Corona vaccination: Expert advises vaccination with an adapted vaccine

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Austrian virologist Florian Krammer relies on the new Omicron-adapted vaccines and the Wuhan variant for the fourth vaccination against the SARS-CoV-2 pathogen.

While these bivalent vaccines from Biontech and Moderna are now approved, “we don’t know when they will be available in Austria,” explained the Icahn School of Medicine expert at Mount Sinai in New York. “I would wait for that,” Krammer told APA.

Boost with adjusted vaccine
“If it were a little clearer when the adapted vaccine would be available in Austria, it would be a good idea to get a booster with it,” the scientist said. Despite the National Immunization Panel’s (NIG) recent recommendation for the fourth prick for everyone twelve and older, the expert says it “makes little sense to get the old vaccine now when the new one might be here in two weeks.” Unfortunately, he said, there is currently little communication on the timing of availability and the number of doses available.

“But that would be important,” because case numbers currently fall in Austria could rise again during the fall. The current situation would thus be a good one to mitigate future waves, partly because the recommended window after the third vaccination is just about to expire for some. However, he said, many people are now uncertain about how to proceed in the vaccination schedule and which vaccine they should and can take. The problem, he said, is that demand probably won’t pick up until case numbers are high: “It’s just almost too late then.”

Protective effect
The fact that the new vaccines are adapted to the omicron sub-variant BA.1 and not to BA.5, which is currently in circulation, naturally makes a difference in the protective effect. Says Krammer, “Still, it would be better to get this vaccine than the old vaccine again.” Suppose someone is worried about their protection and now reaches for the conventional vaccine. In that case, they will have to wait long before a new vaccination with the adapted vaccine makes sense.

According to comprehensive studies, protection against symptomatic infections increases for a few weeks after the fourth vaccination with the conventional vaccine, but it drops off again quickly. However, he said, especially in older people, the protective effect against severe infections also increases significantly in the longer term. “But what would be important now is long-lasting protection against symptomatic infections with Omicron and its circulating subvariants. That’s where the matched vaccine probably works better,” Krammer said.

Protection after infection
Studies from Portugal also show that breakthrough infections with BA.1 or BA.2 “bring about 75 percent protection against BA.5,” Krammer explained. Even if a BA.5 infection has been passed in the summer, protection is likely to be relatively high for a few months; he added: “But that doesn’t mean reinfection doesn’t occur in individuals.” He said that the optimal strategy for dealing with vaccination and co had become a complex matter in the meantime, in which one’s infection and vaccination history play a significant role.

Krammer disagrees with the argument that one should orient oneself more or less only on the vaccinations received: “I would count every breakthrough infection as a booster.” However, one should not forget that every infection carries a particular risk – even on “long covid.”

Recent BA.4/BA.5 waves have been characterized by many cases and hospitalizations in many countries but relatively few covid-19 deaths. “That already indicates a lot of basic immunity here, and people are getting relatively good protection. We’re already at the transition to a non-pandemic period in some ways. The question is where that settles now and how severe the waves will be in the winter,” Krammer said.

It should not be forgotten that a significant comeback of influenza has failed to materialize recently. This year could be different, as evidenced by Australia’s relatively severe flu season with the H3 variant in its winter. This could strain the healthcare system in the northern hemisphere in winter and spring.

The fact that the first nasally administered vaccines are now being licensed in Asia is interesting, he said. A team led by Peter Palese, an Austrian researcher at the Icahn School of Medicine, is also developing and testing such a vaccine with numerous international partners. “We are pushing this forward, and I think it makes sense” because nasal vaccines promise good protection against infection in the upper respiratory tract. However, Krammer does not believe that the new vaccines now approved in China or India will also reach the market in Europe.

How things might develop about new variants is, of course, an open question. Among the current Omicron subtypes, BA.5 still dominates, but one has to keep an eye on BA.2.75. The pandemic so far, however, has shown that new variants can always “suddenly emerge and take over the infection process.