Omikron: Moderna, Biontech and Novavax - this is known about their effect with double vaccination and booster

Created: 12/21/2021, 3:45 PM

From: Martina Lippl, Tom Offinger

In view of an impending omicron wave, the corona vaccines play an important role.

But how do Moderna, Biontech and Co. fight against the mutant?

Munich - London imposed a disaster, the Netherlands is going into a lockdown until mid-January - the Omikron variant is working its way from one country to the next bit by bit.

Experts like virologist Dr.

Christian Drosten are certain that the situation will worsen in Germany as well.

“Omikron is an ideal post-pandemic virus.

[Germany,

] is not yet ready for the endemic situation because of the vaccine picking, ”Drosten emphasized the precarious situation surrounding the hot German vaccination campaign.

Virologist Christian Drosten: Vaccination is the order of the day

"Boosters calms the incidence in winter, but with the current vaccination gap we do not get into the endemic situation," says Drosten.

Boosters and vaccinations are the order of the day.

But which of the available vaccines is the most effective protection against the highly contagious Omicron variant?

First preliminary studies provide information and at the same time force pharmaceutical companies to adapt their vaccines.

Omikron: what does the booster do?

With the booster vaccination, antibody levels can be raised again to protect against infection.

However, according to previous knowledge, the booster is not quite perfect.

It all sounds pretty confusing.

But the immune system is complex.

Antibodies and T cells - this is how our immune system fights against the coronavirus

To put it simply, the immune response to a vaccination is based on two pillars: the antibodies and the so-called T cells.

According to experts, the T-cell response is probably not significantly reduced, even with the omicron mutation.

Because the mutations are not in the places where T cells recognize the virus, explains Prof. Dr.

Christoph Neumann-Haefelin, head of the translational virus immunology working group at the Clinic for Internal Medicine II, Freiburg University Medical Center in a video call on the topic of Omikron.

This is how the booster works against Omikron

Even if the antibody level drops, there is protection against severe courses.

A booster simply provides even more protection against Omikron, as the expert Neumann-Haefelin emphasizes:

“You can perhaps compare it to a certain extent with such a medieval city. The best protection against the intruder is to have a city wall as high as possible. That would be a good antibody response, as it is now being produced again by the boosting. But if individual intruders do penetrate into the city, then the T cells there, acting as soldiers, can also fight the intruder, the virus, and thus protect against a serious infection and illness. "

A booster has great potential against the Omikron variant.

Health Minister Karl Lauterbach writes on Twitter on the subject: “Even the booster vaccination does not protect perfectly.

So far the most likely value is: 70-80 percent protection from symptomatic infection.

But without a booster, the protection is too weak.

We must therefore run an offensive booster campaign and tighten the measures to reduce contact. "

Study data: Moderna booster probably the most effective

Biontech / Pfizer and Moderna have presented the first data from laboratory tests on the effectiveness of corona boosters with their vaccines.

According to both pharmaceutical companies, a third dose after a primary vaccination course increases the antibody level considerably.

A booster vaccination - a third dose - with Moderna apparently significantly increases the immune defense in the body against the Omikron variant. The US company announced that the booster with a dosage of 50 micrograms increased the omicron-neutralizing antibody level in the blood by 37 times. Researchers had analyzed the antibody level in the laboratory 29 days after the booster vaccination. A booster with 100 micrograms even increased the antibody level 83 times. It is currently recommended to use 100 micrograms of Moderna vaccine for the first and second dose and 50 micrograms for the booster dose.

For the laboratory study, Moderna examined blood samples from 40 subjects who had received a booster vaccination against the coronavirus 29 days earlier and who had low antibody levels before the booster.

Half of the subjects were vaccinated with 50 micrograms of the Moderna vaccine and the other half with 100 micrograms.

The levels of omicron-neutralizing antibodies in the blood of the test subjects were then measured.

Moderna points out, however, that these are only preliminary data.

CEO Stéphane Bancel still spoke of "reassuring" results.

Moderna is also pushing the development of an Omikron-specific vaccine.

Clinical studies could therefore begin in early 2022.

Biontech-Booster against Omikron - This is how the third dose works

Biontech / Pfizer had already announced at the beginning of December that three doses of their product were necessary for adequate protection against the Omikron variant.

According to the company, a Biontech booster increases the neutralizing Omicron antibodies by 25 times.

Preliminary laboratory data would show that.

Accordingly, two doses did not provide sufficient protection against infection with this variant.

Biontech / Pfizer assumes, however, that protection against serious illness continues to exist even with an Omicron infection.

Immunologists also consider Novavax vaccine to be well suited for boosters

According to immunologists, the vaccine from the US manufacturer Novavax, which has recently been approved in the EU, is also suitable for booster vaccinations. "Everything that is known so far indicates that Novavax is probably a very good vaccine," said the Secretary General of the German Society for Immunology, Carsten Watzl, of the

. "According to a British study, Novavax is not quite as effective as the mRNA vaccines for booster vaccines, but significantly better than vector vaccines," said the Dortmund immunology professor.

This distinguishes the Novavax vaccine from the dead vaccine approval candidate Valneva.

"With booster vaccinations you saw that mRNA vaccines improved antibody protection twenty to thirty times, Valneva only twofold," Watzl told the newspaper.

The Novavax preparation must now also be adapted to the Omikron variant and its modified spike protein, said Watzl.

"The development of a new cell line will be a little more complex for the manufacturer than it will be for the producers of the mRNA vaccines to convert their starting product."

Booster vaccinations with Moderna and Biontech: This is what Stiko recommends

The permanent vaccination commission Stiko recommends a booster vaccination for everyone aged 18 and over and three months after the second vaccination.

For the booster vaccination in Germany, the vaccines from Biontech / Pfizer and Moderna are currently possible.

In a separate article we have summarized an overview of the Stiko recommendation for boosting for you.

Antibody tests in the laboratory

In order to examine the effect of a vaccine against a virus variant, researchers usually do so-called neutralization tests.

It is checked how many antibodies a vaccinated person has in the blood, which can bind to a - mostly artificially produced - virus variant and thus switch it off.

The actual protection of vaccinated persons cannot be determined with this, however, clinical studies with thousands of test persons or evaluations of the ongoing infection process are required.

Examination of Covid vaccines in case of double vaccination or recovery

Scientists from the USA, Europe, South America and Australia are also currently investigating the effectiveness of the currently available corona vaccines.

How do the vaccines work in people who have been vaccinated twice?

Researchers examined the number of neutralizing antibodies still present after two to four weeks in test subjects, which suggests that they were vaccinated.

This included people who had already recovered or had been vaccinated twice with Biontech, Moderna, Astrazeneca, Johnson & Johnson, Sputnik or the Chinese vaccine Sinopharm.

The data speak for Moderna, albeit with a clear drop in effectiveness.

“Biontech secured second place.

Astrazeneca and Sinopharm do poorly.

Johnson & Johnson and Sputnik equal zero ”, summarizes the US epidemiologist and health economist Dr.

Eric Feigl-Ding on

.

A “halfway decent” protection can be achieved by cross-vaccinating Astrazeneca and Biontech, Feigl-Ding continues.

Another finding of the vaccine comparison: A person who has recovered from a corona infection but has not been vaccinated has practically no verifiable vaccination protection against Omikron.

A vaccination in addition to a survived infection, on the other hand, has a positive effect on vaccination protection.

Data from Germany provide worrying findings

Virologist Sandra Ciesek from the Frankfurt University Hospital did not announce any good news either.

The corona vaccines showed a drastically weaker defense reaction against Omikron.

That would have shown the first laboratory tests.

"The data confirm that the development of a vaccine adapted to Omikron makes sense," tweeted Ciesek (December 8).

The virologist also pointed out, however, that it is not possible to read from her analysis whether people who have been vaccinated are protected from a severe course at Omikron.

Because the immune response is not only based on antibodies, but also, for example, on T cells.

The study relates solely to the transferability of the virus.

According to Ciesek, the antibody response against Omikron is drastically reduced compared to the Delta variant - there is also a reduction in people with a booster vaccination. Anyone who has been cross-vaccinated twice with Biontech, twice with Moderna or with Astrazeneca and Biontech will no longer have any immune protection from the antibodies against the new Omikron variant after six months. "0 percent neutralization at Omicron," writes Ciesek. The booster vaccination from Biontech only resulted in a 25 percent neutralization after three months. In the delta variant, however, this was still 95 percent.

Christian Drosten classified the findings a little later.

On Twitter he wrote: “A 40-fold reduction in neutralization activity does NOT mean that the vaccination is 40 times less protective.

The real loss of immunity is much less.

At the moment triple vaccination is the best protection.

New vaccines only after the winter wave.

Don't wait, just boost. "

Biontech, Moderna and Astrazeneca: Manufacturers develop special Omikron boosters

On the manufacturer's side, the next steps are now clear: Biontech and its US partner Pfizer have already started adapting their mRNA vaccine to Omikron. The modified variant should therefore be on the market by the end of March 2022. Moderna is also continuing to work on an Omicron vaccine. "In order to react to this highly transferable variant, Moderna will continue to rapidly bring an Omikron-specific booster candidate into clinical testing if this becomes necessary in the future," said Moderna CEO Stephane Bancel. Clinical trials with an Omicron-specific vaccine called mRNA-1273.529 are expected to start in early 2022, according to the company. Astrazeneca is currently investigating the extent to which the vector vaccine protects against omicron infection and severe disease. Same goes for Johnson &Johnson, the US manufacturer, is working on a new vaccine in parallel.