Will Moderna offer Omicron-containing vaccines to S. Africa, Botswana and WHO to help address vaccine inequity in early 2022?

Daniel R. Lucey, MD, MPH, FIDSA

12/20/2021

Today, Dec. 20, Moderna announced that in early 2022 it will begin clinical trials of an Omicron-specific vaccine and evaluate including Omicron in its multivalent booster program. Importantly, at this time in 2021 and into 2022, they emphasize the value of a booster dose of their current vaccine to increase neutralizing antibodies against Omicron.

In a Dec. 10 Science Speaks post, the concern was raised that non-mRNA COVID vaccines would not perform as well against Omicron as the Moderna and Pfizer mRNA vaccines. As a result, a worsening of global COVID vaccine inequity should be anticipated.

Now Moderna can help fight that vaccine inequity by offering South Africa, Botswana and WHO inclusion in their Omicron-containing vaccine programs for testing in early 2022 and initial vaccine distribution programs.

If Moderna does so, then they will help address the ongoing crisis of global COVID vaccine inequity, especially in Africa. WHO and its partners could implement an equitable distribution program of what initially will likely be limited doses of monovalent Omicron-containing vaccines and perhaps later in 2022 multivalent Omicron-containing vaccines.

In addition, in practical terms (i.e., vaccine doses) Moderna would acknowledge the critical contribution of South Africa and Botswana in first alerting the world to the presence of the Omicron variant; however, much of the world reacted quickly with travel bans and restrictions against these two nations and others in southern Africa. They did the world a great service given that Omicron is the most rapidly spreading variant, the most mutated and the most able to evade both convalescent immunity, and vaccine immunity against infection.

Given these unprecedented abilities of Omicron, in a Dec. 17 post, I proposed that Omicron be recognized as the second pandemic due to SARS-CoV-2 and named the “COVID-21” pandemic virus.

Lastly, concerning data is emerging that Omicron might be as severe as Delta in Europe for individual persons. Even if Omicron is somewhat less deadly for individual patients, it may exceed Delta in total numbers of hospitalizations and deaths due to its ability to infect so many people. Omicron can infect people whether they are unvaccinated, vaccinated-but-not-boosted (or boosted) with an mRNA vaccine, or even previously infected (i.e., “reinfected”).

A small sample of relevant Omicron references from Europe include:

European CDC (Dec. 15): Assessment of the further emergence and potential impact of the SARS-CoV-2 Omicron variant of concern in the context of ongoing transmission of the Delta variant of concern in the EU/EEA, 18th update

European Society of Clinical Microbiology and Infectious Diseases (ESCMID) (Dec. 19): COVID-19 update on the Omicron variant

U.K. London School of Hygiene and Tropical Disease (LSHTM) (Dec. 11): Modelling the potential impact of Omicron in England

U.K. Imperial College (Dec. 16): Report 49 - Growth, population distribution and immune escape of Omicron in England

Denmark Statens Serum Institute (SSI) (Dec. 19): Note that Denmark uses an Omicron-specific PCR and thus identifies Omicron in real-time and without the delay required for whole genome sequencing.

Netherlands (Dec. 19): Has returned to “lockdown” despite holidays.