What you are looking for is tal:condition, possibly combined with the not: and exists: prefixes:
<span tal:replace="here/getFieldA" />
<span tal:condition="not:exists:here/getFieldA" tal:replace="here/getFieldB" />
Alternatively, you can use the | operator, which acts like an if operator, testing existence of the first element. If it doesn't exist, it'll use the next expression, and so on:
<span tal:replace="here/getFieldA | here/getFieldB" />
The tal:omit-tag attribute means something very different. If it's expression evaluates to True, then the tag, and only the tag itself, is omitted from the output. This is best illustrated with an example:
<span tal:omit-tag="">
<i>This part will be retained</i>
</span>
Rendering that piece of pagetemplate results in:
<i>This part will be retained</i>
The surrounding <span> tag was omitted, but the contents were preserved.