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RollingNews.ie

Professor Christine Loscher Why boosters are so important in the fight against Omicron

Why do we care so much about boosters right now? Let’s look at how we got here.

LAST UPDATE | 18 Dec 2021

BEFORE 2020 MOST people didn’t think too much about vaccines unless they had a baby or were going on holidays to exotic lands. And before the summer of 2021 most people didn’t know what a booster was – now all we hear is boosters boosters boosters.

So why do we care so much about boosters right now? 

Let’s look at how we got here.

When we started to roll out the Covid-19 vaccine in early 2021, we had the clinical trials data from each of the companies that guided us on timing of shots and number of shots. 

We knew that following this regime would provide significant protection against getting infected with the virus and even better protection against severe illness and death. 

Most of the vaccines we have taken in our lifetime have required two or more doses plus boosters so this has been no different. We wondered as the Alpha variant took hold in early 2021 as we rolled out the vaccines and were relieved that data showed that protection against infection, severe illness and death was still very high. 

Just as we were reaching a high level of vaccination in Ireland, topping the league tables around the world,  and starting to open up, the Delta variant struck and we wondered once more. Thankfully the vaccines stood firm but we did see evidence that the Pfizer and Moderna vaccines provided a higher level of protection than Astrazeneca and Janseen vaccines against this Delta variant. 

The next data that turned up wasn’t surprising to those that understood the immune system but was difficult for the general public to understand. 

The immunity from the vaccines was waning after four or five months and we didn’t have as much protection as we did after the second dose of our vaccine. This normally happens after all vaccines. The initial antibody levels are high and they decrease over time.

For most viruses this waning immunity might not matter too much, mostly because you are rarely exposed to the virus as community levels are low. When was the last time you were exposed to measles or rubella? But given the case numbers and community transmission of Delta in the winter months our exposure to Covid-19 had never been higher. Breakthrough infections were on the rise here and case numbers climbed. 

Data then quickly emerged that the solution was to boost immunity with a third shot of vaccine and booster became the topic of conversation all over the world.

Israel had led the way and boosted their way out of a Delta surge and proved to the world that boosters worked. Other countries followed suit and we began boosting in Ireland a few months ago and after a slow start have eventually ramped up. This has been predominantly driven by the arrival of yet another variant. 

Three weeks ago, Omicron came on the scene and with increased transmissibility as a key characteristic, has spread rapidly throughout the world. The difference with this variant is that it’s much more highly mutated than the ones that came before it. Along with its increased ability to transmit, it’s better at evading vaccines too.

Just what we didn’t need as we were on the road to boosting our way out of the winter Delta surge. After an anxious wait of just over a week, data demonstrated that Omicron was indeed vaccine evasive and two doses would only give us about 30% protection against infection but some better protection against severe illness and death. 

This was as low as 13% with the single shot Janseen vaccine. Thankfully, the data also showed that the booster boosted this up to 70-75% and we all breathed a sigh of relief.  

As data emerged from other countries showing Omicron to be more transmissible than any other variant and the numbers from over the water in the UK started to rocket, all hands to the wheel was the mantra for the boosted booster programme here in Ireland. 

So the big question is whether the boosters will solve the problem of Omicron acceleration as it becomes ever more present here with each passing day. 

The Health Protection Surveillance Centre said it estimates that approximately 35% of reported cases are now the Omicron variant. It will no doubt be dominant before Christmas Day.While the boosters will provide significant protection against severe illness and deaths, the protection is less against infection with Omicron. This super transmissible Omicron will take full advantage of that gap in protection and breakthrough infections will accelerate fast.

We also won’t have time to get everyone boosted before Omicron takes off and it will take advantage of that too. We are hopeful that this variant may cause milder illness which may translate into less incidence of hospitalisation and ICU admissions, but the sheer volume of potential cases might make this completely irrelevant and we may see hospitalisations and ICUs climb regardless of it being milder.

A small percentage of a big number is still a big number. We also don’t have definitive information about what infection looks like across a range of age cohorts and across different vaccine status, so there’s still a lot we don’t know.

But we do know is that Ireland will not be any different to any other country in terms of surging case numbers – we’ve been the same as the rest in the previous fourth waves, this time won’t be any different.

The most we can do is manage the impact. The booster programme will no doubt provide the best defence in minimising the impact of that surge on both our people as well as our healthcare system, but it is still a race against time.

I think we’ve been in this race before, but this time our opponent is faster.

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54 Comments
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    Mute Mary Jordan
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    Dec 17th 2021, 11:12 PM

    The booster shot is fine for those who can tolerate the vaccine. What happens when there has been a serious adverse reaction to the initial vaccination??
    M J.

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    Mute John Hazelnut
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    Dec 17th 2021, 11:31 PM

    @Mary Jordan: Not a nice situation. They have to avoid breathing infected air, and live like hermits (which may not be possible if they have medical appointments), or risk getting seriously ill.

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    Mute Michael Bodycoach
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    Dec 17th 2021, 11:42 PM

    @Diarmuid O’Braonáin: chemo causes cancer… I don’t see you giving out about that…

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    Mute Michael Oats
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    Dec 18th 2021, 10:47 AM

    @Michael Bodycoach: cancer clinics have stopped due to lockdowns, cancer appointments have been delayed for weeks because of lockdowns, weeks are a matter of life and death in cancer diagnosis, treatment etc.. Tony holohan the “Chief medical officer” in this country tried to cover up the smear scandal in which many many women have died prematurely… I will most certainly complain about that

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    Mute Honeybee
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    Dec 18th 2021, 11:02 AM

    @Mary Jordan: @Mary Jordan: I have suddenly found myself in this position, a very bad reaction to a contrast used in a scan some time back and when I turned up for my booster (moderna) I was refused and told I must see an immunologist , apparently the chemical make up of the Moderna and the contrast is similar as also is Pfizer, They thought perhaps the Janssen vaccine but I see in the USA they are not recommending this vaccine for adverse events so I am at a loss .

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    Mute Johannes Baader
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    Dec 18th 2021, 2:34 PM

    @Mary Jordan: How serious?

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    Mute Michael Geraghty
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    Dec 19th 2021, 8:34 AM

    @Michael Oats: I think you just overlooked my point. I know all about that. The point made was that vaccines cause other illnesses to people. My point is that a lot of treatments for disease cause illness. Like… Chemotherapy. We’re not all on the streets protesting about it though. Because for a large portion of people that unfortunately get cancer it can help them recover. The rest you just said is deflecting to another topic.

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    Mute Paul Whitehead
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    Dec 19th 2021, 12:59 PM

    @Johannes Baader: Serious enough to tell everyone. Though I understand getting covid and ending up in ICU is pretty serious too.

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    Mute Philip Broderick
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    Dec 17th 2021, 10:20 PM

    To those that understood the immune system but was difficult for the general public to understand.
    Who does Professor Christine Loscher think she .?…

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    Mute lelookcoco
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    Dec 17th 2021, 10:29 PM

    @Philip Broderick: Obviously she’s not as smart as Professor Philip Broderick.

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    Mute Soinbhe Lally
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    Dec 18th 2021, 8:24 AM

    @Philip Broderick: Professor Loscher is an expert in her field. Are you?

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    Mute CASO
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    Dec 18th 2021, 11:10 AM

    @Soinbhe Lally: so is the local farmer.

    24
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    Mute Connor Coady
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    Dec 18th 2021, 12:08 PM

    @CASO: well when I need advice on how to look after my cattle ill get in touch with my local farmer

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    Mute Jason Healy
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    Dec 18th 2021, 12:38 PM

    @Soinbhe Lally: think you jumped the gun on that one.

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    Mute SheepleDog
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    Dec 18th 2021, 7:43 PM

    @Philip Broderick: the immune system is more complex than the human brain

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    Mute Attilio
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    Dec 19th 2021, 9:57 AM

    @Philip Broderick: are you serious? What’s your field of expertise, please do share. Then maybe you will be taken seriously

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    Mute Colm Molloy
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    Dec 18th 2021, 9:51 AM

    All Propaganda.
    Can we have a more efficient health system where everyone gets looked after, pandemic or not?

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    Mute Sara McS
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    Dec 18th 2021, 10:19 AM

    @Colm Molloy: there’s no “or not” about the it. We are in a pandemic with a broken healthcare system- the pandemic still has to be addressed so what are your suggestions?

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    Mute Mick Tobin
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    Dec 17th 2021, 11:28 PM

    I’ll be getting mine, but at the same time I’m aware of the fact that a virus mutates to get around barriers, as well as that from the point of view of the virus – assuming there is one for the sake of the argument – there is no evolutionary advantage in killing off its host. So it’ll presumably evolve into a mild version at some point but we don’t know what strain this’ll be or when.

    At some point the question arises of letting some strain move around among the population, but as long as cases rise exponentially – and they do – then even a relatively mild strain can still overrun the healthcare service if it spreads faster, which it does.

    I’m hoping this is the covid strain by which it has mutated itself into oblivion, from society’s point of view, but we simply don’t know that yet.

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    Mute Michael Bodycoach
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    Dec 17th 2021, 10:28 PM

    Not a single antivax comment… Too hard for them to read

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    Mute Franny Ando
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    Dec 17th 2021, 11:54 PM

    @Michael Bodycoach: Be careful you don’t fall off that high horse!

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    Mute Damo
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    Dec 18th 2021, 12:02 AM

    @Michael Bodycoach: thats some pedestal you are on mate, bodycoach right?

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    Mute Michael Bodycoach
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    Dec 18th 2021, 7:00 AM

    @Franny Ando: facts keep me up here

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    Mute Margaret Mcgarry
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    Dec 18th 2021, 10:12 AM

    @Michael Bodycoach: I’m surprised too but the facts are laid out in the article maybe the anti vacs read it

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    Mute Nigel o'Neill
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    Dec 18th 2021, 10:15 AM

    @Michael Bodycoach: youre obviously not of high enough intellect to realise you don’t have the intellect to realise you actually done that for them

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    Mute GrumpyAulFella
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    Dec 18th 2021, 10:17 AM

    @Margaret Mcgarry: they’re still too exhausted from yesterday and flooding social media channels with faux outrage over pubs closing a couple of hours earlier over Xmas and trying to drum up attendances for the Xmas bumper Freedom looney march.

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    Mute GrumpyAulFella
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    Dec 18th 2021, 10:38 AM

    @Nigel o’Neill: “did” that for them.

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    Mute Franny Ando
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    Dec 18th 2021, 1:35 PM

    @Michael Bodycoach: No its your over inflated ego.

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    Mute Michael Creagh
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    Dec 19th 2021, 8:07 PM

    @Michael Bodycoach: a_ _ _hole

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    Mute ChadChaderson
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    Dec 18th 2021, 9:42 AM

    Why the fourth jab is the most important …

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    Mute Nigel o'Neill
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    Dec 18th 2021, 11:27 AM

    Tell that to the 1.4m people who have got one already but can’t sit down in a restaurant with their fellow ‘boosted’ friends for a dinner and a glass of wine at 8.30 next Tuesday evening!

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    Mute Attilio
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    Dec 19th 2021, 9:59 AM

    @Nigel o’Neill: ah the tragedy!

    4
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    Mute John Hazelnut
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    Dec 18th 2021, 12:00 AM

    Worthy article by Professor Loscher, but given the heavy reliance on vaccinations and booster shots, I would have liked to see something in the article about the immunocompromised and their subgroups. The immune systems of the populace, it seems, will be left to do most of the heavy lifting against the virus, and I would be concerned about the welfare of this group.

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    Mute John Hazelnut
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    Dec 17th 2021, 11:48 PM

    @geraldmbarry on the race between the booster rollout and the spread of the Omicron variant:

    https://twitter.com/TonightVMTV/status/1470903830531481602?t=KBHOiU-rgEuYXX4k9Dls9Q&s=19

    The majority of Journal commentators have little interest in such Professional opinion, preferring their own opinions.

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    Mute Tracktrack
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    Dec 18th 2021, 1:31 AM

    @John Hazelnut: very interesting interview.

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    Mute Mary O Dwyer
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    Dec 18th 2021, 10:29 AM

    Boosters will hugely help transmission but until everyone acknowledges the importance of having clean air in all indoor spaces where people congregate such as pubs, hotels, cafes , work , restaurants, educational facilities we will just be playing catch up as the virus mutates . Why is installing Hepa filters in Ireland not a standard . Nursing homes where residents share common areas to eat or sit could hugely benefit . If a cafe is full of the unmasked and if even 1 of those present has the virus even if asymptomatic and no clean air filtration, this possibly four times more transmissible variant could have a field day . Government and Niac need to mandate for clean air in all hospitality /educational/work sites . We have very high vaccination yet one of highest infection rates . Why?

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    Mute Bill ORourke
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    Dec 18th 2021, 11:17 AM

    “predominantly driven by the arrival of yet another variant”
    “Data then quickly emerged that the solution was to boost immunity with a third shot of vaccine”

    Great – problem solved!

    15
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    Mute David Saunders
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    Dec 18th 2021, 3:31 PM

    Got my booster jab yesterday and my arm is very sore. My hands and feet swollen but it’s better than being in ICU and dieing

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    Mute Michael Creagh
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    Dec 19th 2021, 8:09 PM

    @David Saunders: settled on a colour yet?

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    Mute NotMyIreland
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    Dec 18th 2021, 11:58 AM

    The appointments and treatments that have been delayed have been delayed because of the spread of the virus, restrictions have been used to minimise this happening. Note in this surge elective treatments were being cancelled before any new measures were introduced. So you have it slightly backwards, without restrictions we would have had more cases, more in hospital and so even more non covid care cancelled.

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    Mute Albert Brennerman
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    Dec 19th 2021, 1:13 AM

    If 35% is here now, why do we not see a footprint of acceleration directly related to its presence, surely it didn’t become actively contagious on the presence of headlines. So where is that signal all through December. It been flat 4000/5000 daily. Does that signal translate to hospitalisations.
    The manufaturers seem to be informing the doctors, a few months ago the experts were on for full blown openings and concerts and in 3 weeks the real world facts blatantly disagreed. Then a new fact emerges of vaccine waning in the face of that contradiction of numbers back on the up. We need more examination from all these panlists, we know the vaccine wanes now, but nobody was saying this before September they were banging the drum on full reopening and music events. Weren’t we once told masks didn’t matter and not use antigens. We are 40bn down and nowhere further to dealing with this, same hospital system , same place as last Christmas. Back up the science with hypotheses and predictions that will prove indeed you have knowledge. Otherwise I fear we are regurgitating the vaccine manufaturers data. No closer to this becoming a living with covid scenario.

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    Mute Mick Dunne
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    Dec 18th 2021, 5:20 PM

    I haven’t heard anything yet about my booster yet

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    Mute Shane Brigdale
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    Dec 19th 2021, 11:30 AM

    @Mick Dunne: it seems really slow being rolled out. I had planned to wait until called but went to a walk in clinic yesterday as I had heard nothing.

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