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Studies Show Boosted Immunity Against Omicron with Booster Doses
Posted on January 28, 2022
Neither primary vaccination nor natural immunity is generally stopping infections with the omicron variant, but research shows booster doses substantially increase protection. Yet, Republican Sen. Rand Paul claimed that a case of COVID-19 provides “an immunity better than the vaccine.”
Recovering from COVID-19 is expected to confer some immunity from reinfection – just as getting vaccinated prevents symptomatic illness. The Centers for Disease Control and Prevention says that several studies have shown that prior infection or vaccination provide high protection for at least six months against “antigenically similar variants.”
Those who wish to engage in a vaccine-or-natural-immunity debate can find studies supporting both sides, depending on the variant – though the added benefit of vaccination is to gain immunity without having to suffer through an illness, possibly a severe one. And studies have found that having vaccination and a previous infection, so-called “hybrid immunity,” provides even stronger protection, as we’ve written before.
Paul’s office pointed us to a recent report from the Centers for Disease Control and Prevention that found prior infections conferred more immunity against the delta variant than the primary vaccination series. But the study period was before the highly mutated omicron variant took over and before booster shots were widely recommended.
The early research on omicron suggests Paul’s statement now is simply wrong. What’s the stronger immunity to ward off an omicron infection, from what we’ve learned so far? Booster doses, whether you’ve had a bout of COVID-19 before or not.
The Kentucky Republican made his claim in a Jan. 21 interview on Fox News’ “The Ingraham Angle.” Paul said that “millions” were getting infected with the virus — “The world is being inoculated by the virus, whether they like it or not,” he said. “Over half of my staff has had the omicron variety.” He then went on to say that natural infection was better.
Paul, Jan. 21: And what we found is the natural infection — you may not want it, and people unfortunately still will die from it. But if you get it and survive, it is giving profound immunity and then giving an immunity better than the vaccine, because the disease is now evading the vaccine for the most part.
The disease is evading the standard vaccination now “for the most part,” but the same is true of natural immunity. As for what comes next, that remains to be seen.
“The message is pretty clear as far as I’m concerned: Everyone should get vaccinated and get boosted and try to not get infected because there’s no, there’s no reason to go out and try to get yourself infected,” Alejandro B. Balazs, who, as the principal investigator at the Ragon Institute, has studied immunity responses to omicron and other variants, told us. “I’ve seen no evidence that it actually is superior in any way to actually getting the vaccine and the booster.”
Deepta Bhattacharya, an immunologist at the University of Arizona, told us assessments of immunity depend on the variant. Before delta, both types of immunity (natural and vaccine-induced) produced strong immune responses “at about the same ballpark level,” he said in an email. With delta, “recovery from an infection probably did give you better immunity against Delta re-infections than did 2 shots of an mRNA vaccine, but not relative to 3 shots.”
But the CDC’s findings on the delta wave don’t apply to omicron.
“What is pretty clear is that neither 2 mRNA shots nor recovery from a Delta (or earlier variant) infection by itself are likely to do much to stop symptomatic Omicron infections,” Bhattacharya told us. “It is just too different from prior variants. But a (recent) 3rd shot or a dose after recovering from an infection helps substantially against Omicron, especially for severe disease.”
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This is all good news for those who had a prior infection — at least when it comes to the delta variant. But, again, the study didn’t assess omicron, or the impact of booster vaccine doses, because those largely came after the study period. It was late September when the CDC first recommended booster doses for older Americans and certain other groups, concerning the Pfizer/BioNTech vaccine, and late November when the agency said all adults should get booster doses. The CDC says either the Pfizer or Moderna mRNA vaccines are “preferred” for boosters.
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A CDC study released Jan. 21 and using data from 10 states found vaccine effectiveness against COVID-19-association hospitalizations when omicron was predominant increased from 57% at six months or more after a second mRNA dose to 90% at least 14 days after the third dose. Two other CDC studies, one published in JAMA, also found lower case rates among vaccinated-and-boosted individuals, compared with the unvaccinated and those with only primary vaccinations.
Another peer-reviewed paper, published in the New England Journal of Medicine on Dec. 30, by Rockefeller University researchers, found “low or undetectable” levels of neutralizing antibodies against omicron in samples from those with two-dose vaccinations or recovery from COVID-19 without vaccination. But for those who got three doses of an mRNA vaccine or had COVID-19 and then were vaccinated, neutralizing antibodies were “substantial.” Plasma specimens were used from 47 people.
“What some are missing is that 3rd (booster) shots don’t simply restore immunity that has waned since the 2nd,” Paul Bieniasz, a virologist who co-led the study, said on Twitter. “Rather, they expand and broaden the antibodies and memory cells, likely giving a degree of protection against variants you NEVER previously had.”
As for what immunity one can expect after recovering from an omicron infection, that research is even more preliminary.
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Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, has said that when people are reinfected with COVID-19 it mostly involves a different variant from the original infection. At a Jan. 21 White House briefing, he said “it is unlikely that if you mount a good immune response — at least over a period of several months — it is extremely unlikely that you will be reinfected with the same variant.”
“As for the next variant,” Bhattacharya told us, “it’s tough to know what will come next. It could be more similar to the original than to Omicron, or vice versa, or something substantially different than either one (hopefully not!).”
Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over our editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.
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