Israeli Health Ministry recommends covid booster shot for elderly population

Amir Levy Getty Images A woman receives her third dose of coronavirus vaccine at Sheba Medical Center on July 14, 2021, in Ramat Gan, Israel.

TEL AVIV â€" Just before midnight Wednesday, Israeli Health Ministry experts agreed by an overwhelming majority that coronavirus booster shots should be administered to elderly adults in the face of the potential risks posed by the vaccine’s apparent waning efficacy and the current fourth wave of covid-19.

The decision coincides with the release of a paper published by executives from the pharmaceutical giant Pfizer that said that while their vaccine was shown to have only slightly diminished, though still strong, effectiveness six months after administration, booster shots would soon be needed.

The director general of the Israeli Health Ministry is expected to accept the recommendation in the coming days and will decide whether the target group will include those above 60, above 65 or above 75 years old.

[Pfizer data shows vaccine protection remains robust six months after vaccination even as the company argues that boosters will be needed]

Israeli Prime Minister Naftali Bennett and Health Minister Nitzan Horowitz are also expected to accept the proposal and unveil plans for the booster campaign, which could start as early as next week.

In a video statement Thursday, Bennett said the recommendation carried “significant weight,” adding that the “strategy was clear: to preserve life and daily routine in the state of Israel.”

On Thursday morning, the head of the Israeli Nursing Homes Union said that facilities across the country were already preparing for the possibility of administering booster shots by the end of the day, according to Israel’s Channel 12.

Despite the lack of regulatory approval in the United States and Europe and the absence of definitive data about the effectiveness of the booster shot in preventing serious illness and mortality, the experts concluded that pursuing it for elderly Israelis could be the best chance to stem a spike of infections in the past six weeks, as cases have jumped from the single digits to more than 2,000 a day.

The soaring cases, mostly due to the delta variant, have not led to a corresponding rise in the number of seriously ill and hospitalized patients, however.

The Health Ministry panel said Wednesday that protection against serious illness for those over 60 who were vaccinated in January has dropped from 97 percent to 81 percent.

For those over 60 and vaccinated in March, it fell to 94 percent. The panel added that 93 percent efficacy was maintained for people 40 to 59 years old and that the Pfizer vaccine seems to have maintained 91 percent protection against the delta variant.

Health Ministry data shows that vaccine protection for the delta variant against hospitalization remains at 91 percent, but drops to 40 percent for milder infections and symptoms.

Israeli health experts have been divided on how to translate the relatively preliminary data into government policy, especially given starkly contrasting research from Britain, which has a vaccination rate similar to Israel’s.

A study published by British health authorities in the New England Journal of Medicine showed that two weeks after the administration of the second dose, the Pfizer-BioNTech coronavirus vaccine is 88 percent effective against the delta variant, only slightly less than its 93 percent protection for the alpha variant.

Some health experts say that the Israeli studies showing far less vaccine protection over time are skewed because they mostly focused on covid hot spots and elderly populations. Others have argued that the findings could be an accurate reflection of the fact that Israel was among the first nations in the world to achieve wide-scale vaccination.

“Because we were the first to vaccinate extensively, we have no one to learn from,” said Nachman Ash, the Health Ministry director general, before the panel meeting on Wednesday night.

Because of its small size, meticulously organized public health-care system, ethnically heterogeneous population and its leaders’ close relationship with Pfizer CEO Albert Bourla, Israel has been seen as a test case for the rest of the world, publishing data on the vaccine in return for a regular shipment of doses. That has remained the case even as the neighboring Palestinian territories have lagged behind in their own efforts to vaccinate their population, recently rejecting a vaccine swap deal on grounds that the vaccines were too close to their expiration date.

The disparity has resurfaced an argument among human rights organizations that Israel has a legal responsibility to provide vaccine doses in the territories it occupies.

In the past two weeks, relying on its still steady supply, Israel has gone forward with administering third doses of the Pfizer-BioNTech vaccine to a limited number of severely immunocompromised adults, including transplant recipients and cancer patients, in efforts to boost protection for the most vulnerable.

Former prime minister and current opposition leader Benjamin Netanyahu, who was the first Israeli to receive a dose of the Pfizer vaccine in December, has been a vocal advocate for the third shot for all Israelis older than 60. His office said a serological test showed he had a low covid antibody count. He has since been seen double-masking in the Knesset, according to the Israeli news site Walla.

Israeli experts say that the decision to kick-start a booster shot policy is made possible by an expected Aug. 1 delivery of millions of Pfizer vaccines, as some of Israel’s current stockpile is set to expire.

“Israel can do this because we have the doses,” said Eyal Leshem an infectious-disease specialist at Sheba Medical Center in central Israel. “But also, unlike other countries which don’t have the regulatory flexibility to say this is an emergency, Israel has decided, strategically, that it is willing to move on with intervention that is reasonable, clinically and scientifically, but not yet proven. It’s not the way we traditionally regulate and approve and distribute vaccines, but these are not normal times.”

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