REGIONAL- While COVID-19 has faded from the headlines the past few months, state health officials and others are still concerned a combination of factors could trigger another spike heading into winter.
In both 2020 and 2021, COVID cases spiked significantly in the fall and winter months, and January 2022 had the single largest spike of the entire pandemic, drive by the Omicron COVID variant. The January spike was relatively short-lived and plummeted dramatically, leading to the year’s lowest COVID case levels statewide in the spring before rising again in July, driven primarily by two new Omicron variants, BA.4 and BA.5.
Since the public health community has transitioned away from using case counts as a measure for COVID, due to the increase of unreported home testing, alternate measures of hospitalizations and death rates have declined only moderately since July, although the trend has been downward.
New bivalent vaccines from Pfizer and Moderna specifically targeting the BA.4 and BA.5 variants were approved in late August, giving health officials hope that Minnesota and the country could avoid another fall spike.
There’s been no increase in COVID activity thus far this fall, but it would be far-fetched to attribute that to the new bivalent booster, as only a small percentage of people— 13 percent in Minnesota— have chosen to receive them.
Health officials acknowledge that immunity from prior vaccinations and boosters wanes over time, meaning the possibility of another surge of COVID cases still looms.
“Cases have been on a steady, but elevated plateau for some time now and there continues to be plenty of virus circulating in our communities,” Minnesota Department of Health State Epidemiologist Ruth Lynfield told the Timberjay last week. “So even though the course of COVID-19 in Minnesota has been challenging to predict, the potential for a surge as we head into peak respiratory disease season over the winter months is real.”
Last week, Pfizer released the results of a small 76-person study showing that its bivalent booster increased antibody levels in people over 55 years old about four times more than the prior non-targeted boosters. The company’s report came on the heels of two small studies conducted by reputable independent labs at Harvard and Columbia Universities showing that the bivalent boosters did not provide a larger response in immunity compared to previous booster. While U.S. Food and Drug Administration official Peter Marks was quick to dismiss the Harvard and Columbia results because of their small sample sizes, he was equally quick to tout the results of the Pfizer study, which had nearly the same number of people in its treatment group as the other two combined.
“Based on all the data we now have in hand, we have confidence in the bivalent COVID-19 vaccines and their ability to create better protection against COVID-19, including these currently circulating variants, than the original vaccine would have,” Marks said about the Pfizer research in remarks reported by CNBC.
However, all three studies demonstrated that the bivalent shots boosted immunity against BA.4 and BA.5, and getting boosted now is something Lynfield strongly supports.
“We recommend that everyone 5 years of age and older who is eligible, receive one dose of the updated booster,” she said. “The updated bivalent booster helps protect against the newer Omicron variants that are circulating and can help restore protection that decreased since previous vaccination. Since it provides broader protection against newer variants, we view it as a key tool in our toolbox for lessening the impact of a potential surge.”
But how those targeted boosters will fare against even newer, more infectious variants that have started to replace BA.4 and BA.5 in the variant pool causing COVID is largely unknown at this point. Since variants such as BQ.1, BQ 1.1, and XBB that are on the rise are derivatives of previous variants, health official have speculated that the bivalent boosters should be at least somewhat effective against them as well.
A second concern for a possible surge in Minnesota is the comparatively low rates of vaccinations and boosters received by school-age children. Less than half of those between the ages of five and 11 have been vaccinated, and only 1.2 percent are up-to-date with the bivalent booster. Booster uptake among students 12-17 is less than half of the overall state rate. Lynfield recommended that parents should have the new booster administered to their children.
“While the risk to children for severe infection with COVID is lower than it is for adults, some children can get very sick,” Lynfield said. “Unlike other respiratory diseases for which we don’t have vaccines, we do have vaccines for the currently circulating variants of COVID-19 and we have vaccines for flu. By getting vaccinated for COVID-19 and for flu, we can reduce the impact of respiratory disease this winter.”
Health officials are also concerned that even a moderate rise in COVID cases paired with the normal rise in cases of the flu and other respiratory ailments at this time of year could create another critical health care shortage, as health care facilities across the state continue to have significant staffing shortages as a result of the pandemic.