The latest on the coronavirus pandemic and the Omicron variant

There’s no doubt that even fully vaccinated people will become infected with the Omicron variant of the coronavirus, but boosters will help protect them more – and the real risk is being unvaccinated, Dr. Anthony Fauci said Wednesday.

Lab evidence indicates that boosters will protect people, however, said Fauci, who is director of the National Institute of Allergy and Infectious Diseases.

“The vulnerable people are the people who have not been vaccinated, and I hope that the possibility that we're seeing -- that we're going to be getting a surge of Omicron, which is almost inevitable given its characteristic of high degree of transmissibility,” Fauci added. “We have the tools to be able to blunt this. We just need to implement them.”

The Delta variant is causing the real trouble now, however, Fauci noted. 

The head of Cornell University said Wednesday that he will make a decision in a few days “as to whether to mandate the booster” to help deal with a rapid Covid-19 surge that is tied to the Omicron variant.

Cornell University announced a shutdown of its main campus because of a spike in Covid-19 cases. The university reported that more than 900 students tested positive this week, and the school says many of its cases are the Omicron variant.

Dr. Anthony Fauci, President Biden’s chief medical adviser, said Covid-19 booster shots can help improve protection against Omicron.

"I will point out that many of our students are not yet eligible to be boosted," Kotlikoff said. "You need to be six months after the last vaccine shot. So many of our students had that shot in August or September and won't be eligible until the spring semester starts."

Only about one in six people in the United States are fully vaccinated and boosted against Covid-19, leaving hundreds of millions at risk as the threat of the Omicron variant looms.

Health officials warn that Omicron could soon become the dominant variant in the US, and preliminary data suggests that a booster dose of the Pfizer/BioNTech or Moderna vaccine provides substantially better protection against the Omicron variant than the primary two-dose series. 

One year into the Covid-19 vaccination campaign in the US, here’s a breakdown of the population’s vaccination status, based on a CNN analysis of data from the US Centers for Disease Control and Prevention: 

Fully vaccinated people 16 and older are eligible to receive a booster shot if they completed their initial two-dose series of Covid-19 vaccines from Pfizer/BioNTech or Moderna at least six months ago or their initial shot from Johnson & Johnson at least two months ago, according to CDC guidance. 

The CDC notes that data on people who are fully vaccinated and those with a booster dose may be underestimated, while data on people with at least one dose may be overestimated.

US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky declined to provide specific details on whether or when the CDC would change the definition of “fully vaccinated” from its current definition to include additional doses of Covid-19 vaccine, saying that data was being evaluated and recommendations would be updated “as necessary.” 

But Walensky’s lack of a specific answer comes as scientists have reported significant increased protection from the Omicron coronavirus variant for those who have received a booster shot. 

Covid-19 booster shots can help improve protection against the Omicron variant and there is no need for a variant-specific booster dose at this time, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said earlier in the briefing. 

Fauci added that the effectiveness of the Pfizer/BioNTech coronavirus vaccine against symptomatic Omicron infection is significantly lower than against the Delta variant, but with a booster dose, it increases to 75% effective.

Walensky declined to say what more data the CDC is waiting on to make such a decision. 

A third dose of Moderna’s Covid-19 vaccine offers protection against the Omicron variant that’s 20 times better than the antibody response of two doses, according to a study from the National Institutes of Health. 

Dr. Anthony Fauci presented a sample of the data on Wednesday during a virtual briefing by the White House Covid-19 Response Team, noting that the full study is part of a series of data that will be published on a preprint server next week.

The neutralizing activity against Omicron was “substantially low” two weeks after just two doses of vaccine, Fauci said, but there was a “substantial degree” of improvement two weeks after a third dose. The data shows that a third dose provides protection that is “well within the range of neutralizing Omicron,” he said.

This data was part of a selection of findings from in vitro studies that Fauci presented on Wednesday.

Fauci also presented data from Pfizer/BioNTech that showed a booster dose greatly improves antibody response to the Omicron variant.

A month after a third dose, antibody levels had risen 25-fold compared to the level of protection three weeks after a second dose.

“This is one of a number of representative studies,” Fauci said.

The US Centers for Disease Control and Prevention’s vaccine advisers will meet on Thursday to revisit the benefits and risks for the Johnson & Johnson Covid-19 vaccine. The Advisory Committee on Immunization Practices is scheduled to vote on the vaccine’s recommendation for use.

According to an agenda posted online on Wednesday, the group will hear presentations about thrombosis and thrombocytopenia syndrome – known as TTS – a rare but serious type of blood clot that has been linked to the vaccine, as well as the benefits and risks assessment of the vaccine.

The CDC has said for months that the J&J vaccine’s known and potential benefits outweighed the known and potential risks. However, it says, women younger than 50 years old should be aware of the rare but increased risk of TTS, which involves blood clots with low platelets. Safety monitoring has been ongoing since the adverse event was first identified in April.

The advisory committee is scheduled to meet from noon to 4 p.m. ET Thursday. It is scheduled to vote at 2:30 p.m. ET. It’s not clear what the voting question will be.

The single-dose Johnson & Johnson vaccine is authorized for use in people age 18 and older, and can be used as a booster shot for adults fully vaccinated with the J&J, Pfizer or Moderna vaccines.

The vaccine advisers will also hear a presentation on vaccine safety in children ages 5 to 11.

During a White House Covid-19 briefing on Wednesday, CDC Director Dr. Rochelle Walensky did not say why the committee was meeting about the Johnson & Johnson vaccine or whether she believes the benefits of the vaccine still outweigh the risks. 

A source close to the situation told CNN the CDC has been "coy" about what the vote will be about, but it may involve limiting who's recommended to get the vaccine.

"I think a fair amount of the discussion will be about J&J — do we need to use this one at all since we have so much of the others, or, if it's used, should it be focused on certain populations?" the source said. "J&J hasn't lived up to its billing as one and done."

"We could just take J&J off the table and do fine in this country," the source said.

The source added that it’s possible the CDC could recommend against the use of Johnson & Johnson’s vaccine in women under age 50. While women 30-49 have seen the highest rates of the TTS blood clot, the source noted that it has also occurred in older women and in men. 

J&J did not address the ACIP meeting in a response to CNN on Wednesday. It acknowledged that the US Food and Drug Administration updated its fact sheets for the vaccine on Tuesday to say people with a history of TTS should not get the Johnson & Johnson's Janssen Covid-19 vaccine.

Johnson & Johnson said "the safety and well-being of the people who use our products is our number one priority" and that it "strongly support raising awareness of the signs and symptoms of this rare event." 

At least 56% of people in the Latin American and Caribbean region have been fully vaccinated against Covid-19, said Dr. Carissa F. Etienne, the director of the Pan American Health Organization (PAHO), in a news conference on Wednesday.

Across the Americas, more than 1.3 billion vaccine doses have been administered, said Etienne, regional director for the Americas of the World Health Organization.

Chile, Cuba and Uruguay are among the countries with the highest vaccine coverage in the world, Etienne said. But still, vaccine inequity pervades the region, Etienne said.

Like the rest of the world, the PAHO is also monitoring the spread of variants, said Sylvain Aldighieri, PAHO’s Covid-19 incident manager.

The Delta variant still dominates in all subregions, but Omicron has been detected in nine countries and territories in the Americas: the United States, Canada, Mexico, Argentina, Chile, Brazil, Cuba, Trinidad and Tobago, and Bermuda.

Most of the cases are associated with travelers, which has limited the amount of transmission data available, Aldighieri said.

“It is important to remind ourselves of the basics of the readiness of health systems and the basics of the operational response to the pandemic,” Aldighieri said. “Regardless of the variants circulating, all the public health already implemented to limit the transmission of the virus are working. Therefore, these measures should be maintained and reinforced.”

The 5th US Circuit Court of Appeals issued an order Wednesday reviving in some parts of the US the Biden administration’s vaccine mandate for health care workers – effectively allowing the mandate to be enforced in about half of states.

The mandate had previously been frozen nationwide by federal judge in Louisiana, whose order followed the move by a federal judge in Missouri that blocked the mandate in 10 states. On Monday, the 5th Circuit — faced with a request by the Justice Department to reinstate the mandate – said that the hold on the mandate will remain in place in the 14 states that brought the challenge in Louisiana. 

However, the appeals court pushed back on the Louisiana judge’s move to issue a nationwide order blocking the mandate, as it scaled back the reach of the judge’s order. The 5th Circuit order did not disturb the move by the Missouri judge to block the mandate in the 10 states in the challenge of the requirement that was brought in Missouri. That order was recently left in place by the 8th US Circuit Court of Appeals.

The vaccine policy in question was rolled out by the US Department of Health and Human Services’ Centers for Medicare & Medicaid Services. 

The agency sought to require the Covid-19 vaccine for health care workers at certain providers that participate in Medicare and Medicaid. Two other major Biden vaccine policies – one dealing with federal contractors and another aimed at companies with 100 or more employees – have also been halted by courts.

The states where the CMS mandate is currently on hold, under the orders of the 5th and 8th Circuit, are Louisiana, Montana, Arizona, Alabama, Georgia, Idaho, Indiana, Mississippi, Oklahoma, South Carolina, Utah, West Virginia, Kentucky, Ohio, Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota and New Hampshire.

Younger adolescents ages 12 to 15 appear to have a "much more robust" immune response to coronavirus vaccines, so they might not need booster shots at this time – but health officials are continuing to examine that possibility, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a virtual White House briefing Wednesday.

"Having said that, we continually look at the durability of response and the level of response in the people that have been followed in the various studies," Fauci added. "So, this is something that we will continue to examine as to the possibility or necessity of providing a boost for that cohort of young people."