COVID-19 Update: Fourth Dose Value Questioned, CDC Promises Improved Messaging

COVID-19 Update

While wealthier countries have come a long way to boosting their populations with an extra shot of COVID-19 vaccines to protect against Omicron, studies are ongoing in Israel on whether a fourth dose of an mRNA vaccine offers additional protection. Although the data is still early, it suggests that it might not. 

Israel Study: Fourth Dose of Pfizer-BioNTech COVID-19 Vaccine Offers Questionable Protection

A study of people who received a fourth dose of the Pfizer-BioNTech COVID-19 vaccine in Israel suggests that although it increases the antibody levels, it might not be enough to prevent breakthrough infections from the Omicron variant. The data is very early and has not been published or peer-reviewed yet. Israel’s Sheba Medical Center initiated a study in December 2021 of healthy people on a fourth shot (or second booster) of the Pfizer-BioNTech vaccine as well as the Moderna mRNA vaccine. The study included 154 healthcare workers who received a fourth dose of the Pfizer-BioNTech vaccine, 120 who received a fourth dose of the Moderna vaccine, and a control group who did not receive a fourth dose. To date, there does not appear to be a significant difference in antibody levels between the two types of vaccines’ fourth doses.

Dr. Gili Regev-Yochay, director of the Infection Prevention and Control Unit at Sheba, said, “I think that the decision to allow the fourth vaccine to vulnerable populations is probably correct. It may give a little bit of benefit, but probably not enough to support the decision to give it to all of the population, I would say.”

A Word of Caution About Omicron Being the End of the Pandemic

There has been a lot of speculation by the public and some scientists that the fast-moving Omicron variant will burn through the population and lead to the end of the pandemic. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and President Biden’s chief medical advisor, cautioned that that might be premature.

“It is an open question whether it will be the live virus vaccination that everyone is hoping for,” Dr. Fauci said during a virtual panel at the Davos Agenda, World Economic Forum. “I would hope that that’s the case. But that would only be the case if we don’t get another variant that eludes the immune response of the prior variant.” And even if it did, COVID-19 will likely hang around and become an endemic disease.

CDC Director Promises to Improve Messaging

The U.S. Centers for Disease Control and Prevention (CDC) has been the target of some well-deserved criticism for poor and contradictory messaging. CDC Director Rochelle Walensky agreed and promised to work to improve the agency’s communications.

“I think what I have not conveyed is the uncertainty in a lot of these situations,” Walensky told the Wall Street Journal.

She also defended recent changes to isolation and quarantine guidance, which had triggered a new round of criticism. The recommendations shortened quarantine time from ten days to five if infected with COVID-19 or exposed but modulated the guidance if there were no more symptoms or if symptoms were improving. The recommendations also said a negative test would not be necessary to come out of quarantine.

Omicron Symptoms May Include Night Sweats

Although the key difference between other COVID-19 strains and the Omicron variant is its high infectiousness, it does seem to present a few other symptoms than previous strains. Some physicians’ patients are reporting night sweats, which the Mayo Clinic defines as “repeated episodes of extreme perspiration that may soak your nightclothes or bedding and related to an underlying medical condition or illness.”

Night sweats are also linked to sleep disorders, some cancers and the flu. Unlike most other versions of COVID-19, Omicron does not appear to be associated with loss of taste or smell, at least not as much. Typical COVID-19 symptoms include fever or chills, cough, shortness of breath or trouble breathing, fatigue, body aches, headache, sore throat, congestion or runny nose, diarrhea, nausea or vomiting, and loss of taste or smell.

Experts Predictions: Good News and Bad News

The same World Economic Forum at Davos that Dr. Fauci spoke at also had the input of numerous other experts. And the consensus seems to be, well, no consensus. Things could get worse. Or better. But we’re better equipped to deal with it.

Most think Omicron will not be the final variant. Others will emerge. Annelies Wilder-Smith, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine, said, “Omicron will not be the last variant. There’s a high probability we will have another variant coming up. The question is when and will it be less dangerous?”

Otherwise, there does seem to be a consensus that the world is better prepared to deal with the disease. Vaccine production—and distribution—is improving, with work being conducted on vaccines that would defend against multiple variants. In addition, there are currently three antiviral drugs authorized or approved to treat and prevent the disease, with more in the pipeline that shows promise.

There are, however, still issues of vaccine inequity. Although boosters, even a fourth shot in some cases, are being given to wealthier countries, other countries are still struggling to get the first shot into arms. Manufacturing enough doses doesn’t seem to be as much of an issue as distribution in countries that lack the necessary infrastructure for comprehensive vaccination programs.

Richard Hatchett, head of the Coalition for Epidemic Preparedness Innovations, noted that the World Health Organization’s COVAX program has delivered 1 billion doses to primarily low-income countries, which he called “an important milestone.”

Although there have been demands that biopharma companies release the intellectual property for the vaccines so poorer countries can produce the vaccines themselves, Hatchett thinks that’s a “last option.” Instead, he focused on what he called “the last mile,” making sure the vaccines get into arms.

Back to news