Pfizer's top scientist Mikael Dolsten tells us the 2 factors that will determine if Omicron is a true threat and shares Pfizer's worst-case-scenario plan

Pfizer's chief scientific officer told Insider that the drugmaker is already preparing for the worst-case scenario that Omicron variant-specific shots will be needed. To get to that point, he's watching how two unknown elements play out in the next few weeks.
The first thing to know is how well the current vaccines hold up. The answer will be a sliding scale of protection.
Experts don't think Omicron will be able to get all the protection from the current shots. There are many more genes needed to reach that point, according to previous research.

The Delta andBeta strains have shown they can diminish vaccine protection. Omicron has more mutations on the spikeProtein, which is the target of vaccines.

Omicron is expected to decrease levels of neutralizing antibodies, a key part of our immune response. How much of a decline this variant could cause will be the question that laboratory testing will answer.

The current vaccine won't be enough if the current amount of antibodies is decreased tenfold, according to the man.

"If we exceed a tenfold drop in neutralization of Omicron, I think we are about to enter the yellow to red zone when your immunity is likely lowered and there's limited time after your boost until waning," he said.
The current vaccines could be shown to hold up well enough against Omicron in laboratory tests over the next week or two. For the time being, the best protection a person can get is either getting a vaccine or getting boosted with a current shot.
He said that they were cautiously optimistic that the current vaccine could provide meaningful protection.
It's too early to know if Omicron will overtake Delta.

The second question will become consequential if there is a major drop in protection. The answer will come in the next few weeks. "We'll probably know in December," he said.
New vaccines would need to be distributed everywhere if Omicron becomes the world's dominant variant. New vaccines probably wouldn't be needed if it dissipated or failed to beat the Delta variant.

There is reason for optimism. Scientists were scared by the ability of the variant to degrade the vaccine response. It never took off around the world despite that attribute.
It's too early to know if Omicron has the same ability as Delta to become a pandemic strain, or if it will be the same strain that started in South Africa and became a local epidemic.
Pfizer didn't need to use either of the shots. The current vaccines held up well against Delta.
The two factors that will determine whether Pfizer is running another fire drill with an Omicron-specific booster shot or if this will be the time a new vaccine is actually necessary are:

A new shot could be ready by March with the help of antiviral pills.

Pfizer will be ready if the worst-case scenario of Omicron defeating the current vaccines comes to fruition. He wants to be prepared to launch a new vaccine campaign by March 2022, if needed.

Many drug companies are preparing for Omicron. Moderna, Novavax, and Johnson & Johnson are all working on new boosters for Omicron.

The manufacturing process for the Omicron-specific shot will be finalized by the end of February. The company might not have to run clinical trials to get an OK if they just share manufacturing details with regulators. He said that they would share their experience in developing and testing Delta-specific shots.
Pfizer could start commercial production in March, increasing its output each week up to 80 million doses per week. Pfizer can pump out 1 billion doses each quarter.

The company's experimental pill, Paxlovid, will have a major impact before then, according to the company's CEO. The treatment reduced hospitalizations and deaths in people who were unvaccinated.
Paxlovid could be used to treat COVID-19 patients within the next few months if the US regulators approve the drug.