COVID subvariants: Vaccinated individuals ‘still at pretty high risk’ of infection, doctor says

Children’s Hospital of Philadelphia Dr. Paul Offit sits down with Yahoo Finance Live to talk about the U.S. government’s move to purchase additional booster shots ahead of the fall season, the prominence of new Omicron subvariants, and the efficacy of vaccines on these newer COVID-19 strains.

Video Transcript

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AKIKO FUJITA: Well, the US government is expected to buy 3.2 million doses of Novavax’s COVID-19 vaccine once the shot has been authorized by regulators. This comes as concerns grow over Omicron subvariants ahead of the fall season. Joining us now to discuss is Dr. Paul Offit, Director of the Vaccine Education Center at Children’s Hospital of Philadelphia. We’ve also got Yahoo Finance’s Anjalee Khemlani. Doctor, it’s good to talk to you. I will tell you, the timing here is impeccable. I’ve been telling Anjalee about my experience over the last 10 days or so with the Omicron subvariant. We have seen these numbers really escalate. What’s different about this?

PAUL OFFIT: Well, so the subvariants– BA.4, BA.5, and now there’s another one called BA.2.12.1– comprise probably roughly 100% of the circulating strains. So Omicron is gone. These are Omicron subvariants. And they are somewhat far away from Omicron so that even if you’ve been naturally infected or vaccinated or both, you’re still at pretty high risk of mild disease if you’ve been exposed to these viruses.

The good news is, you’re still protected against severe disease. So even though we see the cases go up, what we don’t see concomitantly is a dramatic increase in hospitalization and virtually not at all an increase in death. So people should be reassured that the vaccines currently still protect against severe disease caused by these Omicron subvariants.

ANJALEE KHEMLANI: Dr. Offit, to your last point there about that protection, I know that you’ve really talked about the need and questioning the need for boosters this fall, and maybe it’s not everyone but a subset that might need it. I want to talk about that in light of the Novavax news, as well as we got Moderna out today saying that they do have data against the BA.4, BA.5. But you brought up a point in the past week about how the process has been going with the need for boosters this fall and whether or not the US government is pushing ahead despite data that shows that we may not need it. So just share your thoughts on that, please.

PAUL OFFIT: Well, I think if you’re just talking about giving a boost with the current strain, the original recipe vaccine, I think there are certain groups who, prior to the winter months, probably would benefit from a dose. And so for example, people who are the elderly elderly, as Dr. Walensky would say, people who have the kind of co-morbidities that really put them at risk, like severe heart disease, severe lung disease, or people who are immune compromised.

I think what the government was talking about in addition was the so-called bivalent vaccine. So not just the ancestral strain, the original recipe strain, but also Omicron or one of the Omicron subvariants. I think what hasn’t happened yet is that I think neither of these companies, neither Moderna nor Pfizer, has clearly shown that giving that dual vaccine, that bivalent vaccine, is significantly better clinically than just giving a boost with the ancestral strain.

ANJALEE KHEMLANI: And to that point, do you think that the government is sort of moving ahead of the data? Because you said something along the lines of “the fix was in” when it comes to the announcement of Pfizer’s additional doses in time for the fall. Do you think that maybe we’re not paying attention to the science here?

PAUL OFFIT: I think the better phrase would have been “the train has already left the station” rather than “the fix was in.” But I think that everyone’s trying to do the right thing, FDA, administration, CDC, et cetera. But I do think that before you use a new product, and a bivalent vaccine would be a new product, you have to be humble there and clearly show evidence that this is beneficial, not just theoretically beneficial, but actually beneficial.

Which is to show, for example, that the immune neutralizing antibodies against BA.4, BA.5 is clearly dramatically better than just boosting with the ancestral strain, and more importantly, that it’s more likely to protect against even mild disease than the ancestral strain. And that hasn’t been done yet.

ANJALEE KHEMLANI: And what we’re looking at is basically what we see the world over when it comes to China as well, you know, debating lockdowns and stricter measures right now. And we see the rise of BA.4, BA.5 across UK and the US right now. But across the world, we’re still battling various strains and also the potential for new strains. So do you think that we should be chasing the strain right now, and/or are we adequately prepared for what might come in the fall?

PAUL OFFIT: Well, that’s a great question. I mean, if you give, let’s say, a BA.4, BA.5 vaccine now, where are you in January, February, March of next year? Is that still going to be a value? Or will those strains have been replaced by additional strains? Again, I want to say, though, that the current ancestral strain vaccine, the original recipe vaccine, does protect against serious illness. And we do consistently say that’s the goal of this vaccine, keep people out of the hospital, keep them out of the intensive care unit, keep them out of the morgue. And these vaccines, just as they were originally constructed, still do that.

AKIKO FUJITA: Doctor, what should we be anticipating come fall? I mean, it feels very eerily similar to what we experienced last summer, when we saw the spike in the summer and then we saw the Omicron spike back in the fall as well sort of overlapped with the flu season. Is that just kind of the norm that we should expect?

PAUL OFFIT: It’s a great question. I mean, I think at its heart, this is still a winter respiratory virus, although it clearly can spread during the year. If you look at the last two winters, that’s when you really saw the most dramatic rise in hospitalizations, ICU admissions, and deaths. I suspect that would also be true this winter. But this winter as compared to the previous two winters, we have a much higher level of population immunity. There’s– 85% to 90% of this country has been– people have been exposed to the vaccine or they’ve been exposed to the natural infection or both. So I would expect that the bump that we would see this winter would be much less actually than the previous two winters. But again, this virus continues to surprise, so we’ll see.

AKIKO FUJITA: OK. Well, Doctor, it’s always good to get your insight here. Dr. Paul Offit, Director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Our thanks to you as well as our thanks to Anjalee.