Update on Omicron, Covid-19 boosters and ME/CFS

Omicron (B.1.1.529), Covid-19 boosters and ME/CFS

On November 25th scientists in South Africa, where cases of Covid-19 have been rising very rapidly, announced that they had found a worrying new variant of the virus that causes Covid-19. Worrying because the new variant has over 30 mutations (changes in the genetic code) on what is called the spike protein. This is the part of the virus that enables it to gain entry into human cells. The spike protein is also the target area for antibodies that are produced by Covid-19 vaccines. The new variant is also now present in over 25 countries, including the UK – where there are over 200 cases with the numbers here rising quite rapidly as well.

Scientists from around the world are trying to find out whether this new variant is going to (a) be more infectious/transmissible than the delta variant and (b) produce more serious disease We also need to know whether Covid-19 vaccines are still going to provide a high degree of protection from developing serious disease if someone catches the new variant. At the moment there is a high degree of uncertainty about all three concerns. But we should have some fairly reliable answers within the next two to three weeks.

In the meantime, some preliminary information indicates that omicron:

• appears to be significantly more transmissible/infectious than the current delta variant – possibly twice as infectious
• is producing milder and slightly different symptoms in younger people who catch it in South Africa. But there is very little information on severity in older or medically vulnerable people and in people who live outside South Africa
• may be more resistant to current vaccines – as some early data from the UK has found that around half of people testing positive for omicron had been double vaccinated

Covid Boosters

In response to this new variant, the UK government has decided that there should be an urgent and rapid expansion of the Covid booster vaccination programme – as the third/booster stimulates a further large rise in protective antibodies and T cells (which attack virus infected cells).

In addition to everyone over the age of 40 being offered a booster once they are 6 months on from their second vaccine, the booster campaign is being widened to everyone over the age of 18. And the same time the distance from the second vaccine to the booster jab is being reduced from 6 to 3 months. The aim is to do all this by the end of January. Clearly, delivering all these boosters cannot be done at once.

As already pointed out in our guide to flu and covid vaccines, experiencing a short-lived period of minor side effects, or an exacerbation of ME/CFS symptoms, is quite likely after a Covid-19 vaccine. However, a small number of people have had a more severe and/or persistent adverse reaction to first or second vaccines and this is obviously going to influence decisions on whether to have a booster. Feedback from people with ME/CFS who have had a booster dose indicates that having a painful arm, feeling generally unwell, and having some other relatively minor side effects are quite common but usually not lasting for more than 48 hours or so.

So it’s worth planning ahead and doing so at a time when you can take things very easy for the next few days after the booster. We have received very little feedback from people who have had a more severe reaction to their booster dose.

Booster doses are normally being given using the Pfizer vaccine. If Pfizer is contraindicated because of a previous severe reaction, the alternative is a half dose Moderna vaccine, which produces an equally robust rise in protective antibodies

Please note: In some parts of the country the availability of Moderna is limited to special sites – which may involve investigation to find a location, pre-booking, and a long journey to get vaccinated

More information:

NHS Book or manage a Covid-19 vaccination or booster, please click below:

‘To Whom It May Concern' (TWIMC) template letter explaining why people with ME/CFS have a vulnerable medical condition in relation to Covid-19 vaccinations.

MEA leaflet covering Flu, Covid-19 and Pneumococcal vaccines

What happens if you have a flu vaccine and a Covid-19 booster at the same time?

Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association.
Member of the 2018-2021 NICE Guideline Committee.
Member of the 2002 Independent Working Group on ME/CFS.