JEWISH KING JESUS IS COMING AT THE RAPTURE FOR US IN THE CLOUDS-DON'T MISS IT FOR THE WORLD.THE BIBLE TAKEN LITERALLY- WHEN THE PLAIN SENSE MAKES GOOD SENSE-SEEK NO OTHER SENSE-LEST YOU END UP IN NONSENSE.GET SAVED NOW- CALL ON JESUS TODAY.THE ONLY SAVIOR OF THE WHOLE EARTH - NO OTHER. 1 COR 15:23-JESUS THE FIRST FRUITS-CHRISTIANS RAPTURED TO JESUS-FIRST FRUITS OF THE SPIRIT-23 But every man in his own order: Christ the firstfruits; afterward they that are Christ’s at his coming.ROMANS 8:23 And not only they, but ourselves also, which have the firstfruits of the Spirit, even we ourselves groan within ourselves, waiting for the adoption, to wit, the redemption of our body.(THE PRE-TRIB RAPTURE)
BREAKING NEWS-CNN PROPAGANDISES BIGTIME OVER A AIRPORT LIGHT.
CNN CLAIMES THERES BOMBS GOING OFF IN KVIV LEFT RIGHT AND CENTER. THEY HAD THEIR PROPAGANDA BULL SHITTERS SO CALLED REPORTERS. MILES AWAY FROM AN AIRPORT. WITH CLOUDS LIGHTING UP EVERY FEW SECONDS. AND THE PROPAGANDA BULLSHITTER REPORTER HAD AN ARMY HELMET ON WHILE REPORTING THE SCAM TO CRAP HEAD WOLFF BLITZER. AND THEN FROM THE OPPOSITE SIDE OF THE AIRPORT. CNN HAD THIS 2ND PROPAGANDIST CLARIISSA WARD SAYING OH BEHIND ME THE CLOUDS ARE LIGHTED UP FROM ALL THE BOMBS GOING OFF FROM RUSSIA. SHE WAS FARTHER AWAY. FROM THE AIRPORT THEN THAT ARMY BOY BRAIN DEAD PUPPET ON THE OTHER SIDE. AND NOW HERES THE KICKER. THEM SO CALLED BOMBS GOING OFF IN KVIV-ARE NOTHING BUT THE LIGHT AT THE AIRPORT GOING AROUND EVERY FEW SECONDS. SEE HOW THESE BULL SHIT PEOPHILE NETWORK CNN TRYS TO MAKE YOU BELIEVE. RUSSIA IS SHOOTING BOMBS ON KVIV. WHEN ALL IT IS-IS THE LIGHT FROM THE AIRPORT HITTING THE CLOUDS AND LIGHTING IT UP. COMPLETE PROPAGANDA BULL SHIT. AND DON'T BELIEVE A WORD OR PICTURE CNN DOES FROM UKLRAINE. ITS ALL PROPAGANDA LIES AND BULL CRAP. AND I HOPE RUSSIA READS THIS AND NUKES THE HOTEL WERE THE PROPAGANDA BULL SHITTERS CNN ARE STAYING IN KVIV.
BREAKING NEWS-CNN TONIGHT SUN FEB 27 IS DOING A HIT PIECE ATTACK AGAINST ALEX JONES.AND ALL HIS FOLLOWERS.
WELL LAST NIGHT I CAUGHT CNN FAKING RUSSIAN BOMBS ON UKRAINE. AND TONIGHT THE PROPAGANDA PEDOPHILE COMMUNIST-NAZI LIBERAL WHORE MEDIA CNN. WILL BE DOING A DOMESTIC TERRORIST HIT PIECE AGAINST ALEX JONES AND HIS LISTENERS AT 10PM TONIGHT. YOU JUST READ HOW CNN PEDOPHILE NETWORK FAKED THE BOMBS LAST NIGHT. WELL DON'T BELIEVE A THING THIS LEG SPREADER WHORE OF PROPAGANDA CNN SAYS OR DOES. IT IS JUST TO DIVIDE, TO PROMOTE RACIST-BIGOTED-CHRISTIANPHOBES HATE AGAINST EVERYBODY. WHILE SITTING AS THE QUEEN WHORE HITLARY CLINTON AND SODOMITE MUSLIM OBAMA AS THE OWNERS OF CNN. MIGHT AS WELL BE.
COVID 19 WAS MADE UP IN A LAB BY MODERNA IN 2016 ALREADY.
https://www.banned.video/watch?id=62195fa680e6a52c84a0a376
SMOKING GUN: Genetic sequence in COVID-19 spike protein was patented by Moderna three years earlier-02/25/2022 / By Mary Villareal
New evidence shows that the Wuhan coronavirus may have been tinkered with in a lab when scientists found genetic material owned by Moderna in the spike protein of the virus.The group of scientists detected a small snippet of code identical to the gene they patented three years before the pandemic even hit. They discovered the unique furin cleavage site of the virus, which makes it easier to infect people and separate it from other coronaviruses.Furin is a protease enzyme encoded in the FURIN gene. Some proteins are inactive when synthesized, but they may become active when sections are removed. This gene is responsible for proteolytic cleavage of HIV prior to viral assembly and is also thought to play a role in tumor progression.The structure of the virus has been one of the focal points of debate about its origin, as some scientists claimed that it could not have been acquired naturally. An international team of researchers suggested that the virus may have mutated to have a furin cleavage site during experiments on human cells in a lab.The team said there is a one-in-three trillion chance that Moderna’s sequence randomly appeared through natural evolution. There is also some debate about whether or not the match is as rare as the study claims, as other experts described it as a “quirky coincidence” rather than a “smoking gun.” (Related: If the spike protein facilitates entry of a gain-of-function coronavirus into cells, then why are we coerced to submit to spike protein-generating vaccines?) The SARS-CoV-2 virus, which causes COVID, has all the information it needs to spread in around 30,000 letters of the RNA (genetic code). The virus shares a sequence of 19 specific letters with a genetic section that is owned by Moderna, and 12 of the shared letters make up the structure of the virus’s furin cleavage site. The rest match with nucleotides in a nearby part of the genome sequence.-Moderna filed a patent similar to virus genetic material in 2016 - What makes this interesting, however, is that Moderna filed a patent in February 2016 as part of its cancer research. The patented sequence is part of a gene called MSH3, which is known to influence the repair of damaged cells in the body. The patent was approved in March the following year. (Related: Vaccine researcher admits ‘big mistake,’ says spike protein is dangerous ‘toxin.’) In a new study, researchers compared the COVID-19 makeup to millions of sequenced proteins on an online database, and of the 30,000 letters of genetic code that made the virus, it is the only one of its type to carry 12 unique letters that allow its spike protein to be activated by the common furin enzyme, which made it easier to spread between human cells.Analysis of the original COVID genome also found that the virus shares a sequence of 19 specific letters with a genetic section owned by Moderna.Dr. Balamurali Ambati of the University of Oregon and one of the authors of the paper said the matching code may have originally been introduced to the COVID genome through infected human cells expressing the MSH3 gene.Professor Lawrence Young, a virologist from the University of Warwick, admitted that while the finding was interesting, it is not significant enough to suggest lab manipulation.“We’re talking about a very, very, very small piece made up of 19 nucleotides. So it doesn’t mean very much to be frank, if you do these types of searches you can always find matches,” he said.However, a microbiologist at the University of Reading, Dr. Simone Clarke, questioned whether the find was as rare as the study claims. He said there can only be a certain number of genetic combinations within furin cleavage sites, and they do so like a lock and key in the cell. “The two only fit together in a limited number of combinations.”He also said that while it is an interesting coincidence, it is surely not entirely coincidental.
Chinese whistleblower warns the CCP has several virus bioweapons ready to be released at any time-02/25/2022 / By Arsenio Toledo
A Chinese virologist and whistleblower claims the Chinese Communist Party (CCP) has engineered weaponized versions of several viruses that it is prepared to release at a moment’s notice to start the next global pandemic.This information was revealed during the Feb. 22 episode of “Brighteon Conversations” with Mike Adams and his guest Dr. Yan Li-Meng.Yan, a virologist from Hong Kong, fled to the United States in 2020 after she became a whistleblower and began accusing Beijing of actively withholding research critical to the understanding of the Wuhan coronavirus (COVID-19).According to Yan, the CCP’s bioweapons program is working on overdrive to release a new bioweapon that will cripple the world. While she has not been able to confirm it, stories have recently come out that the People’s Liberation Army, China’s armed forces, may have released a hemorrhagic fever virus during the recently concluded Beijing Winter Olympics. (Related: The next plandemic? China’s People’s Liberation Army launches hemorrhagic fever viral attack during Olympics, says source.) Yan was able to confirm through her team’s investigation that the CCP believed the Winter Olympics is the ideal event to release a bioweapon, as thousands of athletes from around the world converged in Beijing. According to Yan’s sources, the CCP was prepared to launch the bioweapon.However, they were unable to confirm if the CCP pushed through with its bioterror attack.Chinese bioweapons pose a great threat to the world-Even if the CCP did not release a bioweapon during the Winter Olympics, Yan warned that China is still “fully prepared” to launch an attack at any time.But there is still a lot of mystery surrounding these bioweapons, Yan pointed out. She is still not sure what specific pathogen the CCP will release. She mentioned the bioweapon will most likely cause hemorrhagic fever, but that only narrows it down slightly as the CCP has several types of engineered viruses that can cause hemorrhagic fever.“I cannot tell you what kind of pathogens they have already used and what haven’t … and I cannot tell you what exactly changed, gain-of-function or not, they have done in their labs,” said Yan.She then pointed out that the CCP has been experimenting with different kinds of viruses, including parvoviruses, hantaviruses, the measles virus and even the Ebola virus.Without treatment, Yan warned that the CCP’s engineered viruses could cause death rates of up to 90 percent.Fortunately, according to Yan, there is already a cure for most of these viruses. It is a drug known as daratumumab, which is sold by Johnson & Johnson under the brand name Darzalex. The CCP is trying to procure as much of this drug as possible because the communist party’s experiments on its people found that it is effective against the engineered viruses.In a parting statement, Yan said the only way the CCP’s aggression can be countered is for people to wake up and stand together against the threat it poses.She said: “We face the Chinese Communist Party and their worldwide allies. They are very rich, they are very powerful… So we must work together, and at this moment, I think the biggest power is when people wake up, when people understood the importance of their rights and their freedom. And what we can do is we need to stand up to protect our future and our kids future. That’s the most important thing.”
Fully vaccinated individuals are SHEDDING GRAPHENE and infecting the unvaccinated, causing serious health complications-02/25/2022 / By Arsenio Toledo
A physician has warned the public that the graphene in Wuhan coronavirus (COVID-19) vaccines is transforming within people’s bodies. Worse yet, the fully vaccinated are now starting to infect the unvaccinated with vaccine toxins through shedding.Dr. Philippe Van Welbergen, medical director of Biomedics Clinic in the United Kingdom, recently demonstrated that the graphene in the COVID-19 vaccines is organizing and growing into large fibers and structures, gaining magnetic properties and becoming more complex.In mid-2021, Van Welbergen first noticed a problem when he started receiving more and more patients who exhibited an unusual array of symptoms. He explained in an interview with a South African media outlet that his patients started complaining about chronic fatigue, dizziness, memory issues, paralysis and even late-onset of heavy menstruation for women in their 60s.Van Welbergen was concerned that it may have something to do with structural changes in their blood, and so he took blood samples from all of them.Upon examining the blood samples under a microscope, he found that their blood was clumping up and forming strange shapes not typically seen in healthy blood. The shape of individual red blood cells was also not round, but more “crumpled.”Van Welbergen also found that the nuclei of the cells were destroyed and many of them were starting to form large gold tubular structures.All of his patients were vaccinated with Moderna’s mRNA COVID-19 vaccine. They all reported feeling extreme fatigue, dizziness, tiredness, a general aura of “not feeling well” and mental confusion.Thick graphene fibers found in the blood of vaccinated individuals-Van Welbergen explained that the gold tube-like structures resemble the graphene oxide samples found by Spanish researchers. He described them as resembling “folded over toilet paper under paint.” (Related: Researcher sounds alarm after finding PARASITES, nanobots and graphene in COVID-19 vaccines.) During another interview with the same media outlet, Van Welbergen presented images of his latest blood slides and explained what happened to the blood of his vaccinated patients.In one image of a blood sample Van Welbergen shared, he pointed out that the vaccinated individual’s blood was coagulated, the red blood cells were badly misshapen and clumped together and the blood was filled with graphene fibers which dwarfed the red blood cells in size. He warned that graphene fibers these massive could block small blood vessels and cause serious health complications.Van Welbergen also warned that he was starting to notice a magnetic or electric polarity effect on different sides of the graphene fibers. This behavior was not present when he first started examining the blood of his vaccinated patients, but they were now popping up out of nowhere.“These things have changed,” he said. “Their reaction with surrounding blood cells has changed … and I don’t know what triggered it.”-The vaccinated are “shedding” and infecting the unvaccinated-Worse yet, during one interview Van Welbergen showed a blood sample from an unvaccinated three-year-old patient. He examined the blood and found thin shards of clear material that resemble smaller versions of the graphene fibers he found in the blood of his vaccinated patients.The three-year-old’s parents were both fully vaccinated. This led Van Welbergen to speculate that the unvaccinated are now being contaminated by fully vaccinated individuals who were “shedding” graphene.Van Welbergen also had another unvaccinated patient – an eight-year-old child – who came to him because of serious health concerns. The child’s right arm and upper right leg were paralyzed and the child was unable to properly move the affected limbs.When he examined the child’s blood, he found a large mass of graphene that was forcing the red blood cells around it to clump together and get squished. This large mass of graphene is most likely preventing the child from properly using the affected limbs.What this shows is that not only are the fully vaccinated in danger of experiencing severe health complications due to the material in the COVID-19 vaccines, but they are now clear threats to the health of unvaccinated individuals as well.
More Evidence Covid Originated in a Chinese Lab-23 Feb 2022
BUCK: There is more evidence covid was tinkered with in a lab now as scientists find virus contained a tiny chunk of DNA that matches a sequence patented by Moderna three years before the pandemic actually began. This is leading to fresh suspicion that this was a manipulated virus. So China may have been responsible, Clay, through its recklessness and perhaps even worse, and we had to find out exactly what happened here.Fresh lab leak fears as study finds genetic code in Covid’s spike protein linked to Moderna patent | Daily Mail Online https://t.co/uQTsnitu3s— lucy johnston (@thelucyjohnston) February 23, 2022-Unleashing a plague on the world that did take millions of lives and shut down billions of people’s day-to-day lives. But you’ll notice the media cannot summon the same kind of outrage or anger about China no matter what the storyline, whether we’re talking about Uyghurs in concentration camps or anything else. “Russia, Russia, Russia” as a media issue has long-lasting consequences.CLAY: Well, a big reason why — and we had a big discussion surrounding this — is there’s so much feeding at the Chinese trough when it comes to American Big Business. The interaction between Russia and the United States from an economic perspective is relatively small, whereas just think about use as an example Apple or Nike or the NBA and their relationships that exist right now in China, NBC with their acquiring of the Olympic Games when they virtually uttered no criticism whatsoever of anything surrounding China.There is such economic might, such economic power that exists surrounding China that they won’t even pick Asian bad guys now for movies out of Hollywood. You noticed James Bond movies, every villain remains Eastern European. The Russian bad guys were going all the way back to the sixties, the seventies, the eighties, the Cold War era. They won’t even make a bad guy Asian for fear that they might offend their bosses in China.And, Buck, this is where we talk about, we need rigorous investigations of Dr. Fauci because, in addition to this virus escaping from a Chinese lab, it may well have partially been funded by our own tax dollars, and we don’t know because it appears that Dr. Fauci and all of his cohorts have helped to cover up all of the early lineage of this story. That’s why we think that Fauci’s gonna retire sometime in the summer and try to ride off into the sunset and claim victory over covid rather than be held accountable in the Senate and in the House.Which is what he should be for this entire mess, not only the response to covid, but the fact that we may well have funded this through gain-of-function research helped to create covid. And, by the way, Buck, do you feel comfortable, the fact that Moderna, who we have try to mandate you get a Moderna or a Pfizer vaccine that, according to this story out of England, that there is a part of a Moderna DNA code or whatever you want to call it…? Again, I’m not an expert when it comes to how we craft unique viruses — but that that could be included in the genome of this covid virus? I mean, this is, I believe, such a monumentally huge story. And we have, I feel like, still only touched the very outskirts of this story for fear from so many big companies out there of what China will say if we really figure out what happened here.BUCK: The implications of the virus being engineered by what is a very often in communication and even tightly knit international health apparatus of sorts, state health apparatus of these different countries, is tremendous. You mentioned the funding of the Wuhan Institute of Virology lab, receiving some funding U.S. based sources or a third party intermediary and what that would mean. But also I think that there’s gonna be enormous pressure brought to bear all over the world, but particularly — and let’s focus in on America for a second here at home — to just move past all of this, to move on.CLAY: Pretend this didn’t happen.BUCK: Pretend like they didn’t put us through all this.CLAY: “It doesn’t matter how it got out. It happened. Let’s move on.”BUCK: And also what we did in response to it. I mean, the first country to lockdown was China, and somehow we looked at that and said, “You know what? Let’s mirror image the Chinese Communist Party’s authoritarianism here to protect people from an aerosolized virus.” That was the thinking of the supposed smartest health and medical minds in the world. This is a stunning failure, and people aren’t going to have faith going forward.And they shouldn’t have faith going forward in public health authorities not being deeply politicized. What a lot of folks found out was the same way that over time you’ve seen journalists are basically second-tier gender studies and social studies majors or socialism majors, maybe, from Northeastern colleges for the most part — and we’re talking about the major national news outlets — and so they’re incredibly left wing.The people that work at the top of the CDC and NIAID, the NIH, they’re also very Democrat aligned and left wing in their thinking. And what’s worse is that this ties into — and you can go back a hundred years, and there were certainly in earlier times in the federal bureaucracy in this country there was a sense that if you only put them in charge, right? The statist, authoritarian left has always wanted greater authority in the bureaucracy with the experts because how can you argue with “experts,” Clay? How can you argue with the people that are supposed to be making these scientists for everybody else? They’re the super smart ones. Look at this. They got the pandemic’s origins wrong, they got lockdown wrong, they got masks wrong, they certainly got components of the vaccine and how well it would work wrong. And all the while, they promised us that they were keeping us so safe.And there were all these benefits from it, and I think people that look at the data and really take a moment of reflection to realize, Clay, they just made it all worse, really. I mean, we should have just worked on therapeutics, protecting the elderly. The Great Barrington Declaration — which they buried online after it came out — was right and the people that slandered it were wrong.CLAY: They were 100% right on the Great Barrington Declaration. But, Buck, even leaving aside the Great Barrington Declaration, how much attention did you see given to the Johns Hopkins study that actually looked at specifically whether lockdowns had in any way been beneficial? Because early on you and I were some of the first people who said this, that every choice you make in a public policy setting has a balancing act. In other words, remember when there were so many people early in the covid situation where they said, “Well, if we can save just one life”? How many times did you hear or see people say, “Well, if we can save just one life,” and if you said something very honest and straightforward, which would have been like, “Well if we made the speed limits on cars 5 miles an hour, nobody would ever die in a car accident. You would have to be a moron to kill yourself driving 5 miles an hour.” I guess you could drive off a cliff but, by and large, in an accident setting it would be virtual impossible.We make balancing decisions all the time based on living life and analyzing risk and not putting everybody in bubble wrap all day. But, Buck, when you or I back in March or April say, “Hey, you know what? Let’s consider the economic impacts of this shutdown.” Nobody was even allowed to have that conversation.
Opinions-The Plandemic Is Imploding And The Rats Who Committed Crimes Against Humanity Are Panicking-by Ethan Huff | Natural News-February 25th 2022, 12:29 pm
A lot is happening these days with the Wuhan coronavirus (Covid-19) plandemic, which is rapidly unraveling amid escalating civil unrest and continued revelations about the crimes against humanity that have been perpetrated on the world.The Freedom Convoy trucker convergence on Ottawa, for example, continues to grow, which prompted Canadian Prime Minister Justin Trudeau to invoke the Emergencies Act, giving him new dictatorial powers.Trudeau has already used these powers to terrorize the protesters by arresting some of them and even stripping them of their banking rights.The U.S. Centers for Disease Control and Prevention (CDC) has also been forced to admit that the Operation Warp Speed “vaccines” create negative efficacy, meaning they damage the immune system and render it less able to ward off disease.Figure 3 in this study by the CDC that was published in the Journal of the American Medical Association (JAMA) corroborates a study out of Denmark, both of which show that covid jabs make a person more prone to infection, not less.Pfizer whistleblower Brooke Jackson also revealed recently that the drug giant committed massive fraud with its covid jab clinical trials. This revelation dovetailed with an announcement by government authorities in Scotland that covid jab injury and death data will no longer be published because it shows undeniably that the injections are killing people.They can try to flee, but the plandemic rats will eventually pay for their crimes against humanityThe corporate-controlled media, in a desperate attempt to deter people from protesting against covid jab mandates, is now harassing Freedom Convoy protesters by doxing their identities in fake news articles.Since it is now obvious that the plandemic sham is falling apart as people wake up to the truth, the lying media has resorted to bullying people who engage in free speech against the government’s dictates.Sen. Ron Johnson (R-Wisc.), one of the leading congressional voices against the covid sham, has still not heard back from the Department of Defense (DoD) about a letter he sent to the agency about the massive spike in injuries and deaths being seen in the U.S. military due to its jab mandates.The Pentagon’s highly accurate and credible Defense Medical Epidemiology Database (DMED) clearly shows that heart problems, neurological damage and other conditions are skyrocketing among fully vaccinated servicemen, and yet the DoD refuses to acknowledge this, let alone provide any explanation for it.The Vaccine Adverse Event Reporting System (VAERS) is also overflowing with jab injury cases, but you will not hear a peep about it from the government or from the media because it rips to shreds the Biden regime’s continued false claim that the injections are “safe and effective.”Excess deaths are also up at least 40 percent, according to the latest life insurance data. This revelation comes as Democrats are suddenly starting to backtrack on their beloved face mask mandates, and possibly soon the jab mandates as well.A mass awakening is happening, and the perpetrators behind this global hoax are starting to bail. Those fleeing are hoping to exit stage left unnoticed, but it will not be that easy for them once the culmination of their lies catches up with them.On the other hand, there are many who are now doubling down even as the ship sinks. History will be especially unkind to them, and rightfully so once they are forced to face the music for their crimes against humanity.“There’s a mind boggling number of guilty people; but fear not, there are people who know what you’ve done and the world community will get the justice it deserves,” is how one of Steve Kirsch’s followers so beautifully put it.
Original Investigation-January 21, 2022-Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants-Emma K. Accorsi, PhD1,2; Amadea Britton, MD1,2; Katherine E. Fleming-Dutra, MD1; et al Zachary R. Smith, MA1; Nong Shang, PhD1; Gordana Derado, PhD1; Joseph Miller, PhD1; Stephanie J. Schrag, DPhil1; Jennifer R. Verani, MD, MPH1
Author Affiliations Article Information-JAMA. 2022;327(7):639-651. doi:10.1001/jama.2022.0470
Question What is the association between 3 doses of mRNA COVID-19 vaccine and symptomatic SARS-CoV-2 infection with the Omicron and Delta variants? Findings In this test-negative case-control analysis that included 70 155 tests from symptomatic adults, the likelihood of vaccination with 3 mRNA vaccine doses (vs unvaccinated) was significantly lower among both Omicron (odds ratio, 0.33) and Delta (odds ratio, 0.065) cases than SARS-CoV-2–negative controls; a similar pattern was observed with 3 vaccine doses vs 2 doses (Omicron odds ratio, 0.34; Delta odds ratio, 0.16). Meaning These findings suggest that vaccination with 3 doses of mRNA COVID-19 vaccine, compared with being unvaccinated and with receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although higher odds ratios for the association with Omicron infection suggest less protection for Omicron than for Delta.Abstract-Importance Assessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance.Objective To estimate the association between receipt of 3 doses of Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine and symptomatic SARS-CoV-2 infection, stratified by variant (Omicron and Delta).Design, Setting, and Participants A test-negative case-control analysis among adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states).Exposures Three doses of mRNA COVID-19 vaccine (third dose ≥14 days before test and ≥6 months after second dose) vs unvaccinated and vs 2 doses 6 months or more before test (ie, eligible for a booster dose).Main Outcomes and Measures Association between symptomatic SARS-CoV-2 infection (stratified by Omicron or Delta variants defined using S-gene target failure) and vaccination (3 doses vs unvaccinated and 3 doses vs 2 doses). Associations were measured with multivariable multinomial regression. Among cases, a secondary outcome was median cycle threshold values (inversely proportional to the amount of target nucleic acid present) for 3 viral genes, stratified by variant and vaccination status.Results Overall, 23 391 cases (13 098 Omicron; 10 293 Delta) and 46 764 controls were included (mean age, 40.3 [SD, 15.6] years; 42 050 [60.1%] women). Prior receipt of 3 mRNA vaccine doses was reported for 18.6% (n = 2441) of Omicron cases, 6.6% (n = 679) of Delta cases, and 39.7% (n = 18 587) of controls; prior receipt of 2 mRNA vaccine doses was reported for 55.3% (n = 7245), 44.4% (n = 4570), and 41.6% (n = 19 456), respectively; and being unvaccinated was reported for 26.0% (n = 3412), 49.0% (n = 5044), and 18.6% (n = 8721), respectively. The adjusted odds ratio for 3 doses vs unvaccinated was 0.33 (95% CI, 0.31-0.35) for Omicron and 0.065 (95% CI, 0.059-0.071) for Delta; for 3 vaccine doses vs 2 doses the adjusted odds ratio was 0.34 (95% CI, 0.32-0.36) for Omicron and 0.16 (95% CI, 0.14-0.17) for Delta. Median cycle threshold values were significantly higher in cases with 3 doses vs 2 doses for both Omicron and Delta (Omicron N gene: 19.35 vs 18.52; Omicron ORF1ab gene: 19.25 vs 18.40; Delta N gene: 19.07 vs 17.52; Delta ORF1ab gene: 18.70 vs 17.28; Delta S gene: 23.62 vs 20.24).Conclusions and Relevance Among individuals seeking testing for COVID-like illness in the US in December 2021, receipt of 3 doses of mRNA COVID-19 vaccine (compared with unvaccinated and with receipt of 2 doses) was less likely among cases with symptomatic SARS-CoV-2 infection compared with test-negative controls. These findings suggest that receipt of 3 doses of mRNA vaccine, relative to being unvaccinated and to receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although the higher odds ratios for Omicron suggest less protection for Omicron than for Delta.
Introduction-On November 24, 2021, health authorities in South Africa reported the emergence of a new SARS-CoV-2 variant, B.1.1.529 (Omicron).1 Omicron has spread rapidly, and as of January 6, 2022, was identified in 149 countries across all 6 World Health Organization regions.2 Omicron was first detected in the US on December 1, 2021, and by January 1, 2022, was estimated to be responsible for 95% of sequenced new cases.3,4Sequencing of early Omicron strains documented more than 30 mutations in the spike protein, including in the receptor binding domain.5,6 These mutations, combined with observed exponential growth in case counts, even in settings with substantial rates of COVID-19 vaccination or previous SARS-CoV-2 infection, raised concerns about potential for increased transmissibility and immune escape.2,7-10 There is an urgent need to understand the protection provided by current vaccination regimens against Omicron, including any additional protection derived from booster doses.In this analysis, a subset of data from the national Increasing Community Access to Testing (ICATT) platform was used to estimate the association of receipt of 3 doses of a mRNA COVID-19 vaccine (vs unvaccinated and vs 2 doses) with symptomatic infection with the Omicron and Delta variants, using an internally validated genetic proxy for variant identification.Methods-Study Protocol Approval-The human subjects advisor for the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases determined that this analysis met the requirements for public health surveillance as outlined in 45 CFR §46.102(l)(2). Because data were collected during routine operational procedures, this secondary data analysis did not require informed consent and was conducted consistent with applicable federal law and CDC policy.Data Source-Data from the ICATT platform11—a Department of Health and Human Services (HHS) partnership facilitating no-cost, drive-through SARS-CoV-2 testing at pharmacies across all 50 states, the District of Columbia, and Puerto Rico—were analyzed. Testing sites were selected by HHS to prioritize access in racially and ethnically diverse communities and areas with moderate-to-high social vulnerability. Data for this analysis were limited to tests occurring between December 10, 2021, and January 1, 2022, at testing sites that collected booster vaccination history and sent specimens to a single laboratory chain (Aegis Sciences Corp) for processing. The laboratory used the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific), which identifies SARS-CoV-2 infections by detecting 3 targets from the viral ORF1ab, S, and N gene regions. The laboratory reported overall test results and cycle threshold (Ct) values for each of these targets for SARS-CoV-2–positive specimens.Individuals registered online for testing at drive-through sites where nasal swabs were collected. During registration, individuals self-reported symptom status (asymptomatic or symptomatic with ≥1 COVID-like symptom), race, ethnicity, sex, age, state of residence, history of prior SARS-CoV-2 infection, and underlying conditions. Fixed categories were used to capture data for symptoms, race, ethnicity, and underlying chronic conditions including the presence of an immunocompromising condition (defined in the questionnaire as “such as from immunocompromising medications, solid organ or blood stem cell transplant, HIV, or other immunocompromising conditions”). Race and ethnicity were collected as required data elements under HHS COVID-19 laboratory reporting requirements.12 The testing program geocoded testing sites to identify their census tract Social Vulnerability Index (SVI) score.13 Patients also self-reported COVID-19 vaccination status, including the number of doses (up to 4), product, and month and year of receipt for each dose. For doses received in the same month or the month prior to testing, an additional question was asked to specify whether the dose was received 14 days or more before testing. Vaccination reporting was not mandatory, and information was not verified. Data were reported to HHS with an estimated 3-day lag and were deidentified to remove any personally identifying information.Study Design-A retrospective test-negative case-control analysis was conducted on samples collected from December 10, 2021, to January 1, 2022, from adults 18 years or older with symptomatic COVID-like illness. The test-negative design is a commonly used observational method for evaluating the performance of vaccines in which participants are enrolled based on a clinical case definition, tested for the vaccine-preventable outcome of interest, and classified as cases or controls based on that testing; the odds of prior vaccination among cases and controls are compared as an estimate of the association between vaccination and the outcome.14,15 A strength of the test-negative design is that all participants seek care (or testing) for a common clinical case definition, which can help reduce bias resulting from confounding by differential care-seeking behavior.16,17-The unit of analysis for this study was tests; positive results were classified as cases, and negative results as controls. The short study period and restriction to symptomatic individuals limited the probability of individuals contributing more than 1 test.Because protection from mRNA COVID-19 vaccines is substantially lower in immunocompromised individuals18 and the recommended vaccine dosing regimen is different from that of immunocompetent individuals,19 tests from individuals reporting an immunocompromising condition were excluded. Tests from persons reporting a positive COVID-19 test result within the previous 90 days were excluded to reduce potential misclassification. Tests with unknown vaccination status or incomplete vaccination data (ie, missing vaccination dates or products), from individuals reporting prior receipt of 1 or 4 mRNA vaccine doses or of non-mRNA COVID-19 vaccines, or from persons with improbable ages (defined as >100 years) were also excluded.Additionally, among tests with positive results, Ct values were described by variant and by vaccination status (3 doses, 2 doses, and unvaccinated). Ct values reflect the number of cycles during polymerase chain reaction amplification needed to detect viral genetic material and are inversely proportional to the amount of target nucleic acid in the tested sample.20 Ct values were examined to better understand the relative amounts of genetic material present in positive samples by variant and vaccination status.Exposure-The exposure of interest was self-report of any 3 doses of BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine (including mixed-product regimens) vs unvaccinated and vs any 2 doses of BNT162b2 or mRNA-1273 vaccine. For individuals reporting 2 vaccine doses, tests were excluded if the second dose was received less than 6 months prior to test date to ensure eligibility for a booster dose. For those reporting 3 doses, tests were excluded if the interval between second and third doses was less than 6 months, as per recommendations during the analysis period for booster doses among immunocompetent individuals,19 or if the most recent dose was received less than 14 days before testing. Another exposure examined was any 2 doses of BNT162b2 or mRNA-1273 vaccine, with the second dose received 14 days or more before testing vs unvaccinated; assessment of this exposure did not limit to those eligible for a booster dose (ie, did not limit to those with 6 or more months elapsed between the second dose and date of testing).Outcomes-The primary outcome was symptomatic SARS-CoV-2 infection with the Omicron or Delta variant. For this analysis, an Omicron case was defined as presence of S-gene target failure (SGTF) in the test sample and a Delta case as absence of SGTF in the test sample. All samples that were determined by the processing laboratory to be SARS-CoV-2 positive had Ct values for at least 2 of the N, ORF1ab, and S genes. SARS-CoV-2–positive samples were considered to have SGTF if they had Ct values for the N and ORF1ab genes but not for the S gene; otherwise, samples were considered not to have SGTF.SGTF may serve as a proxy for the presence of the Omicron variant in samples tested with the TaqPath COVID-19 Combo Kit assay because of the presence of deletions in the S-gene region for Omicron that are not present in Delta2,21; the deletions lead to S-gene–negative results in Omicron lineages BA.1 and B.1.1.529 but not the majority of Delta samples. While levels of non-Delta circulating variants other than Omicron remain low, samples with SGTF may be presumed to be Omicron.22 At the time of this analysis 99.9% of sequenced samples in the US prior to the emergence of Omicron were Delta.4 To validate the use of SGTF as a proxy for Omicron in the ICATT data, the frequency of SGTF was examined in a randomly selected subset of tests with positive results that were sequenced during the same period as the analysis. The sequenced subset was drawn from the complete database of test results from the laboratory, including tests not eligible for the main analysis. Sequencing data were not available for most cases included in the main analysis, which is why SGTF was used as a proxy. The sensitivity of SGTF for detecting Omicron (B.1.1.529 or BA.1 lineage) was 83.4% and the specificity was 99.2% (eTable 1 in the Supplement).Secondary outcome measures included Ct values for the N and ORF1ab genes among Omicron and Delta cases and S gene among Delta cases.Statistical Analysis-The association between symptomatic infection with the Omicron or Delta variants and vaccination was estimated by comparing the odds of prior 3-dose vaccination vs unvaccinated and the odds of prior 3-dose vaccination vs 2-dose vaccination in cases vs controls using multivariable multinomial logistic regression. The odds ratio (OR) for 3 doses vs unvaccinated was used as an estimate of 3-dose vaccine effectiveness (effectiveness = [1 – OR] × 100%), with lower ORs suggesting more protection. The OR for 3 doses vs 2 doses was used as an estimate of relative vaccine effectiveness, reflecting additional protection from a booster dose relative to 2 doses. ORs were estimated for any combination of mRNA vaccine and separately for BNT162b2 and mRNA-1273.Models included the number of days between the start of the analysis period and test date (as a continuous variable), age group, sex, race, ethnicity, testing site HHS region, testing site census tract SVI (dichotomized as 0 to <0.5 and ≥0.5-1), and number of underlying chronic conditions (0, 1, or ≥2) as covariates to adjust for potential confounding bias. Unknown race and ethnicity were coded as categories of their respective variables instead of null values to retain these records in regression models. Data with missing values for other model covariates (specifically, sex and SVI) were coded as null values and therefore dropped from adjusted regression models.Two-sided 95% CIs were calculated for each reported OR, with 95% CIs that excluded 1 considered statistically significant. Two-sided P values for the association between vaccination and symptomatic infection with Omicron compared with Delta were corrected for false-discovery rate (FDR) using the Benjamini-Hochberg method (to account for type I error due to multiple comparisons), and results with Q values (ie, P values adjusted for the FDR) less than .001 were considered statistically significant.To aid in the interpretation of associations of 3 vaccine doses vs unvaccinated and vs 2 vaccine doses, a secondary analysis was performed examining the association between 2 doses vs unvaccinated by time since receipt of second dose. The association between infection and 2 mRNA vaccine doses vs unvaccinated was examined separately for each product-variant combination by logistic regression incorporating the same covariates as above as well as month (0-11) since second dose using a 2-knot spline at months 3.5 and 7.5.For comparison of Ct values among cases by variant and exposure status (3 doses vs unvaccinated, 3 doses vs 2 doses, and 2 doses vs unvaccinated), the 2-sided Mann-Whitney U test was used to identify significant differences in median Ct values. Correction for FDR was applied for each comparison of exposure status, and results with Q < .001 were considered statistically significant.Statistical analyses were performed in RStudio and R, version 4.0.3 (R Foundation). Multinomial logistic regression was performed using the nnet R package, version 7.3-16.-Results-A total of 70 155 tests from 4666 sites on samples collected between December 10 and January 1 across 49 states met inclusion criteria (Figure 1), including 23 391 cases (13 098 Omicron; 10 293 Delta) and 46 764 controls (Table 1) (mean age, 40.3 [SD, 15.6] years; 42 050 [60.1%] women). Included tests were most frequently performed on persons aged 25 to 34 years (30.4%), followed by those aged 35 to 44 years (19.3%), and on persons who reported being of White race (75.5%). More than one-third of tests (36.4%) were from people with reported underlying health conditions, with high blood pressure most common, followed by overweight. Compared with controls, cases were more frequently tests from persons aged 25 to 34 years (Omicron 35.1% and Delta 31.0% vs controls 28.9%), of Black/African American race (Omicron 24.4% and Delta 14.9% vs controls 11.9%), and of Hispanic/Latino ethnicity (Omicron 22.5% and Delta 17.7% vs controls 17.4%) (Table 1).For vaccination history, the most common combination of 2 doses was BNT162b2/BNT162b2 (63.4% of 2-dose regimens), followed by mRNA-1273/mRNA-1273 (36.4%); the most common 3-dose combination was BNT162b2/BNT162b2/BNT162b2 (57.5% of 3-dose regimens) (Table 1). Among individuals receiving 2 doses only, the median time between the second dose and test date was 8 months. Among those receiving 3 doses, the median time between the second dose and test date was 8 months, between the second and third dose was 7 months, and between the third dose and test date was 1 month. Prior receipt of 3 vaccine doses was reported for 18.6% (2441/13 098) of Omicron cases, 6.6% (679/10 293) of Delta cases, and 39.7% (18 587/46 764) of controls (Table 1).Comparison of 3 Doses vs Unvaccinated-Among Omicron cases and controls, the adjusted OR for prior receipt of 3 mRNA vaccine doses vs unvaccinated was 0.33 (95% CI, 0.31-0.35); among Delta cases and controls, the adjusted OR was 0.065 (95% CI, 0.059-0.071; Q < .001 for comparison of ORs for Omicron and Delta) (Table 2). When models were stratified by mRNA product, the adjusted ORs for Omicron were 0.35 (95% CI, 0.32-0.38) for 3 doses of BNT162b2 vs unvaccinated and 0.28 (95% CI, 0.26-0.31) for 3 doses of mRNA-1273 vs unvaccinated. For Delta, the adjusted ORs were 0.077 (95% CI, 0.070-0.086) for 3 doses of BNT162b2 vs unvaccinated and 0.045 (95% CI, 0.038-0.053) for 3 doses of mRNA-1273 vs unvaccinated. Q values for all comparisons (Omicron vs Delta) of product-specific ORs were less than .001 (Table 2). An adjusted OR less than 1 indicates that relatively fewer test-positive cases had prior receipt of 3 doses (vs unvaccinated), with values closer to 0 representing a stronger magnitude of association.Comparison of 3 Doses vs 2 Doses-Among Omicron cases and controls, the adjusted OR for prior receipt of 3 mRNA vaccine doses vs 2 doses was 0.34 (95% CI, 0.32-0.36); among Delta cases and controls, the adjusted OR was 0.16 (95% CI, 0.14-0.17; Q < .001) (Table 2). When models were stratified by mRNA product, the adjusted ORs for Omicron were 0.35 (95% CI, 0.32-0.37) for 3 doses of BNT162b2 vs 2 doses and 0.31 (95% CI, 0.28-0.34) for 3 doses of mRNA-1273 vs 2 doses. For Delta, the adjusted ORs were 0.17 (95% CI, 0.16-0.19) for 3 doses of BNT162b2 vs 2 doses and 0.13 (95% CI, 0.11-0.15) for 3 doses of mRNA-1273 vs 2 doses. Q values for all comparisons (Omicron vs Delta) of product-specific ORs were less than .001 (Table 2). An adjusted OR less than 1 indicates that relatively fewer test-positive cases had prior receipt of 3 doses (vs 2 doses), with values closer to 0 representing a stronger magnitude of association.Comparison of 2 Doses vs Unvaccinated by Time Since Vaccination-Among Omicron cases and controls, the adjusted OR for prior receipt of any 2 mRNA vaccine doses vs unvaccinated was lowest soon after the second dose and generally increased over time since vaccination (Figure 2). The upper bound of the 95% CI was consistently greater than 1 starting at 3 months after second dose for BNT162b2 and at 6 months after second dose for mRNA-1273. For Delta, the OR for any 2 doses vs unvaccinated was also lowest soon after receipt of second dose; however, the ORs remained less than 0.46 for BNT162b2 and less than 0.40 for mRNA-1273, with 95% CIs that did not include 1 (Figure 2).Comparison of Ct Values-Among Omicron cases, median Ct values were significantly higher in samples from persons reporting 3 mRNA vaccine doses vs unvaccinated for the ORF1ab gene (19.25 vs 18.58; Q < .001) but not for the N gene (19.35 vs 18.71; Q = .002) (eTable 2 in the Supplement). Among Delta cases, median Ct values of the N, ORF1ab, and S genes were significantly higher in samples from persons receiving 3 doses vs unvaccinated (N gene: 19.07 vs 18.28; ORF1ab gene: 18.70 vs 17.84; S gene: 23.62 vs 19.58; Q < .001 for all comparisons) (Figure 3; eTable 2 in the Supplement). In comparing median Ct values in samples from persons reporting 3 mRNA vaccine doses vs 2 doses, all were significantly higher (Omicron N gene, 19.35 vs 18.52; Omicron ORF1ab gene, 19.25 vs 18.40; Delta N gene, 19.07 vs 17.52; Delta ORF1ab gene, 18.70 vs 17.28; Delta S gene, 23.62 vs 20.24; Q < .001 for all comparisons) (Figure 3; eTable 2 in the Supplement).Discussion-In this analysis of SARS-CoV-2 tests performed at sites across the US during a 23-day period when incidence of Omicron was rapidly increasing, vaccination with a third dose of an mRNA COVID-19 vaccine was significantly less common among individuals infected with either the Omicron or Delta variants compared with uninfected individuals. Because of the timing of booster recommendations in the US, most booster recipients had recent vaccination (median of 1 month since booster).The magnitude of the association between vaccination and infection depended on the referent group and variant. For 3 doses vs unvaccinated, the ORs corresponded to an estimated effectiveness (1 – OR) of 67.3% (95% CI, 65.0%-69.4%) for Omicron and 93.5% (95% CI, 92.9%-94.1%) for Delta. For 3 doses vs 2 doses, the ORs corresponded to an estimated relative effectiveness of 66.3% (95% CI, 64.3%-68.1%) for Omicron and 84.5% (95% CI, 83.1%-85.7%) for Delta. For Omicron, the similarity between ORs for 3 doses using the unvaccinated referent group and the 2-dose referent group is consistent with the attenuation of the OR for 2 doses vs unvaccinated with time since second dose, which reflected no significant association by 6 months after second dose for both products. For Delta, the association between infection and 2 doses vs unvaccinated also attenuated over time since second dose, which is consistent with previous reports23-26; however, the ORs were statistically significant even up to 11 months after the second dose.Although these findings provide evidence supporting that 3-dose schedules are protective and that booster doses are more protective than primary series alone, the significantly higher OR for Omicron suggests that booster doses are less protective against Omicron than against Delta. These results are consistent with in-vitro neutralization assays that suggested the potential for immune evasion with Omicron.27-30 They also highlight that, in the setting of Omicron, higher booster coverage rates may be needed to achieve the same public health benefit as during Delta predominance. Additionally, nonpharmaceutical interventions may provide an important adjunct to slow the spread of Omicron.Among both Omicron and Delta variant cases, Ct values were generally higher (reflecting less genetic material detected) among those with 3 vaccine doses compared with unvaccinated or to 2 doses; with 1 exception (N gene for Omicron, 3 doses vs unvaccinated), all comparisons were statistically significant. Ct values are not a direct measure of viral load or infectiousness and can vary for a range of reasons including timing of sample collection relative to infection onset, specimen transport times, and laboratory assays and conditions. However, they have previously been used as a crude indicator of transmission potential, with higher values representing decreased likelihood of a case being infectious.31-37 In this analysis, the Ct values were based on 2 targets from a single assay, performed at a single laboratory chain, increasing their comparability. The significantly higher Ct values found in individuals reporting receipt of 3 doses vs unvaccinated or 2 doses, for both the Omicron and Delta variants, may suggest decreased infectiousness in those receiving an mRNA booster dose. However, caution should be taken in interpreting these differences between groups as epidemiologically meaningful because all differences were less than 1 unit on the log scale.-Limitations-This study has several limitations. First, vaccination status and symptoms were based on patient self-reported data, potentially leading to misclassification. Second, because the testing data do not include identifiers, tests rather than persons were used as the unit of analysis, and individuals may have been included more than once. However, the analysis was restricted to symptomatic individuals to reduce inclusion of individuals serially testing for reasons other than symptomatic disease, and the short study period (23 days) reduces the probability of individuals contributing multiple test results.Third, individuals remaining unvaccinated or unboosted may differ from individuals with 3 doses in ways that cannot be adjusted for with the variables in this data set. Fourth, some factors that could potentially be associated with both vaccination and risk of infection and thus confound the observed associations (eg, masking and social distancing) were not measured. Fifth, US adults were recommended to receive booster doses at different dates depending on age, underlying conditions, and occupation; therefore, some subgroups may have had greater access to boosters before broader recommendations were made.Sixth, sequencing data were limited for tests included in this analysis so SGTF was used as a proxy for Omicron infection; however, sensitivity of 83.4% and specificity of 99.2% in internal validation suggest that samples classified as Omicron by SGTF were almost always Omicron. Although some Omicron samples may have been misclassified as Delta, this would not affect the association between Omicron and vaccination status and would bias the association of Delta and vaccination toward that of Omicron such that the reported differences between Omicron and Delta are conservative.Seventh, the analysis of the association between symptomatic infection and 3 vs 2 doses did not directly account for waning of the primary series, although all tests were performed at least 6 months after receipt of a primary series, at which point protection from 2 doses was quite reduced, particularly for the Omicron variant. Eighth, associations between infection and vaccination are not constant and will likely continue to change with time since last dose.-Conclusions-Among individuals seeking testing for COVID-like illness in the US in December 2021, receipt of 3 doses of mRNA COVID-19 vaccine (compared with unvaccinated and with receipt of 2 doses) was less likely among cases with symptomatic SARS-CoV-2 infection compared with test-negative controls. These findings suggest that receipt of 3 doses of mRNA vaccine, relative to being unvaccinated and to receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although the higher odds ratios for Omicron suggest less protection for Omicron than for Delta.Corresponding Author: Emma K. Accorsi, PhD, COVID-19 Response, US Centers for Disease Control and Prevention, 1600 Clifton Rd Mailstop H24-6, Atlanta, GA 30329 (vgi0@cdc.gov).Accepted for Publication: January 13, 2022.Published Online: January 21, 2022. doi:10.1001/jama.2022.0470Author Contributions: Drs Accorsi and Britton had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Accorsi and Britton contributed equally as co–first authors; Drs Verani and Schrag contributed equally as co–senior authors.Concept and design: Accorsi, Britton, Fleming-Dutra, Shang, Miller, Schrag, Verani.Acquisition, analysis, or interpretation of data: Accorsi, Britton, Fleming-Dutra, Smith, Shang, Derado, Schrag, Verani.Drafting of the manuscript: Accorsi, Britton, Schrag, Verani.Critical revision of the manuscript for important intellectual content: All authors.Statistical analysis: Accorsi, Britton, Shang, Derado.Obtained funding: Miller.Administrative, technical, or material support: Britton, Smith, Miller, Verani.Supervision: Miller, Schrag, Verani.Conflict of Interest Disclosures: None reported.Funding/Support: Funding for the Increasing Community Access to Testing platform was provided by the US Department of Health and Human Services. Funding for this analysis was provided by the Centers for Disease Control and Prevention (CDC).Role of the Funder/Sponsor: The CDC was involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication. CDC controlled publication decisions.Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.References-World Health Organization. Classification of Omicron (B.1.1.529): SARS-CoV-2 variant of concern. Updated November 26, 2021. Accessed December 23, 2021. https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern 2.World Health Organization. Enhancing response to OMICRON (COVID-19 variant B.1.1.529): Technical brief and priority actions for Member States. January 7, 2022. Accessed January 11, 2022. https://www.who.int/publications/m/item/enhancing-readiness-for-omicron-(b.1.1.529)-technical-brief-and-priority-actions-for-member-states-3-CDC COVID-19 Response Team. SARS-CoV-2 B.1.1.529 (Omicron) variant—United States, December 1-8, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(50):1731-1734. doi:10.15585/mmwr.mm7050e1PubMedGoogle ScholarCrossref-4.Centers for Disease Control and Prevention. COVID Data Tracker. Accessed January 7, 2021. https://covid.cdc.gov/covid-data-tracker/#variant-proportions 5.Wang L, Cheng G. Sequence analysis of the emerging SARS-CoV-2 variant Omicron in South Africa. J Med Virol. 2021;1-6. doi:10.1002/jmv.27516PubMedGoogle Scholar-6.GISAID. Tracking of variants. Accessed December 23, 2021. https://www.gisaid.org/hcov19-variants/ 7.National Institute for Communicable Diseases. COVID-19 weekly epidemiology brief, South Africa: week 47 2021. November 27, 2021. https://www.nicd.ac.za/wp-content/uploads/2021/12/COVID-19-Weekly-Epidemiology-Brief-week-47-2021.pdf-8.UK Health Security Agency. SARS-CoV-2 variants of concern and variants under investigation in England. Technical briefing 33. December 23, 2021. Accessed December 23, 2021. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1043807/technical-briefing-33.pdf-9.European Centre for Disease Prevention and Control. Implications of the further emergence and spread of the SARS-CoV-2 B.1.1.529 variant of concern (Omicron) for the EU/EEA—first update. Updated December 2, 2021. https://www.ecdc.europa.eu/sites/default/files/documents/threat-assessment-covid-19-emergence-sars-cov-2-variant-omicron-december-2021.pdf-10.Centers for Disease Control and Prevention. Potential Rapid increase of Omicron variant infections in the United States. Updated December 20, 2021. Accessed December 23, 2021. https://www.cdc.gov/coronavirus/2019-ncov/science/forecasting/mathematical-modeling-outbreak.html-11.Miller MF, Shi M, Motsinger-Reif A, Weinberg CR, Miller JD, Nichols E. Community-based testing sites for SARS-CoV-2—United States, March 2020-November 2021. MMWR Morb Mortal Wkly Rep. 2021;70(49):1706-1711. doi:10.15585/mmwr.mm7049a3PubMedGoogle ScholarCrossref-12.US Department of Health and Human Services. COVID-19 Pandemic Response, Laboratory Data Reporting: CARES Act Section 18115. Updated January 8, 2021. Accessed
