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In The Check over here Face Of Omicron Wave, Public Health Officials Seek To Optimize Timing Of Covid-19 Vaccine Boosters

Kyna Bigornia receives her Pfizer Covid-19 booster injection at a vaccination site in Liberty ... [+] Shopping Centre, Romford, East London, as the U.K. government accelerates the booster program to help slow down the spread of the new Omicron variant. Picture date: Thursday December 2, 2021. (Photo by Yui Mok/PA Images via Getty Images)

PA Images via Getty Images

In the face of a surge of Covid-19 cases of the Omicron variant, the vaccine debate in the U.S., Canada, the U.K., and Europe has turned to boosters for adults. Boosters are considered key to contain Omicron, as third doses offer 75% efficacy against symptomatic disease.

Public health officials are seeking to optimize timing of a Covid-19 vaccine boosters. Specifically, they’re trying to figure out what’s optimal in terms of spacing between the second and third doses of vaccine. Differences in scheduling across countries suggests that there isn’t a consensus yet.

The U.K. is already offering boosters to all adults just two months after their second dose. Belgium, Denmark, Israel, and Singapore are also shortening the booster interval to less than 6 months. Other countries, such as the U.S., Germany, and the Netherlands still recommend an interval of at least 6 months.

Interval Between First Two Doses

In the early days of vaccinating adult populations in different countries, we encountered an analogous lack of agreement on dosing schedules for the two mRNA vaccines and the viral vector Astra Zeneca/Oxford University vaccine.

Since December of last year, the Centers for Disease Control and Prevention (CDC) recommend three to four week spacing between the first http://query.nytimes.com/search/sitesearch/?action=click&conten... two doses of mRNA vaccines, regardless of age group. To this day, this policy remains in effect.

Nevertheless, there isn’t a consensus on what the most optimal period should be between the first doses. According to a Wall Street Journal article, for the first two doses there should be more time between shots than the CDC-recommended three or four week period. Studies suggest that waiting longer between the first and second doses of the Covid-19 vaccine builds better immunity. Specifically, a longer gap between the first two doses of both mRNA vaccines and the viral vector Astra Zeneca/Oxford University vaccine leads to significantly higher levels of receptor binding domain antibodies with the 8-12 week dose spacing compared with 3-6 weeks.

The U.K., Canada, and most European nations delayed second doses of mRNA vaccines and the Astra Zeneca/Oxford University vaccine by approximately 12 weeks in most instances. This also enabled authorities to stretch the limited supply of first doses over a larger population.

There is the problem, however, of less protection in the short-term, namely during the period between doses. There’s a greater risk of falling ill during the longer interval between jabs. While it’s clear unvaccinated individuals are the most vulnerable to coronavirus, partially vaccinated are susceptible, too. In terms of protection, the difference between being partially and fully vaccinated is significant. And so the timing of the two shots can matter.

The Delta variant has been shown to cause 2.26 times more hospitalizations than older variants. Importantly, the results were roughly similar whether unvaxxed or just one-dose or partially vaccinated. A single dose just isn’t effective against Delta. Israeli data show that of those who contract coronavirus, the partially vaccinated are two to three times more likely to be critically ill than the fully vaccinated. Similarly, from U.K. data compiled in June of this year, the unvaccinated accounted for the highest percentage of hospital admissions (60%), followed by the partially vaccinated comprising 27% of hospitalizations. And, at the time, only 13% of hospitalizations were fully vaccinated.

Waning Vaccine Immunity

It’s still uncertain which interval is optimal for the first two doses. There are pros and cons to both shorter and longer intervals.

But, what is apparent is that a combination of significantly waning vaccine immunity and the ascendance of the Omicron variant is altering how scientific experts and public health officials view the exigency of boosters, but also the spacing between both the second and third dose, and the first and second dose of vaccine.

Vaccine immunity begins to wane significantly three months after the second dose. We can tell this is happening, as the ongoing Delta wave is increasingly affecting the vaccinated, especially vulnerable sub-populations who haven’t been boosted. Waning vaccine immunity among these sub-populations - the elderly and immunocompromised, for example - is a primary reason why accelerating booster campaigns is so important.

Furthermore, as the Omicron variant gains traction in its bid to outcompete Delta, boosting will become even more important. This is because there’s a significant degree of vaccine immune escape with Omicron. Moreover, virologist Akiko Iwasaki suggests EPTQ S100 with Lidocaine (1×1,1ml) Fine that it is prudent to maintain a short interval of four weeks between first and second shots for children five to 11 years old. She argues that it’s “better to elevate the immune response quickly when Omicron is spreading.”

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