Booster dose builds immunity as omicron variant spreads

Mounting data proves COVID vaccine still safer, more effective than natural infection

A Sanford Health COVID unit nurse in full PPE carries flowers and a heart-shaped balloon that says "Get Well Grandpa."

We’re learning more about a new strain of the coronavirus first discovered in South Africa late November.

The newest data out of the country shows the omicron variant carries a bunch of different mutations — more than delta or any of its previous variants — and it’s starting to give researchers information about its behavior.

Sanford Health chief physician Jeremy Cauwels, M.D., breaks down what we know to date during a Facebook Live Q&A, Dec. 8.

In South Africa, it’s important to note, the population is more naturally immune than protected by the vaccine because the vaccine is not as widely available.

“With that population, omicron appears to spread very quickly,” Dr. Cauwels said, still waiting to learn whether this translates into a rise in hospitalizations.

“We hope omicron evolves into something that is not as virulent, (with) less ability to put people in the hospital, and becomes more like a common cold infection versus previous variants — like delta — that landed more people in the hospital.”

We won’t know more until around Christmas, he said.

Omicron and your COVID immunity

So far, Pfizer’s early data shows some effective protection of its vaccine against the omicron variant.

“We’re busy doing the studies to find out exactly how effective that is compared to a two-shot regimen, as well as a two-shot regimen plus a third or booster dose,” Dr. Cauwels said.

He is eager to learn more about this variant and how effective the vaccine is, how good natural immunity is — and a combination of the two.

“Right now, in this part of the country, we have a lot of people who have been infected with COVID before and many who have been infected after receiving the vaccine.”

Right now, he says, what we know is that’s an “extraordinarily good form of protection.”

Researchers are asking if that will be enough keep people out of the hospital, keep people from dying, or protect people as much as the vaccine alone.

Meanwhile, the same protective measures should help to avoid the variant or any strain of COVID-19.

“If you’re going to be in a large crowd, wear a mask, maintain social distancing when able to, wash your hands and stay home when you’re sick,” Cauwels added. “They’re all things we’ve talked about before that are effective in avoiding the virus and serious illness altogether.”

Natural immunity varies from patient to patient with severity of illness, which makes it harder to study than an individual’s immunity from the vaccine, he said.

“We do know the dose we gave to people, we do know how frequently we gave the dose, so we can measure a population and see how many of them are immune,” Dr. Cauwels said. “With natural immunity, we can’t tell the dose we gave, we can’t tell how long they were exposed, so it’s very difficult to tell how long they’re gonna be immune, how long they’re gonna have antibodies, and so on.”

The best immunity studied in any population, anywhere in the world, is the group of people who have natural immunity and boost it with at least one shot of the vaccine.

With 95% efficacy, vaccination is the best and safest form of protection from COVID-19, serious illness and death.

Vaccine booster bolsters immunity

More patients are now eligible to receive that added layer of protection.

In November, the Centers for Disease Control and Food and Drug Administration approved booster doses of all three COVID-19 vaccines for all adults 18 and older.

Since then, the CDC strengthened its recommendation on booster doses saying everyone 18 and older should get a booster. Meantime, the FDA recently expanded eligibility for the Pfizer-BioNTech booster dose to 16 and 17 year-olds.

  • For Pfizer-BioNTech or Moderna, individuals should wait at least six months after completing the primary two-dose series
  • For Johnson & Johnson, individuals should wait at least two months after receiving that primary dose

Learn more: COVID vaccine boosters available at Sanford Health

If you’re wondering whether to mix or match your first vaccine doses, good question. The short answer is “yes,” and we can thank Canada for the great data.

“There’s some good data to say you should mix them,” Dr. Cauwels explained. “The data we’re getting from people who have mixed and matched does appear to be extremely good at preventing new infections.

“I think it’s reasonable to say when you go in for your booster, pick whichever one and move forward.”

You can schedule an appointment for your COVID-19 vaccination at Sanford Health whether you are a current patient or not. COVID-19 vaccines are offered without an appointment at select locations.

Nursing staff still ‘extremely busy’

The latest hospitalization numbers, as of Dec. 13, still show more than 230 patients in Sanford Health facilities.

Concerns linger over if there will be enough hospital beds through the winter months.

“We haven’t run out of heart attacks. We haven’t run out of strokes. We haven’t run out of all of the things that needed urgent or semi-urgent surgeries. We haven’t run out of cancer,” Dr. Cauwels said. “And so as long as we have those things, we continue to have hospitals full of all of those things.”

When COVID-19 adds 200 patients — and an overwhelming majority are unvaccinated — to those hospital beds, it adds more strain on health care staff.

Throw the flu into the mix as influenza is coming back this year with cases already on the rise.

“A week ago, we had 45 cases of influenza in the system over the course of a week,” he said. “This week, we had 45 cases of influenza on Monday and Tuesday.”

Dr. Cauwels would love to see that staff get a break, enjoy the holidays with their loved ones and take a breath.

“In in order to do that, we have to continue to do the right thing, to keep ourselves as healthy and happy as we can individually, in order to help out the population as a whole.”

Information in this story was accurate when it was posted. As the COVID-19 pandemic changes, scientific understanding and guidelines may have changed since the original publication date.

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Posted In Coronavirus, Expert Q&A, Flu, Immunizations