses work. It was clear from the beginning that covid belongs to this category. We just hadn't had previous exposure yet, therefore it was so severe. We overreacted when we thought that we can eliminate cold virus by strict isolation measures.

Bi-annual is not necessary, even if immunity wanes within six months due to the seasonal nature of the beast. So at worst we are looking at something like the yearly flu vaccination. And also very probably younger and healthier people will be able to skip that altogether, just as with the flu vaccine.

Recent Denmark numbers for Omicron, including Covid-recovered, https://news.ycombinator.com/item?id=29633285

  0% fatal, 0.13% ICU, 1.2% hospital
  4.3% Covid-recovered 
  76% double vax, 7% booster
  14% unvax, 2% single vax
  77% no travel history

IF (will take several weeks to confirm) Omicron is mild and highly transmissible, then people may be infected and recover with protection against a range of variants. While natural antibodies fade, there is likely some ongoing protection from T-cells and memory B cells, e.g. studies showing some SARS1 protection after 17 years.

Leaving aside variants, the end game is for the virus to become endemic and everybody to encounter it every few months or years.

But you cannot do that while the non-immune part of the population is large enough to overwhelm the healthcare system if they get infected rapidly. Hence the focus on getting as many people vaccinated as possible, and keeping more or less non-pharmaceutical interventions in place.

Over the last months, removing non-pharmaceutical interventions has worked relatively well for some Western societies like Denmark (high vaccination rate) or the UK (lower vaccination rate + many previously infected), but not so well for others like Germany.

Variants change the game, but don't completely reset us to square one: Vaccines still provide some protection, but factors like higher transmissibility may work against that. mRNA vaccines can be adjusted relatively quickly.

We're seeing some congruence in the mutations acquired by different variants and most experts I listen to don't expect the virus to keep mutating forever. There is a limited number of options and population immunity will only become more broad.

On the other hand, the variants seen so far have surprised us quite a bit. Given that, it remains difficult to map out a clear path on the scope of years.

Look at the rate of deaths. Last December was about half the death rate of december before that. It's looking like this year will be half of the prior year. This is despite the number of cases generally being higher in the latter years generally. Some dependence on when the virus first hit. Long term side effects and hospitalizations are going to correlate with the death rate more than the infection rate.

I find the the NYT data viz to be the best and most accessible: https://www.nytimes.com/interactive/2021/us/new-york-covid-c...

There is strong reason to believe that despite omicron's higher spread factor, it won't increase exponentially forever and will instead drop off rapidly as its done every year in every geography sometime soon. It's not a dud yet, but it's trending towards that through a combination of better treatment, vaccinations, immunity, and particularly vulnerable people dying.

Omicron looks like it could reach a much higher number of infected in new york soon, but I doubt we will see a higher rate of hospitalizations or deaths than last year in spite of this. We should have the evidence to confirm or deny these assumptions in a few weeks once we're comfortable with any lagging data issues.

> Is vaccine as a bi-annual service really practical?

Sure, why not? The flu vaccine's annual. Hopefully we don't end up there, but if the medium-term end-state is "it's manageable, but everyone needs a booster every six months", that seems... not the worst possible outcome?

Taking vitamin D is great and recommended for pretty much everyone, but the evidence for it being an effective prophylaxis against Covid-19 just isn't there[1]. By all means take it for general health reasons (I do too!) but don't expect it to provide you any specific protection.

[1] https://www.nice.org.uk/guidance/ng187/evidence/evidence-rev...

As part of a generic defensive regimen, zinc + zinc ionophores (OTC options include Quercetin and the green tea extract EGCG) are worth a look, https://www.sciencedirect.com/science/article/pii/S016201342...

> Zinc can play a pathophysiological role in several diseases and can interfere in key processes of microbial growth. This evidence justifies the efforts in applying Zinc ionophores to restore Zinc homeostasis and treat bacterial/viral infections such as coronavirus diseases. Zinc ionophores increase the intracellular concentration of Zinc ions causing significant biological effects. This review provides, for the first time, an overview of the applications of the main Zinc ionophores in Zinc deficiency, infectious diseases, and in cancer, discussing the pharmacological and coordination properties of the Zinc ionophores.

> friends with some people who'd probably consider death before covid vaccines

I know some people like that and I've had some success encouraging them to take the Novavax vaccine (a traditional vaccine that's said to be safer and cheaper [1]) when it's approved. I can't be sure they will but they've said they'd consider it.

1: https://www.theatlantic.com/health/archive/2021/06/novavax-n...

The norm? I'm highly skeptical. Why isn't there more focus on preventative measures? Even with the Measles vaccine we know to give vitamin A for treating measles.

Many vaccines require three shots. A key difference is that the timespan between second and third (booster) shot is much longer than that between first and second shot.

It's a matter of antibody levels. Antibody binding is worse for Omicron, so you need more of them. Booster shots provide you with such increased antibody levels.

Are they still gonna be high enough after a few months? Good question. Afaict, nobody knows yet.

(And this of course leaves aside the whole matter of T-cell immunity still providing protection against severe disease.)

As large as it could be. Recent vaccination gives you basically no protection at all. The graph at the end summarizes it: https://imgur.com/a/XfQstP6

There is no difference between what is injected.

It's more like a retraining program. It's almost like the difference between short and long term memory. One shot will turn on short term memory after a week or two. Repeating shots will turn on long term memory.

But what I personally think is interesting is that a natural infection works longer and broader after just one 'dose'.

It is amazing how complitacted the immuunsysteem is. And I also think this is the reason we should be careful with giving healthy young people the vaccins.

It will likely be too difficult to do a study to answer this precisely. But if you recently got your initial vaccination completed, you shouldn't be in a rush to get a booster. The booster is there to reinforce the immunity after it has had to wear off.

Whoever wrote that sentence can’t write for shit. It’s the most important sentence in that whole document and they fucked it up.

You had one job.

> are they saying double vaccination had no noticeable effect on Omicron?

Practically, yes. See Figure 2. Recent vax (< 3 mos.) and distant vax (6 to 12 mos.) neutralization is between the first two eighth ticks for omicron. (Distant vax + infection is a bit less effective than distant vax with the wild type variant, which should put to bed the nonsense around prior infection being equivalent to innoculation.)

We need an updated vaccine and/or to refresh the vaccination requirement to including boosters.

I read it as they were surprised that regular vaccinations had no effect on Omicron, but that [recent] boosters did (although to a limited extent).

That seems to jive with what I have seen on the ground, around here (New York). Dozens of friends and acquaintances are sick. None, severely. I am quarantined through Christmas weekend. Tests (at least accurate ones) are rare as hen’s teeth. The home test kits seem to be absolutely worthless. I have not talked to one single person that got a positive from a home test (some were clearly symptomatic, when they took the test, and still came up negative).

Other papers show that they have no noticeable effect on how the virus can reproduce, however the T-immune cell response to already infected cells is still good, meaning you most likely won’t go to the hospital if you get omicron and your 2nd dose is not too long ago.

They're saying that it had low effect on immediate neutralization of the virus (sterilizing immunity). You're still well-protected against severe disease.

Far too much fear-mongering has happened based on confusion about what different studies are measuring. Measures of "neutralization titer" are pretty much pointless, outside of a lab -- they're a model for immunity with no demonstrated relevance to real-world outcomes.

Studies involving "symptomatic disease" are trying to measure the chance you might get any symptoms at all -- a very low bar. Even the sniffles count here. This is where most of the pro-booster studies have focused, and it's a pretty lame endpoint, unless you continue to harbor the delusion that "zero covid" is a thing that is possible (it is not).

Basically, if you get infected after two doses, you might get cold-like symptoms, unless you're either severely immunocompromised (e.g. on immune suppressants, AIDS, in the middle of a bone marrow transplant, etc.) or so old that your immune system is failing anyway.