Atlanta—If efforts to increase uptake of the COVID-19 vaccine booster are successful, pharmacists should expect an influx of vaccine-seekers in the upcoming weeks. Otherwise, public health officials are warning about another tough winter with an increase in SARS-CoV-2 cases combined with the possibility of a bad influenza season.

A key issue is the upsurge of new COVID-19 variants in the United States. As of mid-October, those variants—BQ1 and BQ1.1—accounted for more than 11% of all cases nationwide, according to the CDC, and that was almost double the proportion from a week earlier.

“When you get variants like that, you look at what their rate of increase is as a relative proportion of the variants, and this has a pretty troublesome doubling time,” Dr. Anthony Fauci, the President’s chief medical advisor and director of the National Institute of Allergy and Infectious Diseases, told CBS News. He made similar comments to other news outlets.

A major concern is that another sublineage of the Omicron variant, BA.2.75.2, appears to evade neutralizing antibodies in the blood and is resistant to several monoclonal antibody antiviral treatments. The findings were published recently in Lancet Infectious Diseases and raise the specter of increased SARS-CoV-2 infections this winter.

All of the news is not bad, however.

An article in Nature pointed out that booster shots against current SARS-CoV-2 variants can help the human immune system fight variants that do not exist yet. The conclusions came from two recent studies.

The studies—which are yet to be peer-reviewed—were published last month on the preprint server, bioRxiv.

One of the studies, led by immunologist Ali Ellebedy, PhD, at Washington University in St. Louis, Missouri, received funding from Moderna, which makes one of the bivalent boosters. The study team collected lymph-node samples from 26 people and bone-marrow samples from 15 people who had received the original vaccine and Moderna’s booster against the Omicron variant, BA.1. Analysis showed that most of the participants’ B cells recognized both the original and Omicron strains. In addition, most of the participants had a few new types of Omicron-specific B cells.

In the second preprint, scientists collected samples from six people who became infected with Omicron despite having received the original vaccine. In this case, researchers found that, while 1 month after Omicron infection, nearly 97% of the participants’ antibodies targeting SARS-CoV-2 still bound the original strain better than Omicron BA.1, that was not the case 6 months after infection. By that point, nearly half of the participants’ B cells produced antibodies that bound Omicron BA.1 better than the original strain. That is an indication that the immune system continued to adapt long after the infection had passed, the authors noted.

“It’s good to see evidence that, even when it’s imprinted, the immune system is adapting in ways that are helpful in redirecting to the newer variant,” stated Jesse Bloom, PhD a computational virologist at the Fred Hutchinson Cancer Research Center in Seattle, Washington, who was a co-author on the second paper.

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