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How worried should I be about omicron BA.2? And do I need a second booster?


All Maine counties are now considered to be at low-risk.

At the same time, COVID-19 cases and hospitalizations have stopped falling as a new, more contagious version of the virus spreads through the state.

And the federal government has just approved a second vaccine booster for certain people, including anyone over 50.

The long winter that saw the delta surge give way to the omicron wave, ended with a steep drop in cases and hospitalizations.

But the COVID-19 pandemic clearly is not over. And a dizzying mix of recent headlines is raising new questions about what lies ahead and what we should be doing to get ready. Here are some answers.

What is omicron BA.2 and should I be worried?

BA.2 is a subvariant, or slightly modified version, of the omicron variant that arrived in Maine in December and caused a massive wave of COVID-19 infections.

BA.2 is about 50 to 80 percent more contagious than the original omicron variant, although scientists say it does not cause more severe disease. While less severe than delta and previous strains of the virus, omicron and omicron BA.2 can still be deadly, especially for those who are unvaccinated and have higher risk factors for severe disease, such as obesity, diabetes and the immune-compromised.

Vaccines hold up well against all forms of omicron, public health experts have said.

What has BA.2 done in other countries and will the same thing happen here?

Other countries have seen mixed impacts, and it’s difficult to know where cases in the United States will go in the coming months based on other countries.

Take Europe, for instance. Seven-day COVID-19 case averages are up in France, the United Kingdom and Germany, but down in Italy, Netherlands, Spain, Norway, Sweden and Poland.

There are many differences between vaccination rates and demographic profiles in other countries and those in the U.S. And timing is an important difference, too. The U.S. is just now coming down from the winter omicron surge and has a high level of population immunity, through vaccination or infections or both, so the BA.2 variant may not spread as easily here.

How far has it spread in Maine? Is BA.2 the reason cases and hospitalizations stopped dropping in recent weeks?

The official Maine CDC report shows that 10.4 percent of samples tested in March are the BA.2 omicron subvariant, but the report lags real-time data by about two weeks. Testing by Walgreens, the retail pharmacy chain, is showing 37 percent of the cases in Maine are now caused by the subvariant.

Dr. Dora Anne Mills, chief health improvement officer for MaineHealth, the parent organization of Maine Medical Center in Portland and seven other hospitals, said BA.2 is likely the reason that cases have stopped falling and are now holding steady at an average of about 200 a day. Some experts have predicted the rate of new cases will increase, at least to some degree.

However, with high levels of immunity in the population, either through vaccines, prior infection or a combination of both, Maine may not see huge spikes in cases. And if cases do climb, hospitalizations may not follow.

Why was another booster shot approved now? Who is eligible?

Immunity from vaccination – as well as from prior infection – wanes over time. So the U.S. Centers for Disease Control and Prevention is recommending a second booster shot for certain people if they got the first booster shot at least four months ago.

Those eligible for the second booster include anyone who is over 50 and anyone who received the one-shot Johnson & Johnson vaccine plus a booster. People who are immunocompromised also are eligible to get a second booster of the Pfizer vaccine if they are at least 12 years old, or the Moderna vaccine if they are at least 18.

The COVID-19 vaccine may end up being similar to an annual flu shot, where immunity needs to be periodically boosted to protect against severe outcomes from the disease.

If I’m over 50 but not at high-risk, should I get the new booster immediately or wait?

The U.S. CDC is strongly recommending a second booster for those over 65 and people with high-risk health conditions.

But opinions vary about others, partly because it’s unclear how long the benefits of another booster will last. As with previous rounds, medical experts agree the second booster is safe.

Mills, the MaineHealth doctor, said that many people 50 and older have at least one of the risk factors to justify a second booster. For instance, even a sedentary lifestyle puts one at higher risk.

Dr. Bob Wachter, an epidemiologist with the University of California San Francisco, said in a tweet last week that a second booster is an “easy call” for seniors and people at high risk, but “more of a toss-up for lower-risk.” Wachter said even for a healthy 50-year-old, there are marginal benefits for getting a second booster.

Dr. Eric Topol, founder and director of the Scripps Research Translational Institute and a professor of molecular medicine, said in a blog post that he would “recommend the second booster if you are more than 4-6 months from your third shot, you are age 50 plus, you tolerated the previous shots well, and you are concerned about the BA.2 wave where you live…. Or if you are traveling or have plans that would put you at increased risk.” It takes about two weeks after vaccination to get the full immune  response.

But Topol also said “if you had three shots and an omicron breakthrough infection, there’s little need for getting a second booster at this point. You’ve got some hybrid immunity.”

Where can I get the second booster shot?

Pharmacies and medical providers continue to offer vaccines and booster shots at no cost, but you should check ahead.

Some medical providers are offering the second booster to all eligible patients, while others are providing them to those at highest risk.

Dr. Nirav Shah, director of the Maine CDC, said in a post on Twitter last week that the boosters should be widely available soon.

“Providers in Maine are already administering second booster doses to those who are eligible. But as with prior changes, it may take some providers a bit of time to adjust their systems to make the shots more widely available,” he said.

To get help finding a vaccination site, go to maine.gov/covid19/vaccines or call 1-888-445-4111.

What is the new COVID pill and does it mean the pandemic is finally over?

Paxlovid is a new oral medication that – if taken early after the onset of symptoms – reduces the chance of hospitalization from COVID-19 by nearly 90 percent.

Other approved treatments – such as monoclonal antibodies and remdesivir – are infusions and have to be given in a hospital or outpatient setting. The ramped-up supply of Paxlovid plus the logistical advantages of being in pill form, gives the public health system another valuable tool to fight against COVID-19. It’s another way to prevent the hospitals from being overrun with patients. Currently, the pill is approved for those with high-risk factors, such as certain medical conditions, like obesity, diabetes, cancer, those with suppressed immune systems and seniors. Vaccination status does not impact eligibility for Paxlovid.

The availability of the pill does not mean the pandemic is over. We don’t know how the virus will mutate and whether new variants will pose more of a threat. However, at least for now, the pill is another reason public health experts are optimistic about the near future.


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