With the increase in the number of cases, COVID-19 vaccines are on the agenda again... With the ascent in Türkiye as well as in the whole world, experts are calling for a return to masks, distance, hygiene measures, and vaccination. So how much do the vaccines, which were said to be effective in previous variants, protect from new variants of Omicron? Yeditepe University Hospitals Medical Microbiology Specialist Prof. Dr. Pınar Çıragil answered the questions about the course of the epidemic and vaccines.

• Can you evaluate the COVID-19 table for now? Was it a foreseen picture? An unexpected result?

According to the data of the Ministry of Health, the number of new cases detected around 900 in May was reported as 226,532 in the week of July 11-17, 2022. It is observed that there is a significant increase in the number of cases compared to the previous week. As all over the world, the measures/restrictions have been lifted with the last wave starting to fade in Türkiye and today we have faced a new wave.
It is now clear that we are in a similar situation to last summer; moreover, we know that in the ongoing COVID-19 wave this time, especially BA.4 and BA.5, which are the lower lineages of the Omicron variant, are transmitted faster than previously circulating viruses.

• What would be the reflection of this picture for the coming period, especially for the autumn?

With increasing cases, as schools open in the fall and winter, as people return from vacation, and with the onset of cold weather, social mobility indoors will increase even more.  This may also cause an increase in hospitalizations in hospitals and intensive care units due to COVID-19 since measures such as wearing a mask are also removed from the application. With the latest wave, rates of hospitalization due to COVID-19 have doubled, while ICU admissions have remained relatively low so far. However, while infection rates in older groups continue to increase, close to 3,000 people are still reported to die from COVID-19 in Europe each week. 
These numbers paint a picture of the recent past. However, while it is much more difficult to look to the future and prepare for the future, the necessary regulations need to be put into practice and measures need to be taken.  It may be too late to wait until autumn to take action. To this end, who has published its autumn/winter strategy for COVID-19 and other respiratory viruses to help prepare for future waves of infection  
In this context: Performing booster doses by completing the vaccination schedule, Administering a second booster dose to immunocompromised persons and their close contacts and considering giving a second booster dose to certain at-risk groups at least 3 months after their last dose, Promoting the wearing of masks in indoor spaces and public transportation vehicles, Ventilation of crowded environments and public spaces (such as schools, offices, and public transport) is recommended.

• Is the risk related to the disease ongoing these days when measures are almost eliminated? What should especially the elderly, children, and pregnant women pay attention to?

Currently, there is also a very active flu season in the southern hemisphere, which creates constant pressure on health systems with COVID-19. A similar scenario is likely to be seen in the northern hemisphere in autumn and winter. Although more attention should be paid to the elderly and the immunocompromised patient group, it is important to be careful not to be in crowded environments, to encourage the use of masks, to pay attention to physical distance, and to be careful not to be in crowded environments.
Pregnant women have a higher risk of being affected by COVID-19 than non-pregnant people. In addition, there is a risk of complications that may affect the pregnancy process and the developing baby when COVID-19 occurs during pregnancy.
Pregnant women should also pay attention to protection by getting a COVID-19 booster vaccine and using a mask when the time comes and pay attention to not being in indoor environments and physical distance.

• The vaccination process has started again. What can you say about that?

The CDC recommends a COVID-19 vaccine for everyone ≥ 6 months. This includes people who are pregnant, breastfeeding, or who may become pregnant in the future. The CDC also recommends COVID-19 vaccinations for infants 6 months of age and older whose mother has been vaccinated or had a COVID-19 infection while pregnant or before. It is also important that people 50 years of age and older and people who are immunocompromised also have their booster doses.
COVID-19 vaccine booster doses should be administered to reduce transmission to minimize serious illnesses and deaths, protect health care capacity, and protect high-risk populations.

• Does vaccination help to relieve the disease?

Adults 65 years or older who have been fully vaccinated with the COVID-19 vaccine have been reported to have a 94% reduction in the risk of hospitalization due to COVID-19, and vaccination is 64% effective among partially vaccinated. According to these data, the risk of hospitalization and serious illness is considerably reduced in individuals who are fully vaccinated and receive a booster dose at the appropriate time.

• Are new vaccines also effective for BA.4 and BA.5?

While data are limited at this time, there are reports that two doses of the mRNA vaccine are less effective in preventing Omicron infection than previous variants, with good rates of protection against more serious diseases requiring hospitalization. We also know that a supportive dose is a valuable tool in protecting against infection, and we hope that the supportive dose will provide very good protection against serious diseases. 
Applying booster doses, encouraging mask-wearing, staying indoors for a minimum of time, and paying attention to physical distancing are important to help protect society and maintain health system capacity against COVID-19 at this time.

• How do those who are under-vaccinated manage the disease?

Although vaccination in Türkiye was quite successful and started early, the first elderly group was vaccinated with inactivated vaccines. But we know that inactivated vaccines are not as protective as mRNA vaccines. For this reason, booster doses should be given to all segments of society, especially to elderly people, immunocompromised people, and children before schools are opened. It is seen that hospitalization, severe illness, and intensive care admissions are higher in people who do not receive booster doses and are under-vaccinated. 

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