Expert Panel Backs Fourth COVID Vaccine Dose for Israelis 18 and Over

The recommendation will expand Israel's fourth COVID dose rollout, previously limited to Israelis above 60 and at-risk adults, but still awaits the Health Ministry director-general approval before implementation

Ido Efrati
Ido Efrati
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A nurse administers a fourth COVID dose, in Jerusalem.
A nurse administers a fourth COVID dose, in Jerusalem. Credit: Ohad Zwigenberg
Ido Efrati
Ido Efrati

The expert panel advising the Health Ministry on the coronavirus recommended Tuesday offering a fourth shot to Israelis aged 18 and above, on condition that five months have passed since they received a third shot or recovered from the disease. 

The recommendation, which will expand Israel's limited fourth vaccine rollout for Israelis above 60 and at-risk adults, still awaits approval by the Health Ministry director-general before implementation.  

The panel cited data showing that a fourth dose of the COVID-19 vaccine given to people over 60 in Israel made them three times more resistant to serious illness than triple-vaccinated people in the same age group.

This figure is based on a comparison with people in the same age group who received a third dose at least four months earlier. The ministry said its analysis was based on statistics of some 400,000 people who had received a fourth shot and 600,000 who had received a third shot.

Last week a study by Sheba Medical Center found that a fourth shot of the COVID-19 vaccine boosts antibodies to even higher levels than the third jab, but it likely is not enough to prevent omicron infections.

The study, led by Prof. Gili Regev-Yochay, included 270 staffers who received the fourth dose and a control group of employees who were not given a second booster. 

Prof. Regev-Yochay, who is not on the advisory panel which made the recent recommendation, criticized the decision and said that the number of young Israelis in "serious condition or on ECMO machines" is still low and that therefore offering a fourth shot to "young people is wrong."

She also expressed concern that the move would reduce the public's trust in the vaccines and health system. 

A member of the panel who supported the decision, however, stated that "young people who got three shots are fairly protected, but if one wants to improve the level of protection, a fourth dose will definitely do that."

Of the 50 members on the advisory panel, 33 voted in favor of the decision. Eight were in favor of allowing only people above 40 to get the fourth dose and eight believed that only at-risk Israelis should receive the second booster. One member of the panel was against expanding the vaccination campaign at the moment. 

Israel recorded 845 serious cases, 228 of whom are in critical condition with 177 on ventilators and 19 on ECMO machines. The R number – the average number of people each coronavirus carrier infects – stood at 1.23.

As of Tuesday, 580,369 Israelis are diagnosed with coronavirus. Since the beginning of the pandemic 8,487 Israelis have died of COVID.  

On Monday Health Minister Nitzan Horowitz discussed the fourth vaccine in an interview for Radio Israel, saying that the decision to allow the fourth shot for the elderly and immunosuppressed was not an easy choice. Regarding vaccinating the general population he said: "I don't think we will go there."

The Health Ministry's announcement came after the release of substantial U.S. studies led by the Centers for Disease Control which analyzed the vaccine protection against omicron.

Israel was one of the first countries to vaccinate its population early this year and then carried out the world’s first booster campaign over the summer.

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