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A booster clinic for teens in Berkley, Mich., a suburb of Detroit, on Thursday.Credit…Emily Elconin for The New York Times

Booster shots of the Pfizer-BioNTech and Moderna vaccines aren’t just preventing infections with the contagious Omicron variant — they’re also keeping infected Americans from ending up in the hospital, according to data published on Friday by the Centers for Disease Control and Prevention.

The extra doses are 90 percent effective against hospitalization with the variant, the agency reported. Booster shots also reduced the likelihood of a visit to an emergency department or urgent care clinic. The extra doses were most effective against infection and death among Americans aged 50 and older, the data showed.

Over all, the new data show that the vaccines were more protective against the Delta variant than against Omicron, which lab studies have found is partially able to sidestep the body’s immune response.

It is generally accepted that booster shots keep people from becoming infected, at least for a while. Data from Israel and other countries have also suggested that boosters can help prevent severe illness and hospitalization, especially in older adults.

“Data from other countries have also shown significant benefit of getting the booster, but this is really showing it in the U.S.,” Akiko Iwasaki, an immunologist at Yale University, said of the figures released on Friday. “These numbers should be very convincing.”

On Thursday night, the C.D.C. published additional data showing that in December, unvaccinated Americans 50 years and older were about 45 times more likely to be hospitalized than those who were vaccinated and got a third shot.

Yet less than 40 percent of fully vaccinated Americans who are eligible for a booster shot have received one.

New reported doses administered by day

Dec. 20Jan. 2021Feb.MarchAprilMayJuneJulyAug.Sept.Oct.Nov.Dec.Jan. 2022135 million doses1.14 million averagedoses per dayNew dosesreportedSource: Centers for Disease Control and Prevention | Note: Line shows a seven-day average. Data not updated on some weekends and holidays. Includes the Johnson & Johnson vaccine as of March 5, 2021. The C.D.C., in collaboration with the states, sometimes revises data or reports a single-day large increase in vaccinations from previous dates, which can cause an irregular pattern in the daily reported figures.

Friday’s results are based on three new studies led by the C.D.C. In one study, researchers analyzed hospitalizations and visits to emergency departments and urgent care clinics in 10 states from Aug. 26, 2021 to Jan. 5, 2022.

Vaccine effectiveness against hospitalization with the Omicron variant fell to just 57 percent in people who had received their second dose more than six months earlier, the authors found. A third shot restored that protection to 90 percent.

It’s unclear whether protection from the boosters might also wane as it did after two shots, noted Natalie Dean, a biostatistician at Emory University.

“We just have to recognize that all these estimates of Omicron third-dose protection are going to be people who are pretty recently boosted,” she said. “We do wonder the durability of boosters themselves.”

When debating booster shot recommendations for all American adults, scientific advisers to the Food and Drug Administration and the C.D.C. repeatedly bemoaned the lack of booster shot data that was specific to the United States.

There are differences between Israel and the United States — for example, in the way Israel defines severe illness — that made it challenging to interpret the relevance of Israeli data for Americans, they said.

Omicron in retreat. Though the U.S. is still facing overwhelmed hospitals and nearly 2,000 Covid-19 deaths a day, encouraging signs are emerging. New cases are plummeting in several parts of the country, and recent studies of wastewater are helping scientists learn more about the Omicron variant.

Free tests and masks. The Biden administration’s new website allowing each U.S. household to order up to four free at-home tests is live. The White House also announced that it would make 400 million N95 masks available free of charge at health centers and pharmacies across the U.S.

Around the world. Austria is nearing the approval of a vaccine mandate for almost all adults, putting it on the path to be the first European country with such a wide-reaching mandate. In France, where a presidential election looms in April, officials set a timeline to lift restrictions over the next few weeks.

Staying safe. Worried about spreading Covid? Keep yourself and others safe by following some basic guidance on when to testwhich mask to pick and how to use at-home virus tests. Here is what to do if you test positive for the coronavirus.

Some members of the Biden administration supported the use of booster doses even before the scientific advisers of the agencies had a chance to review the data from Israel. Federal health officials intensified their boosters-for-all campaign after the arrival of the Omicron variant.

The C.D.C. now recommends booster shots for everyone 12 years and older, five months after getting two doses of the mRNA vaccines made by Pfizer-BioNtech and Moderna, or two months after a single dose of the Johnson & Johnson vaccine.

The usefulness of booster shots in Americans younger than 50 was a topic of vigorous debate in the fall. Several experts argued at the time that third shots were unnecessary for younger adults because two doses of the vaccine were holding up well.

Some of those experts remained unconvinced by the new data.

It was clear even months ago that older adults and those with weakened immune systems would benefit from extra doses of the vaccine, said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a member of the F.D.A.’s vaccine advisory committee.

But “where is the evidence that a third dose benefits a healthy young person?” he asked.

“If you’re trying to stop the spread of this virus, vaccinate the unvaccinated,” he added. “We keep trying to further protect the already protected.”

But other experts changed their minds in favor of boosters because of the highly contagious Omicron variant. Even if two doses were enough to keep young people out of hospitals, they said, a third dose could limit virus spread by preventing infections.

“They’re both data-driven, legitimate positions,” said John Moore, a virologist at Weill Cornell Medicine in New York. But at this point, the debate is over: “We are using boosters in everyone, and that’s what’s happening.”



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What to know about the symptoms, severity, and transmissibility of the two strains.

The Delta variant of COVID-19 is no longer the dominant cause of infections in the US. Now, just weeks after it was identified in South Africa—and subsequently named a “variant of concern” by the World Health Organization (WHO)—Omicron accounts for the majority of COVID-19 cases in the US.

As Omicron continues to sweep through the US (and the world), scientists are working to uncover what makes this variant different than previous variants. Information is coming together slowly—Omicron, for example, is less likely to cause severe illness, but it also spreads easier, even among the vaccinated population—but there are still many things we don’t yet know, which is why it’s more important than ever to maintain (or ramp up) COVID-19 safety precautions.

Here, with the help of infectious disease experts and research, we explain what is known about how the Omicron and Delta variants of COVID-19 compare—and what that means for your health.

Omicron vs. Delta: How the 2 COVID Variants Compare



First: Keep in mind that whether we’re talking about Delta or Omicron (or any other variants of COVID-19), it’s still the same SARS-CoV-2 virus—and that means while certain symptoms may appear more prominent or noticeable in one strain versus the other, the symptoms of all COVID-19 variants will be similar, the CDC says.

To reiterate, the CDC says people with COVID-19 can show a wide range of symptoms, spanning from mild to severe illness. Though it’s not an exhaustive list, the following symptoms that are the most common with COVID-19 in general include:

  • Fever or chills
  • Cough
  • Shortness of breath/difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

There’s no official guidance on which symptoms are more prevalent with certain strains of the virus, but there have been a handful of anecdotal reports on symptoms with both variants.

The Delta variant, for instance, seemed to bring on more headaches, sore throats, and runny noses, Tim Spector, a genetic epidemiologist at King’s College London who helps lead the ZOE COVID Study, told The New York Times in June. Meanwhile, fever, cough, and loss of smell were reported less often.

Omicron, too, has seemingly brought on more cold-like symptoms: According to data collected again by the ZOE COVID Study—which requires people to report their disease symptoms in an app—the top five symptoms associated with confirmed or suspected cases of the Omicron variant include: runny nose, headache, fatigue, sneezing, and sore throat. Also like Delta, people with Omicron less commonly reported fever, cough, or loss of smell or taste. Overall, the ZOE COVID Study analysis found “no clear difference in the symptom profile of Delta and Omicron.”


Though the symptom profile isn’t too drastically different between the Delta and Omicron COVID-19 variants, data shows that Omicron appears to be milder than Delta. The most robust information pointing to the decreased severity of Omicron comes from a study funded by the Centers for Disease Control and Prevention (CDC) using data from the Kaiser Permanente Southern California health care system. Though the study was published on the preprint server medRxiv—and thus, hasn’t been peer-reviewed—CDC director Rochelle Walensky, MD, MPH, tweeted out the findings on January 12.

The study looked at data from 69,279 patients—52,297 with the Omicron variant, 16,982 with the Delta variant—between November 30, 2021, and January 1, 2022. When comparing the two variants, the study found that Omicron cases resulted in 53% less risk of hospitalization, 74% less risk of ICU admission, and 91% less risk of death. The study also found that none of the patients with Omicron required mechanical ventilation.

Other preliminary evidence from researchers at Case Western Reserve University showed similar findings: Data from 577,938 first-time COVID-19 patients—14,054 who became ill when the Omicron variant emerged and 563,884 who became ill during the Delta variant’s predominance—found that the infections during the Omicron variant were “significantly less severe” than those during the Delta variant.

“The symptoms are slightly less intense, and it’s a milder disease that results in less hospitalization and death than Delta,” Robert Murphy, MD, a professor of infectious diseases and executive director of the Havey Institute for Global Health at the Northwestern University Feinberg School of Medicine, tells Health.

The reduced severity may be more of a testament to an increasingly vaccinated or otherwise protected population, not the variant itself. According to the most recent data from The New York Times’ COVID vaccine tracker, 61.3% of the global population has received at least one dose of a COVID-19 vaccine. And since the beginning of the pandemic, a total of 321,852,826 people have contracted and recovered from COVID-19. Ultimately, “a population that has been exposed to COVID-19 before, through vaccination or infection, has some semblance of previous immunity, which protects from severe disease,” Joel Chua, MD, chief of surgical infectious disease at the University of Maryland Medical Center and assistant professor at the University of Maryland School of Medicine, tells Health.

Though many experts are looking at the decreased severity of Omicron with cautious optimism, it’s still important to note that, “while Omicron does appear to be less severe compared to Delta, especially in those vaccinated, it does not mean it should be categorized as ‘mild,'” WHO director-general Tedros Adhanom Ghebreyesus, PhD, said in a press briefing. “Just like previous [COVID-19] variants, Omicron is hospitalizing people, and it is killing people.”

Hospitalization rates are rising in the US during the Omicron surge: According to the latest CDC data, an average of 20,637 people were admitted to the hospital for COVID-19 each day from January 5–January 11; that’s up 24.5% from the week prior. According to Dr. Chua, this spike in hospitalizations is more likely due to the increased transmissibility of the virus—the more people who get the virus, the more of a chance for hospitalizations. Because of the decreased severity of the variant, fewer of those hospitalizations will result in severe illness or death, but “we are still seeing people die of Omicron, particularly if they are unvaccinated or vaccinated with [a weakened immune system or] medical condition,” says Dr. Chua.


To see how transmissible or contagious the Omicron variant is, it’s helpful to look at the timeline of the spread of disease: The variant—then known as B.1.1.529—was reported to the World Health Organization on November 24, 2021, after being detected in Botswana and South Africa. The first confirmed case of Omicron in the US was identified on December 1, 2021. Now, just over a month later, the variant makes up 98.3% of all US cases, per the CDC. (The Delta variant is still active in the US, accounting for the other 1.7% of cases.)

Back when Delta was the dominant variant—from July 2021 through December 2021—the CDC reported that it was more than two times as contagious as other variants. Unvaccinated people remained at the greatest risk for Delta infections; they were much more likely to contract the virus and then spread it to others. Fully vaccinated people were still able to get the virus—known as a breakthrough infection—but at lower rates. The vaccine still provided ample protection against severe illness and death.

The data available on the transmissibility of Omicron right now is preliminary, but it shows that the variant spreads more quickly than Delta—which is what researchers suspected early on, based on Omicron’s high number of mutations (there are about 50 altogether; 36 in the virus’ spike protein alone).

preprint study from Denmark shows this increased transmissibility by looking at the spread of Omicron and Delta variants within the same household. Researchers found that Omicron is about 2.7–3.7 times more infectious than Delta in vaccinated and boosted people. In unvaccinated people, however, there was no significant difference in the rates of infection. According to the study authors, if confirmed, these findings support the idea that Omicron’s increased transmissibility could be due to the variant’s ability to evade immunity—not some other characteristic that makes it inherently more contagious.

But the contagiousness doesn’t appear to hinge on Omicron’s ability to evade immunity alone. Other factors that may add to the increased transmissibility of the variant include its shortened incubation period of just three days, as compared to Delta’s four-day incubation period. This could mean those exposed to the virus have less time to take precautions to protect others.

Another possible factor in increased contagiousness: Omicron’s apparent ability to stay in the upper respiratory tract and multiply quicker there. A December study from the LKS Faculty of Medicine at the University of Hong Kong found that Omicron infects and multiplies 70 times faster in the bronchus (the airway that connects the trachea to the lung) than Delta and other COVID variants, which was more likely to affect the lungs. According to researchers, this “may explain why Omicron may transmit faster between humans than previous variants.”

What this means for you

It’s important to keep in mind that, while COVID-19 variants can differ in severity, transmission, and sometimes even how symptoms present, they’re still all the same SARS-CoV-2 virus that has wreaked havoc on the global population for nearly two full years.

That means, even with some differences, the main preventive measures remain the same: vaccines, wearing face masks, practicing social distancing, and keeping your distance from people with the virus (and staying away from others if you have the virus).

Regarding the Omicron variant specifically, the importance of boosters is a key focus at the moment, along with using higher-quality face masks. “Get the vaccine and the booster when it’s available to you, and if you’re in a setting beyond your core group of people or family, wear a high-filtration mask like a KN95,” says Dr. Chua.

The CDC backs that up, as well: On January 5, the agency expanded booster dose eligibility to those 12–15 years old, allowing people ages 12–17 to receive booster doses five months after their primary series of a vaccine, due to a booster’s ability to “help broaden and strengthen protection against Omicron and other SARS-CoV-2 variants.” The CDC also updated their website on January 14 to say that some masks (like cloth masks) provide lower levels of protection than properly fitted respirators (like N95 masks) which provide the most protection.


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Even a fourth shot of a COVID-19 vaccine is “not good enough” to prevent Omicron, according to a preliminary study in Israel.

Sheba Hospital last month tested a fourth shot given to more than 270 medical workers, with 154 getting the Pfizer jab and 120 receiving Moderna.

The researchers revealed Monday that both groups showed a “slightly higher” increase in antibodies than after the third shot — but still not enough to prevent Omicron, the latest variant responsible for the vast majority of infections around the world.

“Despite increased antibody levels, the fourth vaccine only offers a partial defense against the virus,” said Dr. Gili Regev-Yochay, director of the hospital’s infection disease unit leading the study.

The study saw “many infected with Omicron who received the fourth dose,” she said. “Granted, a bit less than in the control group, but still a lot of infections.”

Moshe Geva Rosso, 62 years old receives a fourth dose of the coronavirus disease (COVID-19) vaccine after Israel's Health Ministry approved a second booster for the immunocompromised
Israel is the first country to offer a second booster shot — and fourth overall — to its over-60 population.

“The vaccines, which were more effective against previous variants, offer less protection versus Omicron,” Regev-Yochay said, adding that the vaccines are “not good enough” to prevent the less-severe new variant.

The findings have not yet been published and do not reveal specific data.

A nurse prepares a fourth dose of coronavirus disease (COVID-19) vaccine as part of a trial in Israel, at Sheba Medical Center in Ramat Gan, Israel
The researchers revealed Monday that both groups who received a fourth vaccine in the study showed a “slightly higher” increase in antibodies than after the third shot.

But the study raised questions about Israel’s decision to be the first in the world to offer a second booster shot — and fourth overall — to its over-60 population.

The government says over 500,000 people have received the second booster in recent weeks. But the country has still seen record-high infections recently, even though 80 percent of Israel’s adult residents have received two shots and more than half have gotten boosted.

Hours after releasing the results, Sheba Hospital called for “continuing the vaccination drive … even though the vaccine doesn’t provide optimal protection against getting infected with the variant.”

Hebrew media reported that the hospital was pressured into issuing that statement after the Health Ministry didn’t like the study’s results, according to the Times of Israel.

Israeli Prime Minister Naftali Bennett
Prime Minister Naftali Bennett has backed the decision to move from a seven-day to a five-day mandatory quarantine.

Dr. Nahman Ash, director of Israel’s Health Ministry, also insisted that the findings did not mean the fourth-shot effort was a mistake.

“It returns the level of antibodies to what it was at the beginning of the third booster. That has great importance, especially among the older population,” he told Channel 13 TV.

On Tuesday, the Israeli government said it was shortening the mandatory quarantine period from seven days to five days in order to help keep the economy running.

“This decision will enable us to continue safeguarding public health on the one hand and to keep the economy going at this time on the other, even though it is difficult, so that we can get through this wave safely,” said Prime Minister Naftali Bennett.


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