NEWS

The omicron variant and vaccines

William Culbert
Guest column

Half of the adults in the United States that have not been vaccinated against COVID-19 say they will not take the jab under any circumstances. This is a big — and rather pathetic -- mistake. The omicron variant is about four times as transmissible as delta and some experts think there will be no herd immunity. In other words, you will either get the shot or you will get COVID-19.

Even though it appears that omicron does not cause more severe illness than delta, this is not certain. Omicron likely developed as a co-infection in someone with human immunodeficiency virus (HIV) and shares some of that virus' genome. If it further mutates to infect our T-lymphocytes that coordinate much of our specific immune response, we could have a serious problem. Vaccination is still the best way to prevent this.

William Culbert

Delta and omicron directly infect fat cells where they can remain a “reservoir” of active virus, slowly replicating and mutating. They also infect some immune cells associated with the fat tissue leading to a chronic inflammatory state that seems responsible for the “long COVID” symptoms experience by about one-third of infected adults.

Although a two-shot vaccination series only reduces the risk of getting COVID-19 from omicron by about one-third, the booster provides closer to 70% protection and is very effective at preventing hospitalization and death. As newer vaccines specific for omicron soon become available, we may also require additional boosters.

COVID-19 has not been the worse pandemic the world has ever seen, but it has been responsible for the untimely deaths of more than 16 million people. This is also a remarkable time in world history with miraculous tools from effective vaccines developed with remarkable speed and now antiviral pills that can dramatically decrease the risk of hospitalization and death, as well as life-saving antibody injections that will be delivered in doctors' offices.

But all pandemics come to an end. Then the bug will likely reach some sort of steady state where its ability to infect is matched by fewer available victims that are still susceptible. In other words, it becomes endemic.

This would show up as pockets of infection and seasonal outbreaks for decades resulting in the deaths of perhaps 50,000 to 100,000 Americans a year.

With time and with repeated vaccination or exposure to infection, our immune systems become better able to handle the virus in all its forms. For example, the antibodies we form from initial exposure mature over about six months becoming better antibodies. Our immune “memory cells” become more skilled at fighting infection when we are exposed to the virus or to a vaccine several times and in different ways, so mixing and matching vaccine types can be helpful. Repeated exposures to different coronaviruses over many years is why older people get fewer colds than the young.

As we slowly emerge from this pandemic and recover some sense of normalcy in our lives, we will continue to see COVID-19 outbreaks. But, if we are fortunate, the virus will become more like the seasonal flu than the more lethal killer it has been.

Physician William Culbert lives in Oak Ridge and has a practice in Clinton.