Detection of Omicron Variant in Indiana

20 Dec Detection of Omicron Variant in Indiana

The IDA COVID Task Force continues to monitor COVID-19 on behalf of members. Below is a message from the Indiana Department of Health regarding detection of the Omicron variant in our state.

On December 18, the Indiana Department of Health laboratories identified the first Indiana resident infected with the Omicron variant. This individual is an adult who was not vaccinated. This case was identified through routine sequencing surveillance.

Studies have shown that the Omicron variant is more infectious that the Delta variant, resistant to certain therapeutics, and can possibly evade vaccine- or infection-induced immunity. Preliminary laboratory-based studies show decreased vaccine- and infection-induced antibody neutralization of the Omicron variant (see Background). Studies are underway to determine if the Omicron variant causes more severe illness; however, given its greater transmissibility, it is expected that a proportional number of people may require hospital care, further stressing hospital systems that are already burdened. The Omicron variant is expected to become the dominant strain in the US in a few weeks.

COVID-19 vaccine booster doses are extremely important to provide full protection against Omicron. Booster doses are effective at preventing infection, severe illness, and death when compared to people who completed a primary vaccine series but did not receive a booster dose (Bar-On et al. NEJM; Arbel et al. NEJM). Preliminary studies show that a booster dose after primary series vaccination can restore a protective level of antibody neutralization (Pfizer-BioNTech media release) and vaccine effectiveness (Andrews et al. preprint) against Omicron.

Given the effectiveness of booster doses at increasing protection and the emergence of the Omicron variant, the IDOH strongly recommends:

• Everyone 5 years of age or older complete a primary COVID-19 vaccination series.
• Everyone 16 years of age or older who completed a primary COVID-19 vaccination series receive a booster dose at the appropriate time interval (at least six months if received mRNA vaccine primary series and at least two months if received Johnson and Johnson initial dose).
• Individuals who had a prior COVID-19 infection should get vaccinated; people previously infected who are subsequently vaccinated have some of the highest levels of protection.

Background:
The SARS-CoV-2 Omicron variant was first reported to the World Health Organization from South Africa on November 24. The first case of Omicron was identified in the U.S. was identified December 1 and has now been identified in at least 44 states, including Indiana. Cases have now been identified in at least 77 countries worldwide. Countries including the United Kingdom and the US have reported that Omicron cases are doubling every 2-3 days.

Omicron has about 50 mutations, including about 30 on the spike protein, which is predicted to increase transmissibility, confer resistance to certain therapeutics (e.g., monoclonal antibodies), and potentially escape infection-or vaccine-induced immunity. The impact of this variant is still being studied, but early lab-based antibody neutralization studies are showing a significant decrease in the ability of infection- or vaccine-induced antibodies to neutralize Omicron (Pfizer-BioNTechmedia release; Cele et al.medRxiv; Wilhelm etal. medRxiv; Roessler etal. medRxiv). Studies indicate that Omicron transmits 2-3x faster than delta, reinfections occur at 5x higher rate with omicron than delta.

Preliminary evidence indicates that a booster dose after primary series vaccination restores antibody-mediated immunity to protective levels (Pfizer-BioNTech media release) and vaccine effectiveness (Andrews et al. Preprint) against the Omicron variant. Because of the emergence of Omicron and the possibility of waning immunity after the primary series, booster doses are extremely important to provide full protection.

The only way to identify a specific variant, including Omicron, is through genetic sequencing, currently being conducted at public health laboratories, academic laboratories, reference laboratories, and the Centers for Disease Control and Prevention. The IDOHL conducts routine surveillance sequencing to monitor changes and proportions of variants in Indiana.

For any questions, please call the IDOH Epidemiology Resource Center at 317-233-7125 during normal business hours from 8:15-4:15 M-F. For after-hours questions, please call the IDOH Epidemiologist-on-Call at 317-233-1325.

CDC: Moderna and Pfizer Vaccines Preferred Over Johnson & Johnson
Expressing concern over Johnson & Johnson’s COVID vaccine’s very rare link to blood clots, USA Today is reporting the CDC now states a preference for Pfizer and Moderna’s COVID vaccines. It also states that Pfizer and Moderna’s mRNA vaccinations and boosters appear to provide more protection that the J&J vaccine. Click here to learn more.