says that boosters give very good cd8+ t-cell protection in mouse model.
another research tells us that cd20 treated persons anyway seem to have a higher cd8+ reaction on vaccines than non treated.
so if we combine that and see that b-cell antibodies cant win against omicron is it wrong to say that cd20 treated might even have a somehow „better“ protection against omicron after the booster?
I’m so thankful for all the information you have shared with us this year. I receive no info from my neurologist or primary care doctors here in the USA. So, you are it for my guidance. 🙏🎄
Thank you so much for giving us so much of your time, and providing us with such clear information. All my best wishes for Christmas and for the next , challenging year
OK, so having had 3 shots now of the Pfizer vaccine, with the last one being at the end of October, I am assuming I should wait until they change up the vaccines to cover the Omicron variant? I would not be eligible for a booster until at least the end of January anyway... Am I on the right track with this thinking? Or should wait until i am 6 months out from the last shot knowing that this was 6 months instead of 3 from the first 2?
I would have the booster as soon as you can, i.e. end of January, to boost both B-cells if you have them and your T-cell immunity. The Omicron vaccine will take months and by then the goalposts may have moved with the next strain dominating by then.
Okay, I’ll see what my MS team say about my recent pre infusion bloods & ask them about this info. If I can & everything is going well for me, I don’t mind delaying my DMD to have another vaccine to gain more protection. Like everyone, I would like to stop worrying & to start going out more! Have a great Christmas and New Year & here’s to a better 2022 :)
Thanks for this post Prof G, and also for all the incredibly useful information and case studies you have provided all year; it makes such a difference! Hope you and your family have a great Christmas and happy New Year!
Thank you Prof G, this is really useful to understand, as such, what is happening out there! My daughter was due back from uni y’day but sadly isolating as she’s been in contact with 2 positive people & she’s got a cold (virus) too! PCR completed y’day & I’m praying it’s just a cold! I want her to come home for Xmas 🎄 I’m on a CD20 therapy & have rec’d an email asking me to have a pcr at home ready! I’m due my next infusion on 7/1 & have had my bloods taken today, hopefully in place for it to go ahead. An antibody test beforehand would be useful to see how much protection I have, for me then to make a choice, whether or not to go ahead & wait to have another covid vaccine over the next 1/2 months?
A lot of antibody tests are just reporting out as positive or negative and are not giving you a titre. What you need is to know that you have high levels of antibody.
I am in between the first and second week of my cladribine treatment on year one, and I just had the booster today, but I am now worried: is there any chance that cladribine won’t work as well for me because I had the booster (which raises the lymphocyte count while cladribine reduces it)? Did I make a mistake by having it right in between the two first weeks?
It was a bit of a rushed decision as I was worried for the omicron variant but now I am worried I might have compromised my treatment. I don’t mind for the vaccine no working as well but I do mind if cladribine doesn’t work as well because of this.
No there is no evidence that having a vaccine stops cladribine from working and similarly patients with MS treated with cladribine seem to make a good response to the COVID-19 vaccines.
"I suspect what will happen is that Omnicron will now act as the world’s vaccine and may drive up herd immunity in countries with low vaccination rates."
What do we know now about severity of infection with omnicron in different scenarios?
In unvaccinated people, in vaccinated people, in those with prior SARS infection, in those with prior Covid-19 infection, ...
Re: "What do we know now about severity of infection with omnicron in different scenarios?"
In previously infected and vaccinated people it seems to cause a mild disease, similar to a mild cold. In vulnerable people (anti-CD20 & S1P modulators) we don't know. In unvaccinated people it causing a more serious infection with hospital admissions increasing. However, it looks as if the proportion of hospitalised patients with COVID-19 needing ITU and/or ventilation is lower than with previous waves. This maybe driven by effective antivirals and the fact that the average age of Omicron cases is lower and age is a major factor keeping you out of ITU and off a ventilator.
The Imperial College report from last week could find no evidence than Omicron caused less severe disease compared to the Alpha and Delta variants. This position may change as there is some data out of a lab in Cambridge showing Omicron causes less damage to lung cells in culture. So it is all looking very positive. Based on the current epidemiology the Omicron surge will peak very soon and fall very soon.
But the spike protein focused vaccines don't really work or they work for maybe 3 months whilst the titres are high. What you need is some background wild-type immunity to the other antigens that SARS-CoV-2 expresses. I suspect relying spike protein immunity is too narrow to keep Omicron at bay. At least the vaccine may make the Omicron epidemic a mild one.
Don't you think it is time to sync the Anti-CD20 with covid waves? It seems that summer makes things go better so it would be a perfect match for holidays and drug holidays altogether to get vaccinated with available b cells as soon as fall comes. I think that to stop this story we need to have a massive increase in antibody titers in the population. I mean mandatory vaccination with repeated doses at short interval of time. This will likely prevent the spread of the virus. Unfortunately governments are not acting in that direction :(
A Pfizer spokesperson said they are able to get omicron vaccine approved and ready for market in 100 days. Do you think they will?
I suspect it will be less than 100 days. That is the beauty and ingenuity of the mRNA platform. It is truly transformational. The other driver is Moderna, or competition; Moderna said they will have their vaccine ready for trials in early January.
thank you!
just read this preprint:
https://www.biorxiv.org/content/10.1101/2021.12.15.472838v1
says that boosters give very good cd8+ t-cell protection in mouse model.
another research tells us that cd20 treated persons anyway seem to have a higher cd8+ reaction on vaccines than non treated.
so if we combine that and see that b-cell antibodies cant win against omicron is it wrong to say that cd20 treated might even have a somehow „better“ protection against omicron after the booster?
merry xmas and a healthy new year!
I’m so thankful for all the information you have shared with us this year. I receive no info from my neurologist or primary care doctors here in the USA. So, you are it for my guidance. 🙏🎄
You mention antivirals which in particular do you see as the most effective? Thanks for all that you do and happy holidays.
Paxlovid from Pfizer
Thank you so much for giving us so much of your time, and providing us with such clear information. All my best wishes for Christmas and for the next , challenging year
OK, so having had 3 shots now of the Pfizer vaccine, with the last one being at the end of October, I am assuming I should wait until they change up the vaccines to cover the Omicron variant? I would not be eligible for a booster until at least the end of January anyway... Am I on the right track with this thinking? Or should wait until i am 6 months out from the last shot knowing that this was 6 months instead of 3 from the first 2?
I would have the booster as soon as you can, i.e. end of January, to boost both B-cells if you have them and your T-cell immunity. The Omicron vaccine will take months and by then the goalposts may have moved with the next strain dominating by then.
Okay, I’ll see what my MS team say about my recent pre infusion bloods & ask them about this info. If I can & everything is going well for me, I don’t mind delaying my DMD to have another vaccine to gain more protection. Like everyone, I would like to stop worrying & to start going out more! Have a great Christmas and New Year & here’s to a better 2022 :)
Thanks for this post Prof G, and also for all the incredibly useful information and case studies you have provided all year; it makes such a difference! Hope you and your family have a great Christmas and happy New Year!
Thank you Prof G, this is really useful to understand, as such, what is happening out there! My daughter was due back from uni y’day but sadly isolating as she’s been in contact with 2 positive people & she’s got a cold (virus) too! PCR completed y’day & I’m praying it’s just a cold! I want her to come home for Xmas 🎄 I’m on a CD20 therapy & have rec’d an email asking me to have a pcr at home ready! I’m due my next infusion on 7/1 & have had my bloods taken today, hopefully in place for it to go ahead. An antibody test beforehand would be useful to see how much protection I have, for me then to make a choice, whether or not to go ahead & wait to have another covid vaccine over the next 1/2 months?
Re: " An antibody test beforehand ..."
A lot of antibody tests are just reporting out as positive or negative and are not giving you a titre. What you need is to know that you have high levels of antibody.
Dear Prof Giovannoni,
I am in between the first and second week of my cladribine treatment on year one, and I just had the booster today, but I am now worried: is there any chance that cladribine won’t work as well for me because I had the booster (which raises the lymphocyte count while cladribine reduces it)? Did I make a mistake by having it right in between the two first weeks?
It was a bit of a rushed decision as I was worried for the omicron variant but now I am worried I might have compromised my treatment. I don’t mind for the vaccine no working as well but I do mind if cladribine doesn’t work as well because of this.
Thank you beforehand for your reply
No there is no evidence that having a vaccine stops cladribine from working and similarly patients with MS treated with cladribine seem to make a good response to the COVID-19 vaccines.
Thank you very much for your quick reply
"I suspect what will happen is that Omnicron will now act as the world’s vaccine and may drive up herd immunity in countries with low vaccination rates."
What do we know now about severity of infection with omnicron in different scenarios?
In unvaccinated people, in vaccinated people, in those with prior SARS infection, in those with prior Covid-19 infection, ...
Re: "What do we know now about severity of infection with omnicron in different scenarios?"
In previously infected and vaccinated people it seems to cause a mild disease, similar to a mild cold. In vulnerable people (anti-CD20 & S1P modulators) we don't know. In unvaccinated people it causing a more serious infection with hospital admissions increasing. However, it looks as if the proportion of hospitalised patients with COVID-19 needing ITU and/or ventilation is lower than with previous waves. This maybe driven by effective antivirals and the fact that the average age of Omicron cases is lower and age is a major factor keeping you out of ITU and off a ventilator.
The Imperial College report from last week could find no evidence than Omicron caused less severe disease compared to the Alpha and Delta variants. This position may change as there is some data out of a lab in Cambridge showing Omicron causes less damage to lung cells in culture. So it is all looking very positive. Based on the current epidemiology the Omicron surge will peak very soon and fall very soon.
Prof G, Australia has vaccination rates of 80-90% and mostly Pfizer. Fingers crossed.
But the spike protein focused vaccines don't really work or they work for maybe 3 months whilst the titres are high. What you need is some background wild-type immunity to the other antigens that SARS-CoV-2 expresses. I suspect relying spike protein immunity is too narrow to keep Omicron at bay. At least the vaccine may make the Omicron epidemic a mild one.
Thanks!! Merry Christmas and all the best for 2022!
Don't you think it is time to sync the Anti-CD20 with covid waves? It seems that summer makes things go better so it would be a perfect match for holidays and drug holidays altogether to get vaccinated with available b cells as soon as fall comes. I think that to stop this story we need to have a massive increase in antibody titers in the population. I mean mandatory vaccination with repeated doses at short interval of time. This will likely prevent the spread of the virus. Unfortunately governments are not acting in that direction :(
A Pfizer spokesperson said they are able to get omicron vaccine approved and ready for market in 100 days. Do you think they will?
Re: ". Do you think they will?"
I suspect it will be less than 100 days. That is the beauty and ingenuity of the mRNA platform. It is truly transformational. The other driver is Moderna, or competition; Moderna said they will have their vaccine ready for trials in early January.