Omicron threat: Covid vaccine will not save you, still go for it

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Most Covid vaccines offer no protection against infection from Omicron except for two mRNA shots from Pfizer and Moderna, but they can protect from serious illness.

The Omicron report card is almost ready – at least from a lab perspective — and the results are a bit depressing. But there are some good things to cheer one as well. Most vaccines offer no protection from being infected by Omicron. Don’t jump to conclusions yet. I said infection. The bright side is that existing vaccines still save us from serious illness, even with Omicron. How is that possible?

Most Covid  vaccines offer no protection against infection from Omicron – except for two mRNA shots from Pfizer and Moderna that need a booster shot. The no-protection vaccines are AstraZeneca, Johnson & Johnson and vaccines manufactured in China (Sinopharm & Sinovac) and Russia (Sputnik, Sputnik Lite).

We are talking about a world where more than 99.6% of Covid-19 infections are not caused by the Omicron variant. Even now, the Delta variant is the most dangerous coronavirus. But this scene may change by the time we celebrate the new year.

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Covid vaccination in India

For India, the scenario is quite depressing. None of the Covid vaccines that are part of our vaccination drive offer protection against Omicron infection. This excludes Covaxin, which has no data collected by a credible and neutral agency to prove or disprove protection. As of now, we don’t know Covaxin’s effectiveness against Omicron. But given its dismal performance against Delta, the worry is that it too will join the list of failed candidates.

The Omicron variant was first reported in South Africa on November 25, 2021. The number of infections has shot up in recent weeks across the world. This variant underwent a large number of mutations, and there is an increased risk of reinfection compared with other variants.

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In India, 166 Omicron cases have been reported from 11 states and union territories. Maharashtra has reported the maximum number of cases (54). Delhi (24), Telangana (20), Karnataka (19), Rajasthan (17), Kerala (15), Gujarat (11), Andhra Pradesh (1), Chandigarh (1), Tamil Nadu (1) and West Bengal (1) have also reported cases.

The biggest problem with the great Omicron vaccine escape is that half of the world’s vaccine shots are from China. They are useless in terms of preventing Omicron infection and their performance against delta was dismal as well. Almost 90% of Indians were vaccinated with Covishield. The story is the same with the British avatar as well. So, most of the world can expect an Omicron bite – except a part of the US where booster shots with Pfizer and Moderna are available right now.

The Covax Initiative has distributed close to 70 million Oxford vaccine shots to sub-Saharan Africa. There too, the stage is the same. So, there will a large number of Omicron infections, and most of the world is without any protection.

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How big a threat is Omicron?

Will the Omicron variant flood the world and kill in large numbers? The answer is a big no. There are two reasons: one, Omicron is a lot less lethal than Delta. So, we are not dealing with a dangerous strain in that sense. The antibodies that are produced by a natural infection or two shots of most vaccines fail to protect us from Omicron infection. That is the problem we face here. However, the human body is a lot smarter than the bug, and that’s probably a survival instinct.

Even when the Omicron virus slips through our antibody walls, something out there identifies the miscreant and blows the whistle. Those are T cells, another set of guards who were underrated in all the initial vaccine studies. They too were slogging it out but we were all brouhaha about the antibody levels. And this is the anti-climax of the Omicron story. The real heroes are T cells, that are primed either by a natural infection or by a vaccine shot.

Preliminary lab work suggests that T cells from vaccinated or previously infected individuals are able to identify the Omicron variant and mount an appropriate response. This becomes highly relevant because antibodies are helpless here. By all logic, this may be the prime reason why all vaccinated and previously infected people have milder illness when infected with Omicron. We get infected, but we don’t need to make that vacation to the hospital. That is the silver lining in the dark sky covered by Omicron clouds.

The world will surely be disrupted with another wave fuelled by the Omicron variant, but it will just be a nuisance with a significant economic burden for a world that already has a big hole in its small purse. The reinfection rates are many times higher with Omicron and we cannot escape another wave. The cases are multiplying at breakneck speed, almost to the point of doubling every 72 hours. It’s raining Omicron and we can’t raise a finger to stop one drop. That’s the reality.

Just relax and keep vaccinating all those remaining. Even today, 99% of infections are not Omicron. So, vaccination is the thing to do. Vaccines reduce the severity of Omicron infection as well. Cover all the no-shot guys ASAP. This is one umbrella that might be old, but will still save us from a trip to the hospital.

The global vaccine divide is huge. Only 13% of the African population has received one shot of a vaccine. That means 87% of the continent is an open playground for Omicron. That’s the tragedy rich countries have forced upon their poor counterparts. Africa deserves a lot more, and the WHO does nothing to make life for Africans any better. Africa may have to pay a huge price for the vaccine deficit.

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Dr Manu Raj is a paediatrician, clinical researcher and research methodologist based in Kochi.

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