Pre-pandemic, I wasn’t anti-vaccine for myself. I was just indifferent. So I didn’t seek out the flu vaccine and if a provider asked me if I had a tetanus shot in the past 10 years, I just shrugged my shoulders. But the COVID vaccine normalized getting vaccinated as an adult for me. So at my well visit this past week, I didn’t give a second thought when the nurse asked if she could poke my arms. So I left with a bandage on my left arm and 2 on my right.
Often in such cases (where I was being treated for some sort of minor wound) I said I didn’t know, but in those cases the provider usually thought a booster would be a good idea just in case, and not a serious problem if I had had one, so I got the shot then.
Even since a bicycle accident in early adulthood, when i got a lot of road rash, I’ve been aware that i needed to keep my tetanus shots up to date, and have done that.
If there’s any movie inaccuracy that really grinds my gears, it’s that nobody seems to get road rash after taking a tumble.
Reminds me of this:
I think we got our tetanus shots updated before we went to Mexico? Not bc it was required but bc the dr thought it was a good idea? But that was more than 10 years ago. I need a shingles vaccine more, I think.
I got a bunch of shots when I visited South Africa, including the first of the Hep A series, a Polio booster, a tetanus booster, and some others.
I completed the Hep A series (and got the Hep B vaccine with it) when I returned home.
I guess that’s why it seems normal to me that we need 3+ covid shots – I got 3 shots for hepatitis. And why needing boosters seems normal – I needed a booster for polio when I went someplace where I might run into polio.
I got my tetanus booster just a week or so ago, planning to get my fourth COVID shot as soon as local pharmacies update to CDC guidelines.
I don’t question what went into my computer to make it work. Smarter people handle that crap. Just shove some vaccine in me and let me clack on the magic light box, I’m not qualified to understand any of it.
text
As people across the world grapple with the prospect of living with the coronavirus for the foreseeable future, one question looms large: How soon before they need yet another shot?
Not for many months, and perhaps not for years, according to a flurry of new studies.
Three doses of a COVID vaccine — or even just two — are enough to protect most people from serious illness and death for a long time, the studies suggest.
“We’re starting to see now diminishing returns on the number of additional doses,” said John Wherry, director of the Institute for immunology at the University of Pennsylvania. Although people who are over 65 or at high risk of illness may benefit from a fourth vaccine dose, it may be unnecessary for most people, he added.
Federal health officials including Dr. Anthony Fauci, the Biden administration’s top COVID adviser, have also said that they are unlikely to recommend a fourth dose before the fall.
The omicron variant can dodge antibodies — immune molecules that prevent the virus from infecting cells — produced after two doses of a COVID vaccine. But a third shot of the mRNA vaccines made by Pfizer-BioNTech or by Moderna prompts the body to make a much wider variety of antibodies, which would be difficult for any variant of the virus to evade, according to the most recent study.
The diverse repertoire of antibodies produced should be able to protect people from new variants, even those that differ significantly from the original version of the virus, the study suggests.
“If people are exposed to another variant like omicron, they now got some extra ammunition to fight it,” said Dr. Julie McElrath, an infectious disease physician and immunologist at Fred Hutchinson Cancer Research Center in Seattle.
What’s more, other parts of the immune system can remember and destroy the virus over many months if not years, according to at least four studies published in top-tier journals over the past month.
Specialized immune cells called T cells produced after immunization by four brands of COVID vaccine — Pfizer-BioNTech, Moderna, Johnson & Johnson and Novavax — are about 80% as powerful against omicron as other variants, the research found. Given how different omicron’s mutations are from previous variants, it is very likely that T cells would mount a similarly robust attack on any future variant as well, researchers said.
This matches what scientists have found for the SARS coronavirus, which killed nearly 800 people in a 2003 epidemic in Asia. In people exposed to that virus, T cells have lasted more than 17 years. Evidence so far indicates that the immune cells for the new coronavirus — sometimes called memory cells — may also decline very slowly, experts said.
“Memory responses can last for ages,” said Wendy Burgers, an immunologist at the University of Cape Town who led one of the studies, published in the journal Nature. “Potentially, the T-cell response is extremely long lived.”
Throughout the pandemic, a disproportionate amount of research attention has gone to antibodies, the body’s first line of defense against a virus. That is partly because these molecules are relatively easy to study. They can be measured from a drop of blood.
Analyzing immune cells, by contrast, requires milliliters of blood, skill, specialized equipment — and a lot of time. “It’s orders of magnitude slower and more laborious,” Burgers said.
Few labs have the wherewithal to study these cells, and their findings lag weeks behind those on antibodies. Perhaps as a result, scientists have frequently overlooked the importance of other parts of the immune system, experts said.
“Most people don’t even know what they are — a lot of doctors and scientists are not completely clear what a T cell is,” said Dr. Dan Barouch, a virus expert at Beth Israel Deaconess Medical Center in Boston who led one of the T-cell studies.
“Fundamentally, I would argue that T cells are probably more important than what many people have given them credit for,” Barouch said.
Antibodies spike after every shot of vaccine — or after each exposure to the virus — and inevitably decline within a few weeks to months.
Waning antibody levels after two vaccine doses prompted federal officials to recommend boosters for everyone older than 12. The extra shots fortified antibody levels and helped to contain omicron’s spread, but they too appear to lose some of their ability to prevent infections within four months, according to recent data from the Centers for Disease Control and Prevention.
Antibodies recognize two or three key parts of the spike protein, a protrusion on the outside of the coronavirus that allows it to latch on to human cells. But T cells detect many more parts of the spike, and so are less likely to fail when the virus gains mutations in some of them.
Vaccines also encode a memory of the virus in B cells, which can churn out fresh batches of antibodies within four or five days after a new exposure to the virus.
This dual punch of T and B cells help explain why many people who received two or even three doses of vaccine could still be infected with the omicron variant, but only a small percentage became seriously ill.
“You will see a decrease of the antibody levels over time, but if memory B cells are still there, and memory T cells are still there, they can kick back into action relatively quickly,” said Alessandro Sette, an immunologist at the La Jolla Institute for Immunology who led a new study of T cells published in Cell.
Memory B cells become increasingly sophisticated over time, and they learn to recognize a diverse set of viral genetic sequences. The longer they have to practice, the broader the range of virus variants they can thwart.
Researchers showed last year that the elite school inside of lymph nodes where the B cells train, called the germinal center, remains active for at least 15 weeks after the second dose of a COVID vaccine. In an updated study published in the journal Nature, the same team showed that six months after vaccination, memory B cells continue to mature, and the antibodies they produce keep gaining the ability to recognize new variants.
“Those antibodies at six months are better binders and more potent neutralizers than the ones that are produced one month after immunization,” said Ali Ellebedy, an immunologist at Washington University in St. Louis who led the study.
In the newest study, another team showed that a third shot creates an even richer pool of B cells than the second shot did, and the antibodies they produce recognize a broader range of variants. In laboratory experiments, these antibodies were able to fend off the beta, delta and omicron variants. In fact, more than half of the antibodies seen one month after a third dose were able to neutralize omicron, even though the vaccine was not designed for that variant, the study found.
“If you’ve had a third dose, you’re going to have a rapid response that’s going to have quite a bit of specificity for omicron, which explains why people that have had a third dose do so much better,” said Michel Nussenzweig, an immunologist at Rockefeller University who led the study.
Memory cells produced after infection with the coronavirus, rather than by the vaccines, seem less potent against the omicron variant, according to a study published last month in Nature Medicine. Immunity generated by infection “varies quite a lot, while the vaccine response is much more consistently good,” said Marcus Buggert, an immunologist at the Karolinska Institute in Sweden who led the study.
Although most people, vaccinated or not, show only a small drop in their T cell response against omicron, about 1 in 5 had “significant reductions of their responses” of about 60%, Buggert said. The differences are most likely because of their underlying genetic makeup, he said.
Still, the recent studies suggest that in most people, the immunity gained from infection or vaccination will hold up for a long while. Even if mutations in new variants change some of the viral regions that T cells recognize, there would still be enough others to maintain a reasonably strong immune response, experts said.
One big unknown is how slowly the T cells may decline, and whether two doses of vaccine can create a long-lasting response, or if instead people would need three — as some experts have suggested — to cement immune memory.
“That’s a question that we don’t know the answer to yet,” Burgers said. “Those are the kind of studies that we’re going to need to do.”
I didn’t read the whole article, but this jumped out at me. [emphasis mine]
I know a bunch of people, hubby and me included, who were triple vaxxed and caught Omicron.
I’m feeling a lot more confident in my naturally acquired immunity than in my vaccine-acquired immunity at the moment.
This makes it sound like if you’re triple-vaxxed you don’t need to worry and that’s blatantly false. They don’t outright say that but it’s implied.
I agree. And while none of my triple vaxxed friends were hospitalized, Omicron wasn’t super easy on them either. And several are under 30.
Yeah, that caught my eye, too.
The studies I’ve read suggest that a third dose (or a case of covid plus a booster vaccine) provides a lot more immunity than just two doses (or just a prior infection). In particular, that booster greatly increases the strength of the cellular immune response. But
- the cellular response is slow, and doesn’t prevent you from catching or spreading covid, it just helps you get better faster.
- antibodies, however broad and however acquired, reduce over time. It looks like sterilizing immunity (the ability to not get sick at all, because the virus is immediately mopped up by circulating antibodies) rarely lasts more than 3-6 months, again, no matter how your immunity was acquired.
You are in the very small minority that caught COVID Omicron and had symptoms and still have them.
Not everyone is totally immune. Just don’t know which ones are not.
After reading the article, I believe the idea is that your b cells create those antibodies after you are infected.
So that wide variety of antibodies is part of how the vaccine protects you against serious infection (meaning hospitalization) and death. But they don’t protect against infection in the first place.
I agree though it’s easy to read that as implying you are immune.
Now 4x vaxxed and caught COVID between dose 3 and 4 (autoimmune - CDC recommended). Hopefully I’m mostly good for a while, partner still has not caught it yet though so still being careful.
Wife & I got J&J a year ago, no side effects. Moderna booster 6 months later, again no side effects. 
When I went to my DR for annual physical, he said he got Delta in Nov a week after he was boosted and then got Omicron in Jan. I’m sure he is exposed more than the normal person, but didn’t seem the booster or actually having it prevented him from getting it fairly quickly afterwards. Just one point.
He did say Delta was like a deep respiratory virus infection while Omicron was more like a head cold. He said other than the fact that he was required by his health care employer (and some common sense) to stay home, he was not sick enough with either that he could not have worked and was extremely bored during his quarantine.
I tested positive in Jan 2021 and got my first shot in July 2021 and second in Oct 2021. I will probably wait until May to July 2022 for my booster. I don’t interact with many people (WFH and rarely go out) so my risk is pretty low.
It takes about 2 weeks for immunity from a booster to kick in, so that’s not really a data point.
This is a data point. It’s yet another data point showing that neither vaccination nor prior infection provides much protection from catching omicron. But they do provide a lot of protection against getting seriously ill, which his experience seems to be in line with.
I’m not 65, I’m not immune compromised, and I’m not obese. But I am kinda close to two of those, and I have a history of getting sicker from colds than most people. So I am considering trying to get another booster shot in early May. Because I only have 2 shots on my official card (although there are 5 in my state registry – my doctor re-entered all my data, including the booster I had with that J&J study) I think I can probably do this without too much trouble.
That would be a couple of weeks prior to a trip I want to take, and would make me a lot more comfortable about doing stuff like eating in restaurants while I’m traveling. (I haven’t eaten in restaurants since the pandemic got going, but it’s much hard to “cook at home” when you are traveling.)