A study out of Sheba Medical Center in Israel has proven that a 4th dose of either Pfizer or Moderna is ineffective against Omicron. Preliminary data was released on Monday 1/17/22 showing high antibody titers but low protection. Here’s an examination of the data, and 3 lessons we can learn from this.
To start, 274 healthcare workers at Sheba Medical Center received a 4th dose. Specifically, 154 received Pfizer, and 120 received Moderna. They were compared with a control group of nearly 6,000 healthcare workers that didn’t receive a booster. Prof. Gili Regev-Yochay, lead researcher commented, “We see an increase in antibodies, higher than after the third dose,” he stated. “However, we see many infected with Omicron who received the fourth dose”. To elaborate, around the same number of individuals that received 4 doses experienced as many breakthrough infections as those who received 3. That said, there are a few lessons to learn from this.
Lesson number one. We need to stop basing vaccine efficacy on antibody titers. In other words, we can’t simply measure the effectiveness of a vaccine based on antibodies levels because quantity doesn’t equal quality.
In the case of Israel, after the 4th dose, antibody levels were robust, yet protection against Omicron was substantially diminished. That evidenced by as many breakthrough cases in 4 dose recipients as 3. Succinctly put, Omicron has changed the game, so COVID-19 strategy needs to evolve.
Importantly, the graphs below are from a very recent Kaiser Permanente study which elucidates the reality of reduced protection against the new variant after dose 1,2, and 3 from mRNA vaccines. As you can see, dose 1 and 2 confer no protection against Omicron after 4 months compared to Delta. Moreover, the booster dose in figure 2 has a very wide confidence interval so protection is likely to diminish fast, and is questionable at best. The silver-lining here, the new variant tends to be mild in nature. So even though protection from vaccination is low, when one eventually meets the virus (and they will), symptoms will likely be substantially less severe than Delta regardless of antibody status.
The solution, base vaccine effectiveness on reduced hospitalizations, death, and severe symptomatic disease instead of antibody levels because more antibodies do not translate to better antibodies.
Lesson number two. Omicron can not be contained by boosting so vaccine mandates have to go for workers, college kids, etc. In light of the many new mutations the virus contains, immune escape is a reality for those who are vaccinated. As a result, diminished protection now illuminates the fact that there are greater harms than benefits associated with boosting.
You see, vaccine effectiveness against Omicron is low which will inevitably increase transmission, and positive cases because current vaccines were engineered to target older variants. Essentially, at this point spread cannot be curtailed regardless of how stringent mitigation is. That means the harms of mandatory boosting like loss of personal autonomy, possible side effects, and the firing of essential healthcare workers are no longer justified. Continuing on with the same protocol, only hastens hospital worker shortages which increases patient mortality and reduces quality of care, while plummeting the quality of life for students. Luckily, signs and symptoms associated with this variant have been mild and correlate with reduced symptomatic hospitalization, ICU admissions, death, and ventilation.
Speaking of healthcare workers, many are forced to either take a 3rd dose or be terminated. Alternatively, many are choosing to leave because of the coercion. Considering the current medical staffing crisis and surge of cases, it is foolish that employees who already double vaccinated, and naturally boosted from repeat exposure have to be inoculated with something that no longer benefits them or the patients they serve. Moreover, further reducing healthcare staff by continuing to uphold an inauspicious booster mandate, not only increases the deficit of much needed medical help, it decreases the confidence in public health officials by those affected. After all, how could someone trust the ones implementing policy when the very decisions they make prove deleterious. Regrettably, healthcare workers aren’t the only ones affected by this kind of reductionist methodology.
Arguably, our youngest, brightest, and least at risk, have endured the barrage of blunt trauma delivered by non-scientific college booster mandates. To be specific, college students are already double vaccinated (mandatory at most colleges), masked, young and healthy, which leaves them at a very low risk for suffering severe outcomes from COVID-19. Ironically, administrators feel it necessary to require boosters against a variant that will inevitably evade the very “protection” the intervention yields. On the other hand, such measures could have been justified with Delta, and the original variant as vaccination then did reduce the rates of transmission, ameliorate the harms from hospital surges, and help people delay their time before meeting the virus so they could vaccinate. Next, another important fact. It is difficult to justify boosting when risk to this cohort is already so low, but harms from vaccine induced myocarditis after dose 2 and 3 (males 16-24) are much higher compared to meeting the virus. Unfortunately, Omicron spreads like wildfire with increased transmissibility, without reverence for any of those factors.
The solution, get rid of booster mandates as they don’t reduce transmission and now increase harms compared to benefits. Instead, encourage masking, and natural immunity.
Lesson number three. Since Omicron will spread regardless of vaccination status or age, and is mild in nature, school closures and Zoom schooling for younger children is no longer acceptable. Yet again, the benefits of draconian shut downs and distance learning no longer outweigh the harms.
As I have laid out in a previous publication, data has emerged detailing the insidious impact school closures, and distance learning have had on young malleable minds. Specifically, there is data correlating at-home learning, school closures, and masking, to decreased neurocognitive developmental quotients in verbal and non-verbal areas of children since the inception of such protocols. What’s more, early learning composite scores that measure the adequacy of a child’s ability to interpret verbal and non-verbal cues, incorporate fine motor skills, and express themselves, decreased largely since the beginning of the pandemic (see 2 images below and click here to read the study).
As a side note, there is no data to suggest children spread the virus at a higher rate than other cohorts. That said, dismissing entire classrooms for quarantine after one child tested positive, while the others exhibit no symptoms is irrational. That said, an amendment of this policy is warranted. Succinctly put, keep the positive child at home and only send other exposed students home if they later experience symptoms or test positive.
The solution, stop closing schools and isolating exposed, but not symptomatic or positive testing children. Regardless, the virus will spread, and not at a reduced rate from said interventions.
If these 3 lessons are realized and action is taken, not only will the cohorts most affected fair better in the end, society will as a whole. Vaccine effectiveness solely based on antibody levels, booster mandates, and school closures are no longer justified as Omicron evades protection conferred by high antibody levels, boosting, and mandates in academic, and hospital settings. At best, Omicron makes individuals exposed mildly ill, and that doesn’t justify the the grim consequences of these now ineffective COVID-19 protocols.
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