Pfizer’s boss says FOURTH Covid jab will be needed next winter

People may need a fourth Covid jab less than a year after getting a booster, Pfizer’s boss said today amid concerns about the rapid spread of the super mutant Omicron variant.

Dr Albert Bourla, chief executive officer of the pharmaceutical giant, today said he previously thought a fourth jab may be needed a year after a third injection.

But the emergence of Omicron may mean people require a total of four injections faster, he said. However, three doses ‘will give very good protection’ against Covid this winter, Dr Bourla added.

It comes after Pfizer yesterday warned two doses of its vaccine won’t prevent Omicron infections, but ‘may still offer protection against severe disease’. Independent scientists believe the same will be the case for other vaccines, such as AstraZeneca’s. 

But preliminary laboratory tests showed a third Pfizer vaccine triggers a ‘more robust’ antibody response to Omicron, similar to two doses against previous strains of Covid — suggesting the boosters will thwart the mutant strain. 

The company — which has earned billions through the pandemic after making an effective jab — also revealed millions of doses of a new version of its vaccine tailored to the mutant strain won’t be ready until March if the current crop of jabs fail in the real world. 

And Dr Anthony Fauci, the US’s top infectious disease expert, said the definition of ‘fully vaccinated’ in America will change to require a booster dose as well. And health officials are already investigating the potential need for a fourth dose of the vaccine after people receive their boosters, he said.

Meanwhile, two separate studies released yesterday showed vaccines appear to work better than expected against Omicron, which is quickly spreading in Britain and has made No10 resort to its ‘Plan B’ to save the NHS from being overwhelmed this winter.  

However, a fourth lab study — based on testing blood from fully-vaccinated people — suggested the variant could evade protection from booster jabs. 

A World Health Organization official insisted the vaccines should still work against Omicron, admitting that the strain appears to be milder than its rivals, such as Beta and Delta.  

But top Government advisers have warned that the NHS could still face severe pressure this winter from Omicron if it is definitively proven to be more transmissible, simply because of the sheer number of people who would get infected. Vaccines are extremely effective but not perfect at protecting against severe outcomes.  

UK officials hope the country’s booster roll-out to all adults — which Boris Johnson pledged to deliver by the end of January — and implementing Plan B will save the NHS in the face of the oncoming wave of Omicron, which leading scientists believe will be dominant by Christmas.    

But less than half of over-18s in Britain have had a booster, meaning 23million who will be eligible by the end of January are yet to get their third dose. No10 last week promised to put the booster rollout on ‘steroids’ — but there were chaotic scenes today as over-40s said they were turned away at clinics. 

Speaking to CNBC, Dr Bourla said real world data will show whether current vaccines offer good protection against Omicron.

But he said: ‘I think we will need the fourth dose. I’ve said that multiple times. 

‘With the previous [variants], I was projecting that that will be on 12 months after the third dose. 

‘With Omicron, we need to wait and see because we have very little information. We may need it faster.’

‘But for right now, the most important thing it is that we have winter in front of us.’

He said a third dose ‘will give very good protection’ and allow countries to ‘go without concerns through the winter’

‘I think we should be in very good safe to control the winter based on what we say right now,’ Dr Bourla said. 

‘And then if there is a need for something different better, we will be able to have in months,’ he added.

His comments come after Pfizer announced results yesterday based on a laboratory study using the blood of 20 people, who were either double-jabbed three weeks earlier or triple-jabbed one month earlier with its vaccine, which Britain is using for its booster programme.

The results showed the third dose may provide a ‘more robust protection’, triggering a 25-fold jump in antibody levels. 

Pfizer, which manufactured the jab with German partner firm BioNTech, said the levels equated to a ‘high efficacy’ based on data against other variants. 

A booster jab offered a boost in antibody levels that are ‘comparable to those observed’ for the original Wuhan virus after two doses, the company said.

The level of neutralising antibodies against Omicron after three jabs was 154, compared to 155 against the Wuhan strain after two jabs.

But the figure was 60 per cent lower than levels seen for three doses against Delta. 

Experts today cautioned that a drop in antibody levels doesn’t necessarily translate into vaccine efficacy, but merely gives an indicator as to what can be expected.

Announcing its results today, Pfizer also said booster injections appeared to increase a specific kind of T cell, which is thought to play a crucial role in staving off severe illness. 

Antibodies attack the virus and stop it attaching to and infecting the body’s cells.  

If the virus manages to breach that defence, T cell protection identifies them and stops them spreading further.

The company will collect data on whether the antibodies remain at that level in the months after a booster dose, with immunity known to wane slightly over time.

It will also monitor real-world data to better understand how its jabs perform against the strain.

Meanwhile, blood samples among double-jabbed people showed a 25-fold reduction in antibody levels against Omicron, compared to the original strain.

Three weeks after the second dose, antibody levels stood at 155 against the Wuhan stain, while it dropped to 6 against Omicron.

A sharp reduction was also seen against the Beta variant, which triggered six times less antibodies (36) than the original strain.  

He said the Omicron variant ‘came as a surprise’ because it has three times as many mutations as experts were used to seeing on variants. 

The UK’s decision to rollout boosters three months after the second dose is ‘the right way to go’ to ensure better protection over the winter, Dr Sahin said. 

It is ‘very clear’ that three doses of Pfizer’s vaccine are needed to provide protection against Omicron, although scientists do not yet understand why two doses do not provide sufficient protection, he added.

Pfizer’s chief executive officer Albert Bourla said: ‘Although two doses of the vaccine may still offer protection against severe disease caused by the Omicron strain, it’s clear from these preliminary data that protection is improved with a third dose of our vaccine.

‘Ensuring as many people as possible are fully vaccinated with the first two dose series and a booster remains the best course of action to prevent the spread of Covid.’

Dr Sahin added: ‘Our preliminary, first dataset indicate that a third dose could still offer a sufficient level of protection from disease of any severity caused by the Omicron variant.

‘Broad vaccination and booster campaigns around the world could help us to better protect people everywhere and to get through the winter season. 

‘We continue to work on an adapted vaccine which, we believe, will help to induce a high level of protection against Omicron-induced Covid disease as well as a prolonged protection compared to the current vaccine.’

Pfizer began developing a Covid vaccine to specifically targets the Omicron variant on November 25, which it can dish out tens of millions of doses from March 2022 if the current crop of jabs are not providing sufficient protection. 

Earlier versions of the new vaccine will be ready for pre-clinical trials in January.

The company said all of its vaccine production — which will reach 4billion doses in 2022 — could be switched to the new version of the vaccine, depending on the spread of Omicron.

Nearly 600 Omicron cases have been spotted in the UK since the virus was first identified in South Africa.

Boris Johnson tonight signed off on Plan B, declaring people should once again work from home where possible. In a gloomy Downing Street press conference, he said ministers would extend the use of masks and introduce Covid passports for nightclubs.

In a move that bounced No10 into activating its back-up plan, SAGE warned ministers Omicron hospitalisations may breach 1,000 a day in England by the end of the year without tougher restrictions to stem the spread of the super-mutant Covid variant.

WHO official Dr Ryan today said the strain is likely more transmissible than previous variants but is ‘highly unlikely’ to completely evade vaccines.

He said: ‘The preliminary data doesn’t indicate that this is more severe. In fact, if anything, the direction is towards less severity.’   

However, Dr Ryan acknowledged that it was possible that existing vaccines may prove less effective against Omicron, which counts more than 30 mutations on the spike protein that dots the surface of the coronavirus and allows it to invade cells.

It comes after researchers at the African Health Research Institute (AHRI) claimed people who received the Pfizer vaccine make 40-times fewer antibodies that can defend against Omicron. 

The scientists examined blood samples from 12 people double-jabbed from Pfizer who had not yet received their booster.

The pre-print study, which is yet to be peer-reviewed, found Omicron could seemingly dodge many vaccine-triggered antibodies. 

However, the study only looked at antibodies, which are just one part of the immune response that fights off the virus. Although they are normally a reliable indicator of immunity.  

It is not clear whether the reduced number of antibodies will translate into lower protection against severe illness, hospitalisation and death among those who catch the strain.

Professor Alex Sigal, a virologist at the AHRI who led the study, tweeted that the results of the study are ‘better than I expected of Omicron’.

He noted there is a ‘very large drop’ in protection from Pfizer compared to other variants, but those who previously had Covid and are vaccinated were more protected against the variant. 

Professor Daniel Altmann, an immunologist at Imperial College London, said the study offers a ‘clear message’ that those who are unvaccinated or double-jabbed ‘are likely to be highly vulnerable to infection’. 

‘However, those who’ve seen spike three times, either by boosting or by infection plus two doses, appear generally in the safety zone, even with a 41-fold drop,’ he said. 

The study provides ‘an even stronger argument for getting boosters as widely and rapidly as possible’, Professor Altmann said.

And Professor Penny Ward, an expert in pharmaceutical medicine at King’s College London, said it is ‘not surprising’ that higher levels of antibodies are needed to neutralise Omicron compared to other strains due to its ‘complex series of mutations’.

She noted that when scientists looked at other strains in the laboratory they found similar reductions in vaccine effectiveness, but this did not lead to a real-world drop in protection against severe illness. 

‘After a year’s experience with the Covid vaccines, we know that lower levels of antibodies, while being less effective at preventing infection, remain very highly effective at reducing hospitalisation and mortality rates,’ Professor Ward added.

And Professor Jonathan Ball, a virologist at the University of Nottingham, noted that while ‘the amount of virus killing observed in the lab is reduced markedly – up to 40-times reduction – there is still measurable virus neutralisation, especially in those who were vaccinated and previously infected.’

‘This group effectively mimics what we would expect in people who had had two doses of vaccine plus a boost,’ he said.

Professor Ball added: ‘Whilst we do not fully understand what protective immunity looks like, the data should give us reassurance that the vaccine will still offer protection.

‘The other thing to remember is that many of the vaccines also generate T cell immunity and we think that this will be less impacted by the high level of mutations that omicron has.

‘Whilst this reduced antibody immunity might mean more people can be infected and have mild symptoms, I am still confident that the vaccines, especially after a boost, will still protect from serious disease. 

‘That’s why we still need to get the message across, get vaccinated, get boosted, even if you have been infected before.’ 

A separate study by researchers in Sweden found that while there is a drop in the body’s ability to neutralise Omicron, it is not seen in everyone and is a smaller drop than feared.

Scientists at the Karolinska Institute in Stockholm found there was an average seven-fold drop in neutralisation potency among 17 blood donors.

Benjamin Murrell, an assistant professor in computational biology, virology and immunology and one of the researchers behind the study, said this is ‘certainly worse than Delta’ but is not ‘as extreme as we expected’. 

He said Professor Sigal’s study reported a ‘much more substantial average reduction’ but noted ‘what is common is that neutralisation is not completely lost for all samples, which is positive’. 

A third set of results shared by researchers in Germany found neutralising antibodies from two doses of the vaccines used in the UK are ineffective against the strain. 

Dr Sandra Ciesek, a virologist at the German Center for Infection Research, tweeted laboratory findings, which have not yet been published.

They show that six months after two doses of Pfizer or Moderna, or a first dose of AstraZeneca and second dose of Pfizer, there was no neutralising antibodies present that could protect against Omicron. 

And even three months after being boosted with the Pfizer jab, people had just 25 per cent protection from neutralising antibodies against Omicron, compared to 95 per cent protection at the same point against Delta. 

Dr Ciesek said this translates into a 37-fold reduction against Omicron compared to the Delta strain. 

The findings confirm that developing new vaccines that target Omicron ‘makes sense’, she said.

But Dr Ciesek noted that the results ‘cannot say anything’ about whether people are still protected from severe illness, which other parts of the immune system play a key part in warding off. 

Professor Francois Balloux, a geneticist at University College London, said results from the different neutralisation studies are difficult to compare and it is too early to know why the results from the German study ‘look so much worse’. 

‘Whatever the reason, those results do not suggest that neutralising antibody activity can be restored by a third dose,’ he said.

‘Those results suggests that a large proportion of the population globally is at risk of (re-)infection by the omicron variant over the coming months,’ Professor Balloux said. 

But he noted milder symptoms have so far been recorded among those infected with Omicron.

And real-world data suggests vaccines are still protecting against severe illness through other antibodies and T cells, Professor Balloux added.

Top US scientist Anthony Fauci echoed the WHO’s view, saying Omicron did not appear worse than prior strains based on early indications – and was possibly milder.

The new variant is ‘clearly highly transmissible,’ very likely more so than Delta, the current dominant global strain, Fauci told AFP.

‘It almost certainly is not more severe than Delta,’ he added. ‘There is some suggestion that it might even be less severe.’

But he noted it was important to not over-interpret this data because the populations being followed skewed young and were less likely to become hospitalised. Severe disease can also take weeks to develop.

‘Then as we get more infections throughout the rest of the world, it might take longer to see what’s the level of severity.’  

‘Professor Lockdown‘ Neil Ferguson today admitted that another nationwide shutdown could be on the cards to tackle Omicron. 

The Government scientist, whose modelling bounced No10 into the original lockdown last spring, said the return of stay-at-home orders ‘certainly might be possible’ if the mutant strain threatens to overwhelm the NHS. 

He told the BBC Radio 4 Today programme: ‘There is a rationale, just epidemiologically, to try and slow this down, to buy us more time principally to get boosters into people’s arms because we do think people who are boosted will have the best level of protection possible, but also to buy us more time to really better characterise the threat.’

Asked outright if a lockdown could be reimposed, he said: ‘Clearly if the consensus is it’s highly likely that the NHS is overwhelmed then it will be for the Government to decide what to do about that but it’s a difficult situation to be in of course. It certainly might be possible at the current time.