NVI and WHO advise on COVID vaccines and new variant
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NVI and WHO advise on COVID vaccines and new variant

National Vaccine Institute (NVI), led by Dr. Nakorn Premsri, Director, in close collaboration with the World Health Organization (WHO), led by Dr. Jos Vandelaer, WHO Representative to Thailand, organised an online seminar on “How to handle when the new variant arrives” on December 15, 2021. The panellists emphasised the importance of complete vaccination doses along with personal preventive measures in order to control the outbreak and efficiently reduce the risk of infection or severe illness from COVID-19.

Regarding the spread of Omicron variant, Dr. Supakit Sirilak, Director-General, Department of Medical Sciences, revealed that from 1 November 2021, 14 patients were found, with nine confirmed to be infected with Omicron (as of 15 December 2021). However, variant identification is not typically conducted and is reserved to certain medical science centres and universities only as the symptoms and treatment for each variant are not different. 

The Omicron is mutated from other variants, including many of their characteristics and properties such as rapid spread and stronger immunity resistance in some vaccines. However, the symptoms are not more serious compare with other variants. In Thailand, COVID-19 variant identification can happen in triple tests of RT-PCR, Target Sequencing, and Whole Genome Sequencing. 

Dr. Supakit reassured that the Department of Medical Sciences test can definitely detect Omicron. Nevertheless, he said people still need to follow VUCA measures: Vaccine, Universal Prevention, COVID-Free Setting, and Antigen Test Kit (ATK).

Regarding vaccine readiness, Dr. Piyanit Thammapornpilas, Department of Disease Control, said: “According to studies in Thailand and abroad, every vaccine available can effectively prevent serious illness and over 90% of hospitalisations and deaths from COVID-19. However, no vaccine can completely prevent virus infection. Normally, immunity decreases naturally after a while.”

She said that according to a domestic study, full doses of inactivated vaccines, such as Sinovac and Sinopharm, which use inactivated technology to fight the disease, can prevent up to 60% of infection in the early stages. With a booster, prevention increases to 90% in the first week. Next, the viral vector type (AstraZeneca) and the heterologous vaccine can prevent up to 70% of infection with a full dose. Lastly, those having received two doses of mRNA vaccines (Pfizer and Moderna) at this moment do not need a booster shot as immunity will remain high.

Dr. Piyanit added: “The Ministry of Public Health has established guidelines for booster vaccinations. At present, the government is urging risky groups, namely the elderly, people with congenital diseases and pregnant women, to receive a booster dose to accelerate the immune response against the mutated virus. The government has secured over 120 million doses for 2022, enough to meet the demand for vaccines in Thailand, and is inviting everyone to get vaccinated, including unvaccinated groups, those who have not completed full dosage and those due to get the booster shot.”

Dr. Sunate Chuenkitmongkol, Deputy Director, NVI, explained the COVID-19 vaccine effectiveness  : “The Delta variant is still the main cause of illness but Omicron is increasingly prevalent. Nonetheless, the current vaccines are still effective. Data from the United States reveals that individuals who receive the full dose of vaccination are five times less likely to be infected with Delta, ten times less likely to be hospitalized and ten times less likely to die from COVID-19, compared to unvaccinated people. Moreover, researchers in South Africa, where there Omicron spread a couple of weeks ago, revealed that the variant is good at evading immunity. It was initially found in the younger population but affects the unvaccinated the most. It was also found that a patient can get infected with the virus more than once.

“In the United Kingdom, the government is campaigning for booster shots, setting the goal of 1 million doses by the end of 2021,” she said. “Moreover, WHO recommends that people who received inactivated virus type vaccines and those with weak immunity should get a booster dose to prevent serious illness. Plus, personal preventive measures should be strictly followed.”

Dr. Weerawat Manosuthi, Bamrasnaradura Infectious Diseases Institute, addressed the urgency of building immunity among vulnerable, immunocompromised groups, including the elderly, people with congenital diseases, pregnant women of over 12 weeks, patients who have received organ transplants, untreated HIV patients, people with comorbidities and patients with allergies.

“They generally build less immunity than normal or receive immune-suppressants. Consequently, if infected, their symptoms will be heavier. The concern is that the efficiency of vaccines after the full dose in vulnerable groups is less than for average people,” he said. 

“For vulnerable groups, an additional dose is recommended over a booster dose. As of 26 October 2021, WHO recommends an additional dose 1-3 months after the first full dose or as soon as possible if over three months for the following individuals: cancer patients who are in the active stage or within 12 months after finishing treatment, and those who are in the first two years of organ transplants or who are taking immune-suppressants.  The group also includes people with very low immunity such as those taking immune-suppressants or steroids, those who receive continuous dialysis and AIDS patients, with a blood cell count lower than 200 cells per cubic mm and have not received antiviral medication.”

Dr. Weerawat added: “The appropriate time to take additional doses varies, so consultation with a doctor is recommended. The standard practice is for an additional dose of the same kind of vaccine as the first full dose. However, personal customisation is possible. In Thailand, the Royal College of Physicians of Thailand (RCPT) recommends three additional doses of mRNA vaccines, one month apart, given one month after the second shot of inactivated virus vaccine. For those who have already received two doses of mRNA vaccines and other heterologous regiments, two additional doses of mRNA vaccines, and one month apart given one month after the second shot are recommended. For immune-compromised individuals and patients previously infected with COVID-19, an mRNA vaccine is recommended.”

Watch the online seminar featuring a question & answer session on related issues at https://www.facebook.com/nvikm/videos/1229179780825487.

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