Alas, this current situation, where some are newly susceptible to infection while others remain protected, is no friend to nuance. It’s difficult to generalize broadly and make bold predictions concerning how well an individual or a population will hold up against infection now or later. But despite Omicron’s knack for circumventing antibodies, it’s clear that prior immunity, be it from vaccines or previous infections, protects from severe outcomes such as death and hospitalization. There has yet to be a variant that negates the benefits of vaccines.
Recently, an early study, which was not peer-reviewed, argued that reinfections are just as dangerous as primary infections, but there is by no means a consensus on this among scientists and medical experts. (The study only really showed that getting reinfected is worse than not being reinfected.) Other scientists are concerned about the long-term risks of multiple reinfections. However, there is no debate that prior immunity, in most cases, reduces the severity of subsequent infections. Catching the coronavirus more than once or after vaccination does not necessarily put someone at risk for the most serious and chronically debilitating forms of long Covid, though more research is needed to understand what might predispose someone to that.
The Food and Drug Administration should move swiftly to authorize new booster shots that target Omicron variants. The existing data suggest that updated shots, even based on earlier Omicron lineages, would be more effective at preventing infections than continuing to use the current vaccine boosters, which are based on the original 2019 coronavirus spike.
In the meantime, if you are eligible, it’s wise to get boosted with the currently available shots, which are still outstanding at preventing hospitalization and death. (This is especially critical for older people.) Wearing a mask when mixing indoors and avoiding indoor dining when case numbers are high remains advisable for those who’d prefer not to kick the tires on their existing immunity. Fortunately, monoclonal antibody cocktails are available that remain effective against BA.5. One such product, Evusheld, is given prophylactically to protect patients, while others are used to treat severe infections. Paxlovid, which can be taken at home, may also be a good option for people who test positive and are eligible for it.
Most immunologists I know are cautiously optimistic about our long-term prospects. We don’t know exactly what this virus will do next, and we should never be dismissive of those who have a high risk profile or are dealing with long Covid. Nonetheless, most of us can have faith in our immune systems, especially when we make use of vaccines and boosters. Recorded history may hold little precedent for the ongoing Covid-19 pandemic. But this is not our immune systems’ first rodeo.
