As the Omicron variant of the coronavirus continues to spread throughout the world, one major question is how well the COVID-19 vaccines will hold up against it?
Currently, we dont have an answer to this. But over the next few weeks, scientists should start releasing data from lab experiments and real-world studies.
These results will give us a better picture of whether Omicron can circumvent vaccine protection and if we will need to update our vaccines to fight this variant.
However, the data wont all be released all at once and much of the initial data will be from preprint studies or company press releases so expect the picture about Omicron to come into focus slowly.
With Omicron, there are already signs that people whove already had a coronavirus infection may more easily develop reinfection.
South African researchers reported on Wednesday that real-world data from the country suggests the variant has a substantial ability to evade immunity from prior infection.
This kind of immune escape was not seen with the Beta and Delta variants during the countrys earlier surges.
However, South African researchers did not have information on the vaccination status of people with the Omicron variant, which limits what they can tell about the effectiveness of the vaccines.
We therefore cannot make any assessment of whether Omicron also evades vaccine-derived immunity, study author Juliet Pulliam, PhD, who directs the South African Centre for Excellence in Epidemiological Modelling and Analysis at Stellenbosch University, said on Twitter.
The results were published on the preprint server medRxiv, so the study has not yet been peer reviewed.
This is just one study, so it may not offer a complete picture of Omicrons behavior.
Scientists will also look at the spread of the variant in other countries, which have different vaccination rates and public health measures in place.
In addition, they will try to control for other factors that can increase a persons chance of acquiring or developing severe illness, such as employment, other medical conditions, and living situation.
And they will look at which vaccines people received, whether they were fully vaccinated, if they received a booster, and how long it was since their last dose.
These studies will take time.
It will take even longer to see if there is an increase in hospitalizations and deaths due to Omicron, as these lag behind cases by several weeks.
While both vaccination and infection can lead to immunity against the coronavirus, infection carries a risk of severe illness.
In the United States, people who are unvaccinated are 14 times more likely to die of COVID-19, compared with people who are fully vaccinated, according to data from the Centers for Disease Control and Prevention (CDC).
Some research also shows that the immune response from coronavirus infection varies greatly among people.
And, like the antibody protection offered by vaccines, infection-acquired immunity wanes over time.
In addition to real-world studies, scientists will test how well antibodies in the blood of people whove been vaccinated can fend off Omicron.
These tests are done in a laboratory. In particular, scientists look at the neutralizing activity of the antibodies against the variant.
Neutralizing antibodies can tightly bind to the virus and effectively neutralize it, such as by preventing it from infecting cells.
If the neutralizing activity drops too low in the face of Omicron, this could indicate that the vaccines are less effective against this variant.
The vaccines approved in the United States target the spike protein of the coronavirus. Omicron has dozens of mutations, with as many as 32 in its spike protein.
We already know about some of these mutations because they have been identified in previous variants.
We have some clues that we may have some reduced efficacy of vaccines [against Omicron]. But we dont have that information yet, Maria Van Kerkhove, PhD, World Health Organization technical lead on COVID-19, said Friday in a public briefing.
It will take a week or two or three to get that [information]. We need scientists to have a little bit more time before we have that answer.
One challenge with testing the level of neutralizing antibodies is figuring out what it means for the real world. Theres not a clear point at which the antibody level drops from good to bad.
Of course, a bigger drop in neutralizing antibodies is worse.
But how far does the level have to fall for a persons risk of infection to increase by a certain amount? Or for their risk of severe illness to become worrisome?
Scientists are working to figure out the answers to these questions, not just for Omicron, but also for Delta.
Even if there is a drop in neutralizing activity against Omicron, the immune system has other ways to protect against the coronavirus.
After vaccination, people also generate other types of antibodies, as well as B cells and T cells. These other layers can kick in even with a drop in neutralizing antibodies.
Scientists will measure the level of T cells and antibody-generating B cells in people who have been vaccinated, looking for ones that target Omicron effectively. These studies, though, are more complicated and can take longer to carry out.
Many experts believe that people who are fully vaccinated will still be well-protected against severe illness caused by Omicron, even if theyre more likely to develop an infection or reinfection than with earlier variants.
A lot of those mutations [found in Omicron] are associated with immune escape. But I think its still very possible that the vaccines will hold up against severe disease, even with those mutations, Dr. Carlos del Rio, a professor of medicine at Emory University School of Medicine, said Thursday in a media briefing of the Infectious Diseases Society of America (IDSA).
At this point in time, we need to follow the science and well get more information in the next couple of weeks.
Its also too early to know yet if we will need an Omicron-specific vaccine or booster.
Vaccine makers reportedly say they can develop a new vaccine within months, but they may wait to see how much of a problem Omicron becomes before rolling them out.
The Beta variant showed signs that it could overcome some of the protection offered by vaccines, but the variant didnt spread much beyond South Africa, where it was first detected.
Also, Delta is still the predominant variant in the United States and many other parts of the world, and is driving an increase in cases and hospitalizations in some areas.
Probably the most important thing for people to do is to make sure that they get their COVID vaccine, because we know thats protective against Delta, said Dr. Ashley Lipps, an infectious disease expert at The Ohio State University Wexner Medical Center.
Research also suggests that boosters of the current vaccine should help people better fend off Omicron, even if theres a drop in the level of neutralizing antibodies.
Theres every reason to believe, as we talk about boosters, when you get a level [of antibodies] high enough, that you are going to get at least some degree of cross-protection [against Omicron], particularly against severe disease, Dr. Anthony Fauci, the countrys top infectious disease official, said at a briefing this week.
Experts also emphasize that we already have other tools that have worked against all the previous versions of the coronavirus: face masks, better ventilation indoors, physical distancing, testing, and contact tracing.
Weve heard these things so many times, but they really do work, Dr. Julie Vaishampayan, public health officer for Stanislaus County, California, said at the IDSA briefing.
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