Biden administration focuses on booster injections as best strategy against novel variant of coronavirus

The Biden administration is focusing on booster injections as a key weapon in efforts to protect the nation from a potentially dangerous coronavirus variant, although the extent of the threat remains uncertain, according to three senior administration officials familiar with with the plans.

A group of senior health officials had a call with South African scientists on Sunday to understand the latest news on the new variant and to help inform next steps, according to two of the senior administration officials, who as the third official, spoke on condition of anonymity to describe the internal discussions.

In an update on Sunday, the World Health Organization said it was still too early to know whether the new variant, dubbed omicron, is more transmissible than the delta variant. Little understanding remains about the severity of disease caused by the variant and the rate of hospitalization. Scientists in South Africa, where the variant was first identified, said they expected more breakthrough cases in people vaccinated against the coronavirus.

[More omicron cases pop up as world scrambles to learn more about COVID-19 variant]

In about a week, researchers might have a better indication of how vaccines protect against the new variant. But the Biden administration is already set to urge as many Americans as possible to receive booster shots in the coming days as the best way to protect against omicron.

This campaign is likely to involve posts urging people to get boosters and effort to ensure that hits are available in as many places as possible.

“Vaccinated people, what we are sure of is that when you boost someone who has been vaccinated with two doses of Pfizer or Moderna, you increase the level of neutralizing antibodies extraordinarily high – much more than even the peak following the first two doses, ”said Anthony Fauci, chief medical adviser to President Joe Biden, in an interview with the Washington Post.

Fauci said that “it is entirely conceivable if not likely” that the booster injections will at least provide partial protection against the new variant.

Omicron has a high number of mutations that could make it more easily transmitted, although this remains unclear. In South Africa, cases are increasing, but it is not yet clear whether this increase is fueled by omicron or other factors, according to the WHO.

Experts, including Fauci, said it was highly unlikely the vaccines would offer any protection against the new variant. The WHO said it was working with “a large number of researchers around the world” to understand the impact omicron would have on existing vaccines and antivirals. Even though there is less protection compared to other variants, there is an advantage in increasing the number of virus neutralizing antibodies upon being boosted, senior health officials and experts have said.

“If you’re worried about omicron, do the same as if you’re worried about delta. Get your boost and get yourself fully immunized, ”said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

The Centers for Disease Control and Prevention has increased communication with state public health officials in recent days, as federal disease trackers learn more from their South African counterparts, according to a U.S. health official and social services. This included daily calls with state-level officials, including epidemiologists, laboratory directors, and city and county authorities.

The White House is also holding meetings with state health officials, members of Congress and governors over the next few days, a White House official said.

While experts have said that the boosters could be useful in protecting against the omicron variant, some have warned against using the supplemental injections at the expense of delivering doses to countries where vaccination rates remain low.

Celine Gounder, epidemiologist and infectious disease specialist who advised the Biden administration’s transition team on the covid-19 response, said boosters should be part of the response to the omicron variant if it is “really. immune “because additional injections dramatically increase antibody levels.

But Gounder said the downside of a booster-intensive approach is that it could mean much of the developing world remains unvaccinated, creating conditions for the emergence of other variants.

“You have an approach that has a likely short-term advantage over another approach that has a very likely long-term advantage, and how do you rate one over the other?” Said Gounder.

But Fauci and others said millions of vaccine doses shipped to low-income countries were not being used, demonstrating the complexity of the global challenge. South African officials recently asked vaccine makers to slow shipments so the country can maximize its existing stock.

U.S. officials asked South African officials over the weekend if they needed more doses, but were told it was the use of the vaccine, not the supply, that was the most important. problem, said a senior administration official.

There has been more backlash on the international front for the United States and European countries after nations closed their borders to travelers from southern Africa as a shield against the omicron. They have also been warned by experts that travel bans may be too late, with confirmed and suspected cases appearing as far away as Asia and Australia.

“By the time we have enough information to impose a travel ban, the cat is already out of the bag, so to speak,” said Nicole Errett, a professor at the University of Washington who has researched the preparation. to public health emergencies, in an email. “Omicron has already been detected on other continents. A travel ban could in theory save time by reducing the spread of new cases of seeds, but we’re talking on the order of a few days to a few weeks. “

Confirmed and suspected cases of covid-19 caused by the new variant have been detected in a growing number of regions, including Britain, Belgium, Botswana, Germany, Italy, Hong Kong, Israel and Czech Republic. Most of the cases outside of Africa appear to involve people who had traveled to the continent.

Austria has also joined the growing list of countries where the variant has been reported, detecting its first suspected case in the Tyrol region, Reuters reported on Sunday, citing Austrian officials.

[What to know about the omicron variant of the coronavirus]

Two planes carrying around 600 passengers from South Africa landed in the Netherlands on Saturday with 61 people infected with the coronavirus – including 13 cases of the new omicron variant – Dutch health authorities announced on Sunday.

Health officials in Australia confirmed on Sunday that two asymptomatic and fully vaccinated passengers on a flight to Sydney had tested positive for the new variant and were in government isolation.

“This clearly shows that the pandemic is not over,” Dominic Perrottet, Prime Minister of New South Wales, seat of Sydney, told reporters on Sunday. “There are limits to what the state and the federal government can do: these variants will enter the country. It’s inevitable.”

The emergence of a potentially more menacing new variant raises questions about the lessons officials have learned in the two years since the novel coronavirus emerged, and whether they are prepared for any disturbing mutations that may elude them. vaccines.

UK Health Secretary Sajid Javid said on Sunday that vaccines may be less effective against omicron, acknowledging that “we just don’t know enough” about the new variant to understand the risk.

From Tuesday, face masks will be mandatory in shops and on public transport in England. The UK will also require all international travelers to take a PCR test, which can detect the new variant, and self-quarantine until the results are returned.

Europe is grappling with an increasingly deadly outbreak of the rapidly spreading delta variant that has prompted officials in some countries to revert to measures such as the closures used to control the virus at the start of the pandemic.

White House officials said the world’s failure to contain the rapid spread of the delta this spring demonstrates the need to be vigilant to avoid the omicron, which public health experts fear could make people sick. people vaccinated and spread faster than the delta.

Designating omicron a “variant of concern,” the WHO said on Friday that preliminary evidence suggests an increased risk of re-infection with this variant for people who have previously had the virus, compared to other variants. However, there are high rates of people living with HIV and AIDS in southern Africa, which experts say makes it more difficult to interpret the effectiveness of vaccine-induced or natural immunity against it. infection.

According to data from Johns Hopkins University, only about 24% of South Africans are fully vaccinated, compared to almost 60% of Americans.

[South Africa health official: Variants ‘haunt’ world with vaccine imbalance between rich and poor nations]

U.S. officials said they took action after learning the new variant contained much feared mutations and appeared to descend from a different genetic line than delta. Senior officials such as Fauci, Centers for Disease Control and Prevention director Rochelle Walensky and others have started talks with government scientists, South African officials and vaccine makers that escalated on Thanksgiving Day. .

The world’s leading coronavirus vaccine makers, including Pfizer and BioNTech, Johnson & Johnson, Moderna and Chinese vaccine maker Sinovac, said they were working to investigate the new variant and tailor their injections if necessary.

Experts have warned that the wave of activity to fight omicron could prove largely unnecessary, as researchers will learn in the coming days whether current vaccines can ward off the variant or successfully limit symptoms.

“Not all variants of covid-19 cause problems. For example, lambda and mu have not taken off globally. So it’s possible that the new variant, omicron, could fizzle out, ”said Sanjaya Senanayake, an infectious disease expert at Australian National University.

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Joel Achenbach, Dan Diamond, Chico Harlan, Jennifer Hassan, María Luisa Paúl and Lesley Wroughton of the Washington Post contributed to this report.

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