Covid-19: Omicron, fourth wave – experts plead with health workers to get their J&J booster shots

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  • Two experts are encouraging healthcare workers to make themselves available for a booster Covid-19 vaccine dose before 17 December.
  • The J&J booster dose offers a strong "top up" to the immune system, she said.
  • SA has experienced a rapid rise in cases and may soon enter a fourth wave.

Healthcare workers in South Africa are strongly encouraged to get their booster shots of the Johnson & Johnson (J&J) Covid-19 vaccine as South Africa heads into its fourth wave of infections.

Covid-19 cases have been rapidly increasing in certain parts of the country. This, after the Department of Health and scientists announced the detection of a new variant of concern, Omicron, last week.

Speaking to Health24, Professor Linda-Gail Bekker, co-investigator of the Sisonke 1 and 2 trials, said a booster dose would make a significant difference and give immune systems a leg up.

"What we know is that the single dose works very well to protect against disease and death. But this additional dose really gives a top up in protection," she said.

Covid-19 is not over

The importance of health workers has increased manifold during the pandemic because they are at the forefront of the battle against the disease.

Said Bekker:

We want our healthcare professionals to be as protected as possible, so we really do want them to take up this opportunity so we know that they've got the best protection. This seems a very important thing to do, especially since it doesn’t look like Covid is over for South Africa by a long shot.

Chairperson of the South African Health Products Regulatory Authority (Sahpra) board, Professor Helen Rees, also told Health24 that "certainly, two doses of J&J vaccine give much superior protection than one dose".

"It's incredibly important that we protect our healthcare workers first, because they're obviously in the front line and at higher risk of exposure.

"We also have the Omicron variant now, which we don't yet know how susceptible it will be to the existing vaccines that we've got. So what we're saying to everybody is get vaccinated – if you haven't been vaccinated at all – but get boosted as soon as possible."

Two doses offer strong protection

Bekker added: "Two doses of J&J really does offer excellent protection according to the ENSEMBLE 2 data - the clinical trial - and so, based on that, we want to offer the best protection to our healthcare workers."

Rees agreed, warning that if health workers, who received their first dose of the J&J vaccine as far back as February, don't get boosted, several things that can happen in the face of the fourth wave.

"[They] will be putting themselves at risk. Secondly, they will be putting their patients at risk if they get infected and spread it to other patients.

"Remember, many patients in hospital are not there because they're Covid patients. They're there for other serious reasons. So they're going to put those patients at risk," she said.

Rees added that healthcare workers were seen as role models to the community, and they should be encouraging others to get vaccinated too because they understand the science and the clinical benefits of the vaccines. 

Uptake not fast enough

Booster doses of the single-dose J&J vaccine became available from 8 November to the 494 424 healthcare workers who received their initial dose during the first phase of the Sisonke trial.

By 25 November, Bekker said that around 100 000 health workers had received their booster shots. She said: "We're over 100 000 now which is a nice step up, but it means we've still got 400 000 to go. So we're very happy that people are beginning to step forward but with the fourth wave coming. We really are encouraging people to go quickly."

Boosters needed for other diseases

She warned that there could be a sense of complacency among health workers.

"I think people thought that they just needed to get this one dose and it was done. So I think there's a little bit of disappointment that hasn't panned out," she added. 

"What we have to reassure people is that there are other diseases, such as flu, where you have to go for a vaccine annually. So this is not completely unprecedented and we don't know yet whether we're going to need more doses after this boost. Maybe that's going to hold us for some time, so we'll have to see," she said.

December deadline

According to Bekker, the Sisonke 2 study will close on 17 December.

Co-investigator on the study, Professor Glenda Gray, previously said that the team aims to provide the government with important evidence about the effectiveness of the booster dose among health workers, as well as what the timing should be between the first dose and booster dose.

Bekker commented: "So there is some urgency, and it is so that we can wrap up this study and get the results to the Department of Health."

What data from Sisonke 1 revealed

Results from the Sisonke 1 study indicated 85% protection against Covid-19-related death, compared to unvaccinated people.

"And this was in the face of the Delta wave and the third surge. It's important to know that," Bekker said.

Sisonke 1's data showed that where there were breakthrough infections among healthcare workers, the majority had been asymptomatic (no symptoms) or were mild cases, Bekker said in September.

Awaiting the SMS

Healthcare workers need to wat for an SMS invitation which contains a link to the online consent form. They then need to read and complete the form in order to receive the booster dose of J&J and participate in Sisonke 2, said Bekker. The process is very simple, she added.

"It's very easy to consent, and then they will get a voucher number that starts with BD (for booster dose). If they go into the site with that BD voucher and their ID book, it will take a few minutes because there are many more sites around the country and the wait is really very short, so it's convenient," she said.

Will a Pfizer booster become available?

The Pfizer booster is a possibility in the future, but it is uncertain when this will happen, Bekker said. Sahpra approval will be required before it can be rolled out.

She said:

What I do see is the numbers going up in the country, and what we have in hand at the moment is the J&J and so, if you want to be topped up and well protected ahead of the fourth wave, then go with what is in hand.

Rees added that Sahpra had not received a submission from the vaccine manufacturers for the evaluation for the use of Pfizer's vaccine as a booster, following a single J&J dose. 

Bekker added: "This notion that J&J is inferior [to Pfizer] has no grounds at all in science, and so we want to advise people that this is not an inferior option and it is the option that is available now, so the recommendation is to go for it."

What about others who've received J&J?

Rees believes that anyone who's had a single dose of J&J should receive a second dose. This includes essential workers, such as teachers.

"Sahpra has been talking to Johnson & Johnson so that we can get the data from them, which they which they're producing through clinical trials, on the benefits of a second dose," Rees said.

This data may then lead to Sahpra approving a second dose for those outside of the Sisonke 2 study.

"Hopefully once we have this data, we'll be able to look at second dose approval for everyone else who has had a single dose," she said.

An opportunity to top up immune systems

It's very important that healthcare professionals are as well protected as possible before the next resurgence, urged Bekker.

"This is an opportunity for a top up to their immune protection and we strongly recommend that people take up this opportunity as quickly as they can," she said.

*For more Covid-19 research, science and news, click here. You can also sign up for our Daily Dose newsletter here.

READ | Covid-19: Three SA experts weigh in on breakthrough infections, immunity, and vaccine hesitancy

READ | Covid-19: Experts urging health workers to get J&J booster before 4th wave

READ | Covid vaccines expected to protect against hospitalisation caused by Omicron, says top expert

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