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Be aware: COVID is not done with us yet

People are sick of hearing about COVID. So are we! But the truth is, the virus is not sick of us, and it’s not going anywhere. There has been nearly a 30 percent increase in COVID hospitalizations among elderly adults in the past two weeks. You should be aware of new information.

More than 90 percent of adults have antibodies from a previous infection, vaccination, or from both. It is little wonder that the virus continues to change in order to evade our immune systems. These changes have left the current monoclonal antibody therapies ineffective against the current Omicron subvariants. The monoclonal therapies are no longer available as the FDA has rescinded their approval.

This is where vaccines can come to the rescue. Although antibodies are the first line of defense, there is another critical arm of the immune system. This second line of defense is made of T-cells that are produced following natural infection or vaccination. These T-cells protect against severe illness by killing the virus and virus-infected cells. Importantly, the T-cells respond to different sites on the covid virus than the antibodies do. The beauty of this is that the T-cells can still get rid of the virus when antibody levels have either fallen to low levels or when the changes in the virus make it so the antibodies no longer bind it.

New data shows that the Omicron booster provides additional protection. The protective effect is greatest in those who receive their Omicron booster dose more than eight months after their last vaccine compared to someone who had their previous shot three or four months prior. Additionally, like many vaccines, there is greater protection in younger adults than in older adults. For adults younger than 50, the infection risk was decreased by nearly half with the Omicron booster. For adults 65 and older, effectiveness at preventing infection ranged from 28 to 43 percent, depending on Omicron booster spacing. Remember, the goal of vaccination is to prevent severe disease. Protection against all infections is the icing on the cake, but sadly, it lasts only a few months following vaccination. There is every reason to believe that the Omicron boosters will provide extended protection against severe illness.

Federal funding covering pandemic vaccination, testing and treatments will stop in 2023. It is a good idea to get your Omicron booster while it is still covered if you have yet to receive it. People at high risk for severe COVID should have an action plan, including where to get tested and treated. Although monoclonal antibodies are no longer an option, oral Paxlovid and intravenous Remdesivir are effective treatment options. COVID-19 treatment should be started as quickly as possible and not be delayed to see if the person develops severe symptoms. Paxlovid should begin within five days of symptom onset and Remdesivir within seven.

Hopefully, this holiday season includes happy gatherings with loved ones. You are protecting others by protecting yourself, and an excellent place to start is with vaccination.

Megan Berman
Richard Rupp
Vaccine Smarts is written by Sealy Institute for Vaccine Sciences faculty members Drs. Megan Berman, an associate professor of internal medicine, and Richard Rupp, a professor of pediatrics at the University of Texas Medical Branch. For questions about vaccines, email vaccine.smarts@utmb.edu.
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