Yeah, BA.5 is going to be with us a bit. 
https://twitter.com/bob_wachter/status/1543780581074292739?s=21&t=VGAk0Rekl4dn9deauxEYdg
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I’m sorry! Hopefully a very mild case for him.
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I’m going to guess that we have BA.5 here, given that DS5 is reinfected after a month. I could be wrong, but it adds up. Luckily we all seem to be recovering well.
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I’m so sorry you took home this “souvenir”. We’re doing a road trip starting next weekend, and I feel sort of like I’m back in 2020 with not entirely understanding how likely transmission is in certain circumstances (when masked, when outdoors, etc.). Praying everyone in your household continues to recover well.
Given Florida’s regional prevalence data, probably, although it could also be BA.4. Those two are in a horse race with BA.5 in the lead. Even though they are often referred to as BA.4/5, that’s just because of concurrent timing, not because they are necessarily similar enough to prevent infection from the other. They are both highly transmissible, which is some TBD combination of innate transmissibility and immune evasiveness. So it’s likely whichever one is better able to overcome immunity from whichever variant DS5 previously had.
So, this is the dilemma we’ve gotten ourselves into:
https://twitter.com/dgbassani/status/1542991378073935877?s=21&t=9hq6ilWDjWJO17x6lMoZtQ
Same situation in the UK:
I’m guessing it would look similar in the US if someone graphed it that way. Can’t find one right off, but this is similar, and shows UK in comparison.
Remember, many of these Omicron subvariants (BA.1x, BA.2x, BA.4x, BA.5x…) are so distinct from each other, they could easily be given their own Greek letter, but apparently they are saving that for the next “out-of-left-field” twist on the evolution tree (like Omicron was).
He saw this emerging back in April:
By letting this spread undeterred, we have given rise to enough distinct evolutionary branches that prior infection gives little-to-no protection against new infection. The current vaccinations based on the common ancestral variant for all of these are giving some protection against infection, but it’s lessening the further it evolves. There is still a fairly solid degree of protection against severe outcomes in the acute state of the disease from the current vaccinations, thankfully. Long Covid is another story. (I’m overdue to post an update on that. Spoiler, it’s a mixed bag of news.)
With this degree of mutation, which variant will be here in November, and which second generation booster would protect best against it, is complete guesswork. Shooting blindfolded at a moving target. Not setting ourselves up for success at all.
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Talking to an epidemiologist friend of mine, the hope is that whatever varent is around in the winter is a descendent of BA.4/BA.5, so that having a vaccine based on that and the ancestral strain (even if not a perfect match) will offer decent protection better than the current boosters. It’s not a bad guess considering we are flying blind otherwise.
Unless we get another out of left field variant (a possibility, but no one has any idea how likely - I’ve seen estimates from a 10% chance to a 33% chance) the new vaccine should be a closer genomic match than what we have been using to this point. 
Until we get to next generation vaccines (nasal, inhaled, pan-coronavirus) I think this is the best we can do given the current mood in the world.
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I would be somewhat more comfortable with this if BA.4 and BA.5 had evolved from BA.2.12.1. But my understanding is they evolved from BA.2? As did BA.2.75, which is the new one gaining traction in Twitter chatter. A BA.4/5 descendent prediction could be spot on. Or that evolutionary branch could be well in the rear view mirror.
I believe that the WHO is recommending that the gen 2 booster be based on BA.1 for broader coverage of any Omicron descendent. Sounds like the US is betting on BA.4/5. 
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Note: We know the earlier bivalent vaccine formula trials were based on earlier Omicron variants (I can’t recall which one(s) specifically), and I believe they still need to do human trials on BA.4/5, so presumably they’ll continue the earlier trials in parallel to try to hedge bets. I don’t know at what point is the final decision to ramp up manufacturing. I don’t think the US has even placed an order yet.
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@amvanhoose_701479 I don’t know how you’re still keeping up with all of this on top of the nine million other things you do every day but thank you.
Edited to tag the right liner.
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The FDA said there was no need for human trials for the fall vaccine as there wouldn’t be time. I think the logic around 4/5 is that they have enough of Omicron in their Genome but also have some key immune escaping mutations that it would be good to get it on the vaccine circulation.
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I looked it up. They are based on BA.1 (alias for B.1.1.529.1).
FWIW, I don’t know if they’ve ever fully resolved this. Bedford said this back in April.
I’ve seen a couple of places referring to BA.4/5 as descendent from BA.2 (but no mention of potentially BA.2.12.1 as the parent and probably unlikely given geographic emergence), but Pango still has them listed as BA.1/B.1.1.529 descendents.
https://cov-lineages.org/lineage_list.html
But regardless of all that Bedford has weighed in for BA.4/5 so
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My understanding is that they still need to do the human trials, but the efficacy data phase doesn’t need to be complete prior to EUA. They will complete safety data phase in humans prior to EUA though. (But I’m concerned there won’t be Gen 2 formula boosters for kids until efficacy data is complete.)
Also, the US does now have a contract in place.
Clips are from these articles (which were conveniently all linked to each other):
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Also FWIW, it sounds like the types of things they are cutting to make room in the budget for the Gen 2 formula boosters include many of their out reach efforts targeted to reduce health care disparities. For those that care about that.
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Sorry, I know it is most likely posted somewhere and I will ask my doctor tomorrow when I see her but any thoughts on vaccine protection three months out from second booster?
I have a conference I must attend next week and the timing (a week before my trip) is worrying me. I will mask in the sessions but all my meals will be in very, very large groups .
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Thanks - it seems like there is not enough data on the 4 dose. Silly to even think about things out of our control, isn’t it?
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I don’t have stats, but I know many people who avoided infection until the past two months, including several people who had their fourth dose. Not all of them got “sick”; some only knew they had Covid because of testing and fatigue.
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@mikejs78 ‘s experience aside, most people I know who have had covid in the last two weeks (it’s everyone down here, aren’t things looking better in the NE, @PrincipalTinker ?) either never had covid at all before or didn’t come down with Omicron in the winter. A number of 4th dose vaccine people, too.
DD and I do seem to have dodged a bullet from last week’s exposure.
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FWIW, up until the beginning of June we had completely avoided COVID in my family. Now we’ve all had it once, with DS5 having it twice in a month.
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Well, FWIW, this guy has been an interesting follow. He runs a company that handles the immediate turnaround PCR testing for a good chunk of the entertainment industry (some studios test everyone on the set) and other corporate clients. They process the tests themselves. So he is regularly testing mostly the same group of people serially, and he knows their vax status and their infection histories.
Here’s his post from today on the subject.
His tweets are often just his random takes on whatever. But he does give in-the-trench reporting on what he sees at their labs and in the entertainment industry policies.
Examples:
He does have a bit of a blind spot on the usefulness of rapid tests because PCRs are his bread and butter and he doesn’t understand why those aren’t universally available with a few hours turnaround. (Privilege bubble.)
But he has been personally getting people hooked up with monkeypox testing that are being denied testing elsewhere, so I’ll cut him some slack on the rapid test attitude.
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PSA…If you or someone you know is immunocompromised, should be on 5th shot by now. CDC just updated their website last week to try to make this crystal clear because there’s been a lot of confusion. Evushield can be added as another layer of protection.
Younger ages, J&J recipients, etc are detailed on the website as well:
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