I hear Bill Paxton’s voice in “Aliens”: Game over, man. Game over.
No, just kidding. This glum assessment from Moderna’s CEO was to be expected, as the freaky number of mutations on the new variant’s spike protein makes it likely that the antibodies created by the current vaccines will have trouble recognizing it. “Material drop” is a vague term, though. If the vaccines are 75 percent effective against Omicron instead of 90 percent effective, as they were against previous variants, that’s arguably a “material drop” — but still darned good.
Maybe Omicron will end up doing to boosted people what Delta did to people with two doses as their immunity waned over time. If you had two shots many months ago, you’re still upwards of 90 percent protected against severe illness from Delta but only 40-60 percent protected against infection. A third dose restores your immunity from infection to 90+ percent. Conceivably Omicron will knock that back down to 40-60 percent among the boosted, which would be bad but not terrible so long as protection from severe illness remains sky high. In fact, that’s what the head of BioNTech expects: “Based on current knowledge about the mechanisms behind the vaccine and the biology of variants, Dr. Sahin said he assumed that immunized people would have a high level of protection against severe disease even if infected by the Omicron variant.”
Of course, it would also mean that people who’ve had only two doses and are currently vulnerable to infection might see their vulnerability deepen against Omicron. That’s a lot of cases among vaccinated America potentially.
Anyway. We’re not back to square one but we’ll probably end up moving back a few squares as the data on the new variant comes in:
“There is no world, I think, where [the effectiveness] is the same level . . . we had with [the] Delta [variant],” [Moderna CEO Stephane] Bancel told the Financial Times in an interview at the company’s headquarters in Cambridge, Massachusetts.
He added: “I think it’s going to be a material drop. I just don’t know how much because we need to wait for the data. But all the scientists I’ve talked to . . . are like, ‘This is not going to be good’.”…
Most experts thought such a highly mutated variant would not emerge for another year or two, Bancel added.
Relative to antibody treatments, the vaccines are well positioned against Omicron. Because the vaccines are polyclonal, the antibodies they elicit are able to recognize different parts of the virus’s spike protein. Even if there’s a mutation in one part (or 30 parts, as with Omicron), the rest of the spike might look familiar enough that the antibodies will proceed to attack it. Antibody treatments are monoclonal, though, which means they zero in on one specific part of the spike protein. If that part has mutated and now looks different, the synthetic antibodies contained in the treatment might not recognize it. Bad news for Regeneron and Eli Lilly:
Preliminary tests indicate the Covid-19 antibody drug cocktail from Regeneron Pharmaceuticals Inc. loses effectiveness against Omicron, the company said Tuesday, a sign that some products in an important class of therapies might need modifying if the new strain becomes widespread.
Separate testing of another authorized Covid-19 antibody drug cocktail, from Eli Lilly & Co., indicates it also isn’t as effective against Omicron, outside scientists said.
Lotta bad news today. Is there any good news to balance it?
There is. Anecdotal evidence from South Africa suggests that the vaccines are working against Omicron:
There’s reason to be optimistic current boosted vaccines will provide meaningful protection against #Omicron – based on both evaluation of new sequence, prior experience with strains with some immune escape, as well as emerging clinical feedback from RSA. https://t.co/COoKevrBm5 pic.twitter.com/XYCT0CMLbP
— Scott Gottlieb, MD (@ScottGottliebMD) November 30, 2021
Since only 25 percent of South Africans are vaccinated, I’m guessing the share that are boosted must be close to zero. If people are dodging illness from Omicron after just two doses, maybe the vaccines will be more effective against it than Moderna thinks.
There’s good news with treatments too. Per the WSJ, Regeneron is already testing an alternative monoclonal antibody which it suspects will have better luck against the variant. And at least three competitors whose treatments haven’t been approved yet say preliminary testing shows their drugs stand up well to Omicron. That’s because, instead of targeting the spike protein, they target parts of the virus that are less likely to change: “Vir and Adagio officials said the companies designed their antibodies with the aim of targeting spots on the virus that are common across different coronaviruses that remained stable even after numerous mutations over many years.”
On top of all that, it seems likely that Pfizer’s and Merck’s wonder drugs will retain some effectiveness against the variant. They don’t target the spike protein either. Merck’s drug scrambles the genome of the virus to disrupt replication while Pfizer’s treatment inhibits the virus’s ability to exploit the part of the human cell it needs to replicate. All of that helps explain why scientists are rolling their eyes at laymen who are worried that Omicron has put us back at “square one.” None of this stuff was available or imminent during our actual square one in March 2020.
The politics of Omicron could get sticky for Biden, though. The White House recognizes by now that voters are anxious about inflation, the supply chain, and the economy’s recovery and that his vaccine mandate is complicating that. Just yesterday, to ease public concern about a deepening labor shortage, the White House said it won’t take action against anyone who misses the vaccine mandate deadline for federal workers until next year. One senses that Team Joe is looking for a way to ease off the mandate, knowing that strict enforcement will lead to more people dropping out of the work force. But the Omicron panic makes that harder for him. A new variant that’s likely to reduce the protection provided by two doses is a strong argument for not only keeping the mandate intact but increasing it to *three* doses. Some doctors see that coming: “If there is some level of immune evasion, but the vaccines continue to have some level of efficacy — which I think is likely — I think the ‘boosters as part of mandate discussion’ moves from a multi-month discussion to a multi-week discussion,” said one. How does Biden dial down the mandate while Omicron is dialing up the pressure to make even those who’ve had two doses go out and get a third?