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Is A Fourth COVID Vaccine The Best Defense Against Omicron?


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Medically reviewed by Kathy Shattler, MS, RDN

Fourth Shot Omicron

After a month of living under the Omicron variant’s iron rule, healthcare experts are concerned. 

The variant does not appear to be as receptive to the antibody-mediated approach[1] to vaccination that kept previous versions of the coronavirus at bay. Two doses alone just aren’t cutting it, even with a booster, in some cases.

Currently, the public health community contends that in lieu of an adequately effective variant-specific vaccination, a third booster dose isn’t just necessary — it actually might be the bare minimum that the body requires under these circumstances. In fact, some early adopters are going so far as to claim that the fourth dose for everybody might be our best bet going forward.

Is a Fourth COVID Vaccination Really Necessary?

Pfizer CEO Albert Bourla spoke out to CNBC[2] in a recent and brief exposé on the matter. He appears to take a data-driven stance above all else but warns that early indicators do indeed confirm the efficacy of a fourth COVID vaccination.

At the time of this writing, Bourla admits that the picture that we currently have at our disposal is still incomplete — only time will tell how long a double-dose vaccination supplanted by a booster will be able to protect any given individual statistically before fading and becoming impotent. At any rate, a full round of vaccination becomes significantly more effective[3] after a booster shot, even if you only receive three doses in total.

The originally-prescribed Pfizer vaccination regime does actually include the fourth dose, although not quite in the form of an immediate booster, and not exactly as a fourth serial dose, either. 

Instead, this fourth shot was intended more as a long-term provision, administered 12 months after the patient’s final scheduled shot in his or her vaccination series. Now, experts are revisiting this notion in light of our current predicament.

What Are Our Other Options?

Many experts have already resigned themselves — a fourth COVID-19 vaccine might simply be the only way forward with Omicron on the table. 

Other innovators are interested in finding alternative means of reckoning with the variant, however. Many call for the “next generation” in COVID-19 treatment, something beyond simply tacking the fourth vaccine onto the tail-end of a Delta-effective vaccine series.

Currently, most COVID vaccination and treatment is taken intravenously, your standard vaccine or booster shot. Pfizer currently has oral antiviral treatment[4] for COVID in the works. It’s been shown to reduce rates of hospitalization by 89%, but this effort and others like it are not being developed to treat Omicron specifically.

The big problem with Omicron is that it appears to be especially adept[5] at outwitting the virus-neutralizing antibodies that the body receives after vaccination and then produces on its own. Some studies show that extending the spans of time[6] between each dose might increase how effective they stand to be cumulative. Others aren’t convinced.

Other vaccine manufacturers believe that overhauling each current vaccine cocktail might actually be a better solution.

 An improved, more Omicron-specific formula could be the key to overcoming Omicron’s characteristic “spike”[7] — a microscopic organ that acts as a bridge between the virus and its cellular victim. This spike becomes more sophisticated and penetrative with each generation of the virus. 

The organ is used to interact with the receptors found on human cells, allowing the virus to hijack them and to continue to spread throughout the body. This appendage may have something to do with its imperviousness to attacking antibodies. Studies of Omicron show that this spike varies significantly from the previous corona “halo” of the original; 32 mutations on this structure alone have been documented in a laboratory setting. 

Antibodies, to put things simply, are the little soldiers that prevent the virus from entering our cells and taking them over. This spike mutation facilitates “viral escape,” bypassing our body’s natural lines of defense. 

As time wears on, the Omicron variant only stands to evolve and to improve itself further in this way. The clock is ticking, which is why many experts in the field are pushing for a fourth dose in the intermediary as we wait for a more elegant solution. Better safe than sorry.

Omicron Recap: Fast Facts on the Omicron Variant

In light of all of these new findings, vaccine manufacturers are working night and day[8] to produce a more effective COVID vaccine, one capable of stepping toe-to-toe with the Omicron variant.

A few quick refreshers on Omicron and its hostile takeover:

  • Right now, nearly three-quarters[9] of COVID-19 cases in the United States were contracted by way of the Omicron variant.
  • The spread of Omicron is one of the most unprecedented aspects of its sudden, uncontainable rampage. It moves much more quickly than previous variants and appears to settle into hosts much more readily because of its mutated shape.
  • Omicron has experts worried because of its tendency to “breakthrough” vaccination regimes that have been proven to be effective against previous variations of the coronavirus.
  • Masks and social distance are both still perfectly effective means of avoidance, even against the Omicron variant.

We’re still in the midst of this disaster, but, already, nations all around the world are preparing themselves for the upcoming holiday travel season, as well as the rest of winter. No mandates regarding a fourth vaccine have officially been rolled out, but many experts are coming out in support of this development.

As of right now, the CDC now recommends that all people over the age of five years old receive a full series of COVID vaccines and that any vaccinated person over the age of eighteen receives an additional booster, at the very least. If you’ve already received them, you’re in good shape for the coming New Year. 

Should You Plan on a Fourth COVID Vaccine in 2022?

The results aren’t exactly conclusive, but early data does indicate that the Omicron variant is much more resistant to the COVID-19 vaccines that we’ve relied on over the last few years than previous variations, including the Delta variant. 

Three doses, at the very least, appear to be necessary in order to gird yourself against the onslaught of Omicron. Our advice? Try not to worry too much if you and your family have already been vaccinated. We’ll be self-quarantining by the fire in the meantime until all of this blows over.

+ 9 sources

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  1. Wilhelm, A., Widera, M., Grikscheit, K., Toptan, T., Schenk, B., Pallas, C., Metzler, M., Kohmer, N., Hoehl, S., Helfritz, F.A., Wolf, T., Goetsch, U. and Ciesek, S. (2021). Reduced Neutralization of SARS-CoV-2 Omicron Variant by Vaccine Sera and Monoclonal Antibodies. [online] Available at: https://www.medrxiv.org/content/10.1101/2021.12.07.21267432v1?s=09 [Accessed 22 Dec. 2021].
  2. ‌Kimball, S. (2021). Pfizer CEO says fourth Covid vaccine doses may be needed sooner than expected due to omicron. [online] CNBC. Available at: https://www.cnbc.com/2021/12/08/omicron-pfizer-ceo-says-we-may-need-fourth-covid-vaccine-doses-sooner-than-expected.html [Accessed 22 Dec. 2021].
  3. ‌Kimball, S. (2021). Pfizer and BioNTech say booster dose provides high level of protection against omicron variant in initial lab study. [online] CNBC. Available at: https://www.cnbc.com/2021/12/08/pfizer-biontech-say-booster-dose-provides-high-level-of-protection-against-omicron-variant.html [Accessed 22 Dec. 2021].
  4. ‌Pfizer.com. (2021). Pfizer’s Novel COVID-19 Oral Antiviral Treatment Candidate Reduced Risk of Hospitalization or Death by 89% in Interim Analysis of Phase 2/3 EPIC-HR Study | Pfizer. [online] Available at: https://www.pfizer.com/news/press-release/press-release-detail/pfizers-novel-covid-19-oral-antiviral-treatment-candidate [Accessed 22 Dec. 2021].
  5. ‌Planas, D., Saunders, N., Maes, P., Guivel-Benhassine, F., Planchais, C., Buchrieser, J., Bolland, W.-H., Porrot, F., Staropoli, I., Lemoine, F., Péré, H., Veyer, D., Puech, J., Rodary, J., Baela, G., Dellicour, S., Raymenants, J., Gorissen, S., Geenen, C. and Vanmechelen, B. (2021). Considerable escape of SARS-CoV-2 variant Omicron to antibody neutralization. [online] Available at: https://www.biorxiv.org/content/10.1101/2021.12.14.472630v1.abstract [Accessed 22 Dec. 2021].
  6. ‌Payne, R.P., Longet, S., Austin, J.A., Skelly, D.T., Dejnirattisai, W., Adele, S., Meardon, N., Faustini, S., Al-Taei, S., Moore, S.C., Tipton, T., Hering, L.M., Angyal, A., Brown, R., Nicols, A.R., Gillson, N., Dobson, S.L., Amini, A., Supasa, P. and Cross, A. (2021). Immunogenicity of standard and extended dosing intervals of BNT162b2 mRNA vaccine. Cell, [online] 184(23), pp.5699-5714.e11. Available at: https://www.cell.com/cell/fulltext/S0092-8674(21)01221-6 [Accessed 22 Dec. 2021].
  7. Ewen Callaway & Heidi Ledford‌, (2021)How bad is Omicron? What scientists know so far . Available at: https://www.icpcovid.com/sites/default/files/2021-12/Ep%20197-2%20How%20bad%20is%20Omicron_%20What%20scientists%20know%20so%20far.pdf
  8. Waltz, E. (2021). COVID vaccine makers brace for a variant worse than Delta. Nature, [online] 598(7882), pp.552–553. Available at: https://www.nature.com/articles/d41586-021-02854-3 [Accessed 22 Dec. 2021].
  9. CDC (2020). COVID Data Tracker. [online] Centers for Disease Control and Prevention. Available at: https://covid.cdc.gov/covid-data-tracker/#variant-proportions [Accessed 22 Dec. 2021].

Medically reviewed by:

Kathy Shattler

Emma Garofalo is a writer based in Pittsburgh, PA. A lover of science, art, and all things culinary, few things excite her more than the opportunity to learn about something new." It is now in the sheet in the onboarding paperwork, apologies!!

Medically reviewed by:

Kathy Shattler

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