Back in July 2021, many scientists had the ill-founded view that the C-19 pandemic was dying out and entering an endemic state. Based on my understanding of the interplay between the virus and the immune system, I knew that this was not going to be the case and reacted immediately to this misinterpretation (https://www.voiceforscienceandsolidarity.org/scientific-blog/a-last-word-of-caution-to-all-those-pretending-the-covid-19-pandemic-is-toning-down). Once again, many scientists find themselves with the belief that the emergence of the Omicron variant announces the end of the pandemic and the virus’ transition into endemicity. Their prediction is largely based upon the initial observation that Omicron seems to be causing rather mild disease symptoms which they interpret as being indicative of a virus that—although more infectious—is now becoming less virulent and, therefore, increasingly featuring endemic behavior. I am afraid that once again, I don’t agree—a pandemic can only be tamed by herd immunity. Given the high vaccine coverage rates in most industrialized countries, we have generated anything but herd immunity. I also have yet to hear any compelling evidence concerning significant mutations in the genes that determine SARS-CoV-2’s virulence. Perhaps we should think twice before making statements that are not supported by immunological evidence.
This is what I believe is currently happening.
As Omicron appears largely resistant to neutralizing antibodies (Abs), it no longer strongly binds to vaccinal Abs (still directed at the spike protein [S] of the Wuhan strain). More specifically, Omicron allows for the restoring of full functional capacity of relevant innate Abs. The latter are known to be very efficient in preventing or abrogating productive infection and, therefore, preventing (severe) disease in individuals endowed with an intact innate immune system (i.e., people in good health and without underlying diseases or immune suppression, including vaccine-mediated immune suppression). As vaccinal neutralizing Abs are highly specific, they are less likely to bind to the receptor-binding domain (RBD) of Omicron, which has undergone a multitude of mutations within this very domain. It is, therefore, reasonable to expect that the vaccine-mediated Abs will fail to outcompete relevant innate Abs in vaccinees and hence, increase the incidence of asymptomatic infections in this population. It is intriguing that the Israeli Ministry of Health interprets asymptomatic infection in vaccinees as proof of “full protection” despite the fact that Omicron is highly suspicious of bypassing neutralizing antibodies (1, 2). Asymptomatic disease is known to lead to a short duration of anti-S Ab titers (3, 4). However, due to the high level of infectivity of Omicron, re-exposure to the virus is highly likely to occur with a timeframe that is short enough to coincide with elevated anti-S Ab levels. Consequently, dominant circulation of Omicron would ultimately make vaccinees more frequently susceptible to disease, whereas fewer and fewer unvaccinated individuals would be susceptible to contracting C-19 disease as a result of innate immune training upon viral exposure. In conclusion, it seems highly unlikely that dominant circulation of Omicron will result in diminished incidence of disease and cause the pandemic to transition into an endemic state. In contrast to the situation in the pre-Omicron era, the incidence of disease is now likely to disproportionately increase in vaccinees. This may, once again, prompt public health authorities to follow the erroneous advice of the vaccine industry and key opinion leaders who will undoubtedly recommend to continue the mass vaccination program using updated vaccines that suit the S version of the Omicron variant. In a previous contribution, I’d already predicted the dire consequences such a decision would entail (https://www.voiceforscienceandsolidarity.org/scientific-blog/mass-vaccination-will-push-sars-cov-2-spike-protein-beyond-omicron)—in brief, it will allow the virus to make a natural selection favoring hosts who preserved a fully functional innate immune defense.
Geert Vanden Bossche received his DVM from the University of Ghent, Belgium, and his PhD degree in Virology from the University of Hohenheim, Germany. He held adjunct faculty appointments at universities in Belgium and Germany. After his career in Academia, Geert joined several vaccine companies (GSK Biologicals, Novartis Vaccines, Solvay Biologicals) to serve various roles in vaccine R&D as well as in late vaccine development.
Geert then moved on to join the Bill & Melinda Gates Foundation’s Global Health Discovery team in Seattle (USA) as Senior Program Officer; he then worked with the Global Alliance for Vaccines and Immunization (GAVI) in Geneva as Senior Ebola Program Manager. At GAVI he tracked efforts to develop an Ebola vaccine. He also represented GAVI in fora with other partners, including WHO, to review progress on the fight against Ebola and to build plans for global pandemic preparedness.
Back in 2015, Geert scrutinized and questioned the safety of the Ebola vaccine that was used in ring vaccination trials conducted by WHO in Guinea. His critical scientific analysis and report on the data published by WHO in the Lancet in 2015 was sent to all international health and regulatory authorities involved in the Ebola vaccination program. After working for GAVI, Geert joined the German Center for Infection Research in Cologne as Head of the Vaccine Development Office. He is at present primarily serving as a Biotech / Vaccine consultant while also conducting his own research on Natural Killer cell-based vaccines.