Top Israeli health officials said that the effectiveness of the second dose of the Pfizer-BioNTech vaccine declined six months after administration, showcasing the necessity of a booster dose for the people of the country.

Israel began distributing a Covid-19 booster to children as young as 12 on 29 August, while prime minister Naftali Bennett said that this campaign, which began a month ago with senior residents of Israel, has shown the result of reducing a rise in serious disease caused by the Delta variant.

Sharon Alroy-Preis, head of public health at Israel's Health Ministry on 29 August during a press conference said: "The third dose brings us to the level of protection achieved by the second dose when it was fresh. That means people are 10 times more protected after the third vaccine dose."

As reported, people who are eligible for the third dose or booster shot must wait at least five months after their second jab—it is less than the eight-month interval, currently in place in the United States, which is considering shortening the waiting period.

While Israel became an example to other countries in terms of vaccine distribution to stop the pandemic, its latest announcement about the third dose is now a controversial topic. Israel has been one of the top countries with the highest vaccination rate. But the spread of the highly contagious Delta variant shocked the authorities, pressurising them to take new measures.

To combat the spread of the Delta variant, Israel began administering the booster to its elderly population a month ago and has gradually lowered the eligibility age. Before making the booster-related announcement on 29 August, the age of eligibility was 30. However, as of now, out of a population of 9.3 million, 2 million people in Israel have received two vaccine doses and one booster shot.

In the latest statement, Bennett said: "There are already results: the increase in severe morbidity has begun to slow. But we have to complete third doses for all of our citizens. I call on those aged 12 and up to go out and immediately take the third shot."

Booster Strategy

Despite objections from the World Health Organization (WHO), which believes that more individuals around the world should be vaccinated with a first dose before receiving a third, Israel and a few more countries have moved forward with booster programmes.

As per the experts, scientific evidence has shown that vaccines prevent serious illness, as well as death, and unvaccinated people are the most vulnerable group. But in the case of the Delta variant, the increased infection numbers and the spread of the variant inside the borders of Israel has prompted authorities to take further steps.

As per the reports, people with two shots are still getting sick with what is called "breakthrough infections"—in a country where more than 60 per cent of people are fully vaccinated. For example, half of the patients in Hadassa Hospital in Jerusalem are twice vaccinated. But according to front-line workers, vaccinated patients who end up in the hospital seem to do better.

Hava Gerdner, a front-line nurse in Israel, told CTV News: "There are definitely very sick people, but I think the amounts are different. So definitely we can feel the difference in the vaccinated patients." Another expert, Yael Haviv-Yadid, who is the head of the critical care ward at Sheba Medical Centre near Tel Aviv, told Reuters: "The vaccinated patients I've treated usually left the ICU in about three days. The unvaccinated patients took a week or two until they stabilised."

As reported, In Israel, laboratory testing reveals that older people with chronic illnesses have few, if any, antibodies from vaccines—it is a fact that antibody generation varies from person to person. Dr Dror Mevorach, who is in charge of a Covid-19 unit in an Israeli hospital, said: "Currently we have about 40 patients. And I can tell you that in January, we had 200 patients."

She explained that "what is interesting is that those [in the ICU] that were vaccinated [are] quite old people with a lot of backgrounds and diseases, and actually I think that a large proportion of them did not really realise the vaccination and did not develop an antibody response to the vaccination because of the background, diseases and age".

Mevorach further added that many patients who arrive at the hospital have low amounts of antibodies or none at all. She said: "So, it is clear that they did not mount the immune response to the vaccination, or the effect declines after five, six months." This is one of the reasons why Israel has announced a new programme to give children and adults a third booster shot to increase immune response.

Israel's case is based on the idea that the Delta variant infection typically has a high viral load, implying that more antibodies are required, which could be obtained via a third shot or booster jab. Mevorach noted that "we know the viral load of the Delta variant is about 1000 times more than the Alpha value. And that's why you need more antibodies to fight the virus."

But many experts still claim that there is no evidence that a third dose is required for everyone. One of those experts, Dr Amish Adalja, with the Johns Hopkins Center for Health Security, told CTV News: "When you're giving healthy individuals a booster, it really should be driven by clinical data. And that clinical data should really point to erosion in the ability of the vaccine to [prevent] serious disease, hospitalisation and death, not just antibody levels, not just breakthrough infection levels, but serious illness—because that's what the vaccines were designed to do."

Adalja explained that the research shows that immunisations are quite successful in preventing severe disease and death. Antibody levels in people who were already at high risk from the virus, including the elderly and immunocompromised people, may not provide the strongest justification for policy decisions to give booster doses to everyone.

He also pointed out the recommendation for a third shot by the Centers for Disease Control and Prevention (CDC) in the United States for immunocompromised individuals and said that the federal agency analysed antibody data, as well as clinical data revealing that immunocompromised people made about 40 to 45 per cent of those hospitalised with breakthrough infections.

Additionally, he said: "For the general healthy population, if they were to contract a breakthrough infection, it's likely to be mild, similar to the common cold. And I don't know that there's much utility in preventing vaccinated people from getting very, very mild illnesses when the main trajectory of this pandemic is being driven by people who aren't lacking third doses but are lacking first and second doses."

Some scientists in Canada also don't see a requirement for a booster jab for healthy individuals. Dr Allison McGeer, an infectious disease expert with the Dalla Lana School of Public Health, Toronto, said: "We do have proof that immunity against mild disease is waning. Our protection against severe disease in all of the studies so far is holding up really well."

But in the case of Israel, they are more worried about restricting the spread of the Delta variant and making sure that all the Israelis are safe, so the authorities are taking no chance. However, their decision to vaccinate all the residents of Israel using the third dose could be an experiment, which is, according to many experts is unnecessary at this moment, but the result of this booster program would help the rest of the world to take further decisions while fighting against the coronavirus pandemic.

Israel Booster Dose

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