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Tuesday 28 November 2023 Dublin: 6°C
Shutterstock/Pete Hansen The adapted bivalent vaccine will be rolled out as a booster early next month.

Explainer: What you need to know about the new adapted Covid vaccines heading into winter

Professor of Immunology Christine Loscher says the new jabs work ‘specifically against Omicron’.

HEALTH MINISTER STEPHEN Donnelly recently announced that new ‘adapted bivalent’ Covid vaccines are to be rolled out early next month.

And while Professor of Immunology Christine Loscher says the emergency phase of the Covid pandemic is behind us, she’s cautioned that there are still good reasons to get the vaccine and booster jabs.

So what is an ‘adapted bivalent’ vaccine?

The adapted bivalent vaccine encodes the spike protein of the original virus strain, as well as a spike protein of an Omicron subvariant, providing broader immunisation against Covid-19.

Speaking to The Journal, Christine Loscher said the new vaccine is “more specific to provide an immunity to Omicron variants” and will offer “better protection”.

Loscher says the original vaccines have offered good protection against the virus but that the additional piece in the bivalent vaccine is “specifically against Omicron”.

She explained: “We’ll definitely get more antibodies, a first line of protection against getting Omicron, and we’ll also get an additional build-up of immunity in the body in general.

“There is specificity about the new parts of the vaccine that means that you get better antibodies to Omicron, but there’s also a body of evidence that shows that the original vaccine gave really good background immunity to reducing severity and death.

“So it’s almost like you’d be able to do both with this vaccine.”

While the other vaccines “still provide a really high level of protection,” she says the adapted bivalent vaccine offers “additional protection” for those who may need it and that not “everybody necessarily needs an even higher level of protection”.

So who does need an ‘even higher level of protection’?

The vaccine has been recommended and approved for use here as booster doses only, and will not be used for the primary vaccination course.

While a booster vaccine is recommended to everyone aged 12 and over, additional boosters are only recommended to:

  • 65s and over
  • People aged 50 to 64
  • People aged over 12 who are at high risk of severe illness
  • People aged over 12 in a long-term care facility
  • Healthcare workers
  • Pregnant women (over 16 weeks)

These vaccines are set to be rolled out from early October, on foot of advice from the National Immunisation Advisory Committee (NIAC).

The HSE will include adapted bivalent booster vaccines in the Vaccination Programme alongside the commencement of the flu vaccine programme.

Anyone who is eligible for both a flu vaccine and a Covid booster vaccine can receive them at the same time once it’s been at least four months since their last Covid-19 vaccine or infection.

Loscher said the adapted bivalent vaccine is being rolled out predominantly as a booster dose to vulnerable cohorts and to those aged over 50.

If I’m due a booster, should I wait for the new vaccine?

No. NIAC advice is: “While bivalent booster vaccines may offer some advantage compared with the original vaccine, timely booster vaccination is more important than which vaccine is administered.”

And in a statement to The Journal, the HSE encouraged anyone who is eligible for a COVID-19 vaccine but has not yet received it to come forward as soon as possible.

Loscher also noted that the original vaccine still offers a high level of immunity.

Should I get a booster?

Ahead of the winter, Loscher says it’s a really good time for people who are eligible for a booster vaccine to get one.

“If we look at the way Omicron has behaved over the last year,” says the immunology professor, “we are likely to see a surge at some stage during the winter.

“So getting your booster onboard as quickly as possible, particularly if you’re over the age of 50, is a really good idea.”

While second boosters are only offered to certain cohorts currently, Loscher says this may change “with the decisions on the winter plan to minimise the impact on hospitalisations and healthcare”.

What is the ‘winter plan’?

While Loscher says the emergency phase of the pandemic is over, she warns that it “needs to be managed coming into the winter”.

“We know an awful lot about how Covid behaves, but we still don’t know what variants we’re going to be facing into next.

“We know that severity is not going to be a huge issue for most people and we got through the last surge without really tipping over the edge in terms of hospitalisations and ICUs.”

However, she warns: “That might be confounded coming into the winter time by the fact that flu will also be there and people can be immunosuppressed coming into the winter time.

“We’re all indoors more and the chance of indoor transmission is increased.”

While Loscher said “we’re in a very good position to have a really good winter plan about how we manage Covid,” she expressed concern that “our winter plan for managing Covid is still not very clear”.

In response, the HSE told The Journal that it has been “working on the Winter Plan over the last number of months to deal with the challenges expected this winter, including detailed vaccination plans”.

Its spokesperson added: “We are currently finalising this plan with the Department of Health. Some measures in the Winter Plan are already being advanced, pending finalisation and agreement of the overall plan.

“A range of initiatives are already being implemented as part of the National Service Plan to alleviate pressures in emergency care. These include additional beds and strengthening teams, such as the Community Care Teams.”

What happens if there is a winter surge?

Loscher describes the current situation, where most people “don’t really consider Covid in our daily lives in the way that we used to”, as appropriate for the phase we are in.

However, she expressed the need to have a plan in place for a potential surge, which may include wearing masks on public transport for a few weeks.

“At the moment, there’s no real reason for us to make huge changes in our everyday lives,” says Loscher.

She continues: “But when we go into a surge, there are small changes that we can make that can have an impact going into the winter months, we need to understand what is the plan around vaccination for the general population, as well as the cohorts that we talk about for boosters.”

She added that the “guidelines on how people should behave if we enter a surge needs to be communicated very clearly” and that the “last few times we’ve had surges, there’s been no real direction about whether the public should respond”.

Should I still be cautious about catching Covid?

Loscher says it is important to “consistently minimise the risk of getting Covid, not because of the impact of the infection anymore, but the impact of post-Covid”.

Post-Covid, Loscher said there has been an “explosion of literature” that shows people who contract the virus have “increased risk of cardiac events, mortality, and blood clotting”.

“We know that when you get a Covid infection, you’re potentially increasing risk for other healthcare issues afterwards.

“So I don’t think we should have a blasé attitude and say, ‘well, with immunity it’s fairly mild.’

“The scientific data is becoming stronger every day and we have to be very mindful that we have to still continue to minimise the risk of COVID when we have surges.”

Is Omicron a milder strain of Covid?

Loscher says there was a “perception” that the Omicron strain was causing a milder illness.

She added that this gave a “degree of reassurance” to those who had not yet been vaccinated that the Omicron strain was less severe.

However, she pointed to the example of Hong Kong, which ran out of morgue space following a deadly Omicron surge in March.

Loscher says Hong Kong had a “very poor vaccine uptake, which means they didn’t have much immunity across the population”.

The immunology professor says this reveals how the Omicron strain “is not very mild in a cohort of individuals that don’t have that level of immunity”.

“This variant can be detrimental to an individual if they have no immunity and vaccines will give you that immunity.

“So I think if anyone hasn’t availed to the vaccine, we are facing into a winter where we know there might be a bad flu on the scene.

“There’s still a real good reason for people who haven’t had a vaccine yet to get one.”

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