How Effective is the Fifth Booster?

This article presents a study showing that the spike proteins in the current Omicron subvariants have evolved to resist the fifth dose of bivalent (BA.1 or BA.4/5) mRNA shots.

The preprint study just came out yesterday, January 23, 2024, and is available at BioRxiv.[1]

The authors are from the Montreal Heart Institute, Uniformed Services University of the Health Sciences, and Drexel University.

Study Design

Eighteen individuals, 11 females and seven males (age range: 51–64 years) were included. Blood samples were collected 22 days after the fifth dose of mRNA injection.

13 of the 18 received the Pfizer mRNA BA.4/5 bivalent vaccine, 2 received the Pfizer monovalent vaccine, and 3 received the Moderna mRNA BA.1 bivalent vaccine.

In the study, the spike protein from several Omicron subvariants, namely the BA.2.75, CH.1.1, DV.7.1, BA.4/5, BQ.1.1, XBB, XBB.1, XBB.1.16, XBB.1.5, FD.1.1, EG.5.1, HK.3, BA.2.86 and JN.1 were evaluated against the antibodies of people who had the fifth dose of the bivalent mRNA jabs.

The image below shows the evolution of D614G, one of the earliest SARS-CoV-2 strains, into the different Omicron subvariants.

Source: Benlarbi et al. Temperature-dependent Spike-ACE2 interaction of Omicron subvariants is associated with viral transmission.

Citing Nextstrain, the authors reported that JN.1 and its derivatives represent around 70% of reported viral sequences. [2]

Results

Omicron subvariants evaded antibody neutralization

They found that the spike proteins can evade the recognition and neutralization of anti-spike antibodies produced after the fifth injection of the bivalent booster. This is due to the rapid mutation of the SARS-CoV-2.

The image below from the same paper showed results after the antibodies produced after the fifth booster dose of the bivalent mRNA shots were mixed with the pseudoviruses with spike proteins from the subvariants.

It shows that the antibodies are effective only against the extinct variant, the D614G. But are ineffective against the currently prevailing Omicron subvariants.

Source: Benlarbi et al. Temperature-dependent Spike-ACE2 interaction of Omicron subvariants is associated with viral transmission.
More infective in Colder Temperatures

Additionally, it was observed that the affinity of the subvariants’ spike proteins to the ACE2 receptors increases in colder temperatures. This explains why more people get sick with COVID-19 during the winter season.

In summary, this study shows that the antibodies produced against the prevalent SARS-CoV-2 Omicron subvariants are ineffective in preventing COVID-19.

This research also exemplifies immune imprinting. Immune imprinting is a phenomenon where the body will produce antibodies only against the first variant it has encountered, even if it is exposed to subsequent variants.

What is Immune Imprinting and Why it is Good to Know.

Now you know why many people, some of whom I know well, continue to have COVID-19 despite being current in their COVID-19 jabs.

Be aware that the study presented here is still a preprint. Do not make any medical decisions based on this study. Consult your doctors and good luck.

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References: 

  1. Mehdi Benlarbi, Shilei Ding, Etienne Belanger, Alexandra Tauzin, Raphael Poujol, Halima Medjahed, Omar El Ferri, Yuxia Bo, Catherine Bourassa, Julie Hussin, Judith Fafard, Marzena Pazgier, Ines Levade, Cameron Abrams, Marceline Cote, Andres Finzi. Temperature-dependent Spike-ACE2 interaction of Omicron subvariants is associated with viral transmission.
  2. https://nextstrain.org/ncov/gisaid/global/6m

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