‘U.S. Is Months Behind Israel’: Top COVID Experts Explain FDA's Booster Decision

Israeli medical experts say FDA advisory panel's recommendation on Pfizer's booster vaccine shots is an acknowledgement that conditions differ in the two countries

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A medical worker prepares a coronavirus vaccine shot in Tel Aviv, Saturday.
A medical worker prepares a coronavirus vaccine shot in Tel Aviv, Saturday.Credit: Moti Milrod
Sam Sokol
Sam Sokol

Israel’s top COVID-19 experts say that they view the Food and Drug Administration advisory panel’s decision to recommend vaccine booster shots only for Americans over the age of 65 or those in specific risk groups as a vindication of their own country’s massive inoculation campaign.

Israel was the first country in the world to begin a widespread booster shot campaign this summer, and Israeli data was used during the FDA panel’s deliberations. Yet while Israel is now offering the booster shot to anyone over the age of 12, the advisory committee decided to limit it to specific high-risk populations for now.

Leading experts in Israel have said over the past two days that they view the American panel’s recommendation as an acknowledgment that conditions differ between the two countries. “The FDA in principle confirmed that the third dose is safe,” said Prof. Nadav Davidovitch, director of the School of Public Health at Ben-Gurion University of the Desert, Be’er Sheva, and head of the Israeli Association of Public Health Physicians.

Davidovitch added that “we need to remember the FDA did approve it for high-risk people with chronic diseases and also those at high risk because of their profession, such as health care workers of all ages. They have their own priorities and Israel has other priorities, because we started earlier. We also started with older people and then moved down and I think this is a very reasonable decision.”

Israel began to offer the third dose to older citizens back in August because of rising concerns, later confirmed by new research, that the effectiveness of the existing COVID-19 vaccines began to wane after approximately six months. An Israeli study published last week showed that booster shots increase protection from infection over tenfold in those over 60, compared to those who received only a second shot of the vaccine months ago.

The study used data on 1.14 million Israelis aged 60 and up who had received two doses of the vaccine by the end of August. It divided cases into two groups: one consisting of people who received two doses of the vaccine, and another consisting of people who received a third dose. The researchers found that at least 12 days after the booster shot, the rate of infection in the non-booster group was 11.4 higher than the booster group, while their rate of severe illness was 19.5 times higher.

The peer-reviewed study was authored by 11 researchers, including Israel’s director of public health services, Dr. Sharon Alroy-Preis, who also spoke in front of the FDA panel and presented relevant data from Israel.

Following the FDA panel’s decision, Alroy-Preis explained how Israel’s considerations differ from those of the United States. “We are three months ahead of the U.S. in the entire vaccination campaign’’, she told the Ynet news website. ‘’They don’t yet see the waning immunity [of the previous doses], but here it’s very apparent.’’

In a statement on Saturday, the Health Ministry also said that the United States is “several months behind Israel” in terms of vaccinating its citizens, many of whom are still within the window of maximum protection offered by the second dose of the vaccine. “At the point in time where Israel is at the moment, it is right for Israel to vaccinate the entire population aged 12 and older with the booster dose,” the ministry asserted.

Prof. Ran Balicer, who heads a panel that advises the Israeli government on COVID policies, appeared to agree, tweeting that Israel’s health authorities also debated over several weeks whether to approve the first stage of the booster campaign, which was originally limited to those over 60.

A man receives a coronavirus shot in Tel Aviv on Saturday.Credit: Moti Milrod

“The American decision from tonight is much broader than the one made back then in Israel,’’ he wrote. “I believe they too will gradually expand the recommendation.”

In an interview with Channel 12, Dr. Ofer Levy, an Israeli member of the FDA advisory panel, concurred that Israel’s situation was different from that of the United States, where he said more data was necessary, adding that Israelis eligible for a third shot should get one, regardless of what was happening in other countries.

On Saturday, the Israeli Health Ministry’s COVID dashboard reported 697 patients in serious condition, 484 of whom were not vaccinated at all. In other words, despite the fact that only 17 percent of eligible Israelis have not been vaccinated at all for COVID-19, the unvaccinated are now more than two-thirds of the country’s severe cases. Meanwhile, there were 158 serious cases of people who received two shots of the vaccine, and only 55 who had received a booster shot.

Over the past week, 119 people have died of the virus, and nearly 60 percent of them were unvaccinated. The disparity is even more apparent when calculating per capita: For every death of an Israeli over 60 who received the booster shot, there are roughly 15 deaths of unvaccinated Israelis in the same age group.

As of Sunday, 3,040,426 Israelis have received a booster, while 5,576,238 have received two doses and 6,062,338 have only received one.

The FDA is expected to make its final decision on the third round of shots soon. It is not bound by the panel’s recommendation but will take it into consideration.

Reuters contributed to this report.

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