Remuzzi: Crucial booster because it acts not as a simple addition but as an enhancement, both at the antibody level and at the level of B and T cells
The Omicron variant seems to give milder and short-lived symptoms than Delta: the hope that after two years of pandemic we can really see the light at the end of the tunnel because the virus is adapting to humans. But this tragedy has taught us that there are many variables involved. Let’s try to line them up with Giuseppe Remuzzi, director of the Mario Negri Institute of Pharmacological Research and renowned professor of Nephrology at the University of Milan.
Omicron less dangerous than the other variants?
There are important works, still under review, which push towards this hypothesis. A Hong Kong University study shows that although Omicron multiplies much faster in the bronchi than Delta does, this does not happen in the lungs which are usually spared. Scientists carried out tests on cell cultures of the human respiratory system. a first scientific confirmation of what has been observed in South Africa, where the variant was identified for the first time and began to spread. The symptoms described appear mild: sore throat, nasal congestion, dry cough and muscle aches. Less frequent loss of taste and smell. Two other preliminary studies, conducted in Scotland and England, show that the new variant is associated with a lower hospitalization of patients (- 40-60%). Then there is another fact: the incubation time. In the case of Delta it was 4-6 days, with Omicron it was reduced to 3. In any case we cannot escape a reflection: a small percentage of serious patients out of a huge number of significant infected. If, let’s say, the Omicron positives with symptoms were a million and of these 1% ended up in hospital, we would be talking about 10 thousand people. If 10% were to request hospitalization, the figure would increase to 100 thousand. Studies on Omicron lead us to be moderately optimistic on several aspects, but we still need great attention from everyone in order not to take risks.
Does the third dose of the vaccine protect us?
According to early studies, two doses of mRna vaccine protect against severe disease, but not symptomatic infection. With the third dose the level of neutralizing antibodies increases significantly (with Pfizer by 25 times). A vaccine with three doses can become infected, but usually has mild forms: we cannot completely exclude the risk of an aggravation. The booster has a specific role: it intervenes on the immune system, already prepared from the first two doses, not as a simple addition but as an enhancement, both at the antibody level and at the level of B and T cells. The response to the third dose is qualitatively different from that of the first two. Right now the essential booster for all age groups, from 5 years upwards. Vaccinating children crucial: as the Washington Post, pediatric wards in the United States are filling up with Covid patients, especially in New York, and 50% are children under 5 who cannot be immunized. Older children must also be vaccinated to protect little brothers and sisters.
Can the healed be reinfected?
Also on this, information at the population level comes to us from the countries where Omicron is most widespread. Getting infected with one of the previous variants does not seem to protect against Omicron, except in a very small form. This is the current orientation of the scientific community, but further data is needed. A study conducted in South Africa (a country to which we must be grateful for the information it is providing to humanity) shows that, despite Omicron’s numerous mutations and reduced susceptibility to antibodies, the T-cell response induced by vaccination or natural infection recognizes the variant. This can help protect against severe forms of the disease.
What do you need to do now?
The third dose for everyone as soon as possible, vaccinate children aged 5 and over and convince the millions of unvaccinated. It would be nice to imagine a European vaccination obligation, a step in which Italy could play a leadership role. The obligation must, however, be associated with support for the states that are lagging behind in coverage. It is also essential to help developing countries, such as Africa, where only 9% of the population is vaccinated. The real investment in the future is to make the virus harmless.
December 30, 2021 (change December 30, 2021 | 13:49)
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