Re-infections doubled after Covid: How to decide if you need a booster

Everyone in the United States knows someone — often several — who has had COVID-19 again.

Despite vaccines, boosters, and natural immunity, the highly infectious omicron variant appears to be able to circumvent any protection you may have gained against SARS-CoV-2.

Even President Joe Biden – who is best known for his full vaccinations and boosters – announced on July 21 that he had contracted COVID-19 and had a runny nose, fatigue and an occasional dry cough.

The newest omicron sub variant — BA.5 — causes re-infection more often in former COVID patients, according to surveillance data from genetic sequencing company Helix.

The share of new reinfected COVID-19 cases has nearly doubled in recent months, rising from 3.6% during the BA.2 wave in May to 6.4% as BA.5 became the dominant strain in July, according to Helix data as reported by CNN.

And now BA.5 is the dominant strain in America, accounting for 80% of new infections, according to the US Centers for Disease Control and Prevention.

“BA.5 is actually the most immune-elusive SARS-CoV-2 variant that we’ve seen up to this point, and it’s pretty scary,” said John Bowen, a researcher in the University of Washington College’s Department of Biochemistry. Medicine in Seattle.

The COVID-19 virus mutates more often than initially thought, and its mutations have proven to be more contagious than previous strains, said Dr. William Schaffner, medical director of the Bethesda-based National Foundation for Infectious Diseases.

“We thought that once you get infected, you’re going to have fairly long-term protection — not complete, but fairly long-term,” Schaffner said. “Obviously this is not the case with omicron. Omicron has the potential to be extraordinarily contagious. In this context, it can infect people who have previously been vaccinated and have previously recovered from natural infection.”

Schaffner said that vaccinations, boosters and prior infections can help prevent more serious cases of COVID-19, but they don’t provide such strong protection against primary infection and mild illness.

“For a truly serious illness to occur, the virus has to leave the respiratory tract, travel through the bloodstream to other organ systems, and during that time travel through the bloodstream, when the antibodies we produce from the vaccine can reach the glomerulus and prevent the virus from localizing in all parts of the body. around the body.”

“But the virus that sticks to the back of the throat, nose, and bronchi, that’s a very easy thing,” Schaffner continued. “It turns out that preventing it is much more difficult than transmitting the virus through the bloodstream.”

Bowen led a study recently published online in the journal Science that came to a reassuring conclusion – all current vaccines offer very good protection against omicron variants.

“Despite how elusive this immune thing is, vaccines actually still do a very good job of neutralizing the virus, and we know that neutralization is associated with protection,” Bowen said of the BA.5 variant. “So we think people will be adequately protected.”

Another piece of mixed news comes from Helix, which has found that the average time between COVID-19 infections has increased in recent months.

Although infections are more common, a person had an average of 270 days between COVID infections in July, compared to 230 days between infections in April.

“This indicates that the vast majority of infections still occur in people who were originally infected prior to the Omicron wave,” Helix wrote in a report. “However, the re-infection rate (or the number of times people are re-infected) is rising faster than before, likely due to poor protection from previous vaccines and infections.”

Schaffner and Dr. Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau in Oceanside, New York, said people need to get used to the idea that COVID has become a disease you’re likely to catch from time to time, just like the flu.

“There is an excellent chance that this will become a chronic viral infection that you may or may not need an annual booster for, and we don’t know that yet,” Glatt said. “And it will continually mutate and will have variants that may or may not be of different severity, different transmissibility, and different potential pathogens.”

As with the flu, annual COVID vaccine boosters will help protect you from serious illness, but won’t be able to prevent mild infections, Schaffner and Glatt said.

Experts agreed that people at high risk of severe COVID-19 should ensure they have full support.

“You should get a current booster if you are someone at high risk of developing severe disease,” said Dr. Amish Adalja, a senior researcher at the Johns Hopkins Center for Health Security in Baltimore. “While the current booster vaccines don’t work well against infection protection, they are important to protect against severe disease. So, if you have risks of developing severe disease, you would benefit from a booster dose now.”

Glatt said you don’t necessarily need to run out and get it before the latest COVID vaccine launches this fall.

“If you don’t already have high risk factors and get one booster dose, you won’t fall into the higher-risk categories of people, whether by age, weight, or because of underlying medical problems, it’s sensible to wait, especially if you are,” Glatt said.

“People who were vaccinated and boosted with a booster and had COVID, I tell them, it looks like you have two boosters,” he continued. “COVID can be considered a booster. Certainly if you’ve had COVID recently, I’d say wait for a better booster that might come with you.”

Furthermore, researchers are working on nasal vaccines that may nip COVID in the bud, by preventing it from infecting the nasal tracts, Bowen noted.

“The idea is that if you can prevent the virus at its source, which is by evoking mucosal immunity, that would potentially be able to naturally stop serious diseases like current vaccines, as well as infection,” Bowen said. “So the virus probably won’t even be able to get into our bodies, but this is something that will require more time as well as funding and a company to support.”

Meanwhile, experts agreed that some communities may require cases to be concealed if COVID cases begin to overwhelm hospitals, but that such measures will often be unnecessary.

“It was always the case for this virus to keep mutating in order to reinfect us, just as other family members do,” Adalja said.

“I don’t think any restrictive measures make sense in an age where we have vaccines that protect us against severe disease, rapid tests to diagnose infections, life-saving antivirals, and monoclonal antibodies,” he added.

“There will always be a substantial number of hospitalizations and deaths, but what we won’t see is our hospitals going through a crisis the way they did before,” Adalja said.

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