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An official from Europe’s top medical product regulation agency said Tuesday that the COVID-19 omicron variant may be pushing the pandemic into becoming endemic.

Marco Cavaleri, head of vaccine strategy for the European Medicines Agency (EMA), told reporters on Tuesday that that the natural immunity conferred by the highly-infectious omicron strain may be fast-tracking the progress towards endemicity.

“With the increase of immunity in population – and with Omicron, there will be a lot of natural immunity taking place on top of vaccination – we will be fast moving towards a scenario that will be closer to endemicity,” Cavaleri said during a media briefing, according to Al Jazeera.

When a virus becomes endemic it means a population has gained enough widespread immunity – either from infection or vaccination – that transmissions, hospitalizations and deaths will start to go down.

Reports from South Africa, where omicron was first detected, have indicated that while the variant is highly-infectious, it does not result in a corresponding spike in hospitalizations and deaths. Another South African study released last month found that omicron may reduce infections caused by the delta variant by building cross-immunity to different strains, an effect that has not been observed in many other mutations of the SARS-CoV-2 virus.

During his briefing on Tuesday, Reuters reported that Cavaleri also expressed doubts about the necessity for a fourth COVID-19 vaccine dose, telling the reporters that such an approach was not “sustainable.”

“While use of additional boosters can be part of contingency plans, repeated vaccinations within short intervals would not represent a sustainable long-term strategy,” he said.

“It is important that there is a good discussion around the choice of the composition of the vaccine to make sure that we have a strategy that is not just reactive … and try to come up with an approach that will be suitable in order to prevent a future variant,” he added.

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Cavaleri’s remarks echo those of British infectious disease expert Sir Andrew Pollard who said earlier this month that repeated vaccination every few months was “not sustainable.”

Pollard, who helped to develop the AstraZeneca COVID-19 vaccine, said, “It really is not affordable, sustainable or probably even needed to vaccinate everyone on the planet every four to six months.”

“We haven’t even managed to vaccinate everyone in Africa with one dose so we’re certainly not going to get to a point where fourth doses for everyone is manageable,” he added.

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