Naftali Bennett explains why Israel is giving booster shots for covid-19
ATHE WORLD fights covid-19, vaccines are essential. But should people in developed countries receive booster doses, especially before other people in poor countries have received their first vaccine? Many countries are grappling with these issues, especially America, Britain and those in Europe. Israel’s experience can be instructive.
In July, my government decided to administer a third dose of the Pfizer-BioNTech vaccine to the Israeli public. It was a difficult decision. Israel began vaccinating last December, after America and Britain gave emergency approval for the vaccine. Yet there was no regulatory approval for the safety or efficacy of a third dose. And the World Health Organization is urging countries not to proceed with recalls until less developed countries have vaccinated the majority of their population with a first dose.
Israel has world-class medical research institutions, but for a small country, taking the lead in this area is another matter. The medical committee advising our government was divided. The easiest would have been to wait for a consensus to form among the experts. But public health experts tend to be conservative and risk averse – traits that serve us all well in normal times but can cripple and slow decision making during a pandemic.
A pandemic is not just a health problem. It has a huge impact in many areas: economics, education, public communications, logistics and supply chains, psychology and mental health, the bonds that unite individuals, families, communities. and entire nations. Fighting a pandemic is like fighting a war, where strategic decisions should not be made by the experts, the generals, but by the elected government, taking into account a larger picture.
Like war, a pandemic is full of uncertainties, partial information, rapid change, and the need to make quick decisions and take decisive action. Sometimes not making risky decisions can be more damaging than taking a calculated risk. Taking these risks is the responsibility of elected leaders.
When my government took office in mid-June, there was a feeling in Israel that we had conquered the coronavirus and that the days of the pandemic were definitely over. Israel’s early vaccine uptake began to curb the devastating third wave of covid-19 in February, allowing us to start breaking out of lockdown. Face masks have been removed with great fanfare, social distancing restrictions and travel restrictions have been lifted. Life was back to normal. Or so we thought.
From April, the Delta variant arrived in Israel and by July the daily number of covid-19 cases, which had fallen to a handful in May, began to rise rapidly, with hospital admissions following suit. Of most concern was that many of those infected were vaccinated. We tried to figure out what had happened. Was the Delta variant so virulent that it was able to overcome the vaccine’s defenses or was it just the weakening of the effect of the vaccine over time?
After repeated meetings with immunologists and reviewing the data, we quickly came to the conclusion that this was a combination of the two factors. The high proportion of Israelis who had received their two doses at the start of the vaccination campaign were also more vulnerable to the new strain when their defenses began to weaken. This was a classic case of “breakthrough” infections, when fully vaccinated people are infected.
Ironically, people receiving two doses may be at increased risk because they think and act as if they are fully protected, even when that protection may weaken. We knew the vaccines worked and their side effects were minor; we had seen it very clearly in February. But their effectiveness over time and against newer variants such as Delta was less clear.
There was another reason for the reluctance of experts to approve the booster shots. The third wave had been overcome thanks to a combination of the vaccine and lockdown restrictions. Some pundits believed we couldn’t rely on vaccines alone and needed to prepare for another lockdown.
As prime minister, I had two options: either drag Israel into a new round of lockdowns and further harm our economy and society, or double vaccines as a central strategy, along with less restrictive measures such as ” a face mask mandate in closed spaces and the “Green Pass” device which requires people to bring proof of vaccination or negative test results in order to participate in the various activities.
Besides avoiding the debilitating damage of another lockdown, there was another reason to move forward with the booster doses. As the Delta wave mounted, we had more cases among those vaccinated than among people who had not received a vaccine. When double-dose people get infected and get sick, it erodes public confidence in vaccines and discourages others from getting vaccinated. Therefore, when many experts advised us to focus on the small proportion of unvaccinated people before issuing boosters, we decided that the third vaccine was necessary to preserve public confidence in the vaccines.
It was to be the first time that we did not close businesses, schools and public events in the face of a surge in cases. It was a calculated risk. But thanks to the 3 million Israelis who rushed to get their third vaccine, we have started to see a drop in the number of infections and hospitalizations. This drop is happening so far despite our decision to reopen schools on September 1 and allow public gatherings during major Jewish holidays this month.
The large number of booster doses allowed researchers to observe the effectiveness of the vaccine in real time after a third dose. Studies so far show that the third dose is enough to bring resistance back to the level after the first two. Waiting too long to administer the third doses risks wasting the gains already made from immunization and eroding precious public trust. Israel’s experience shows that timely booster shots can counter the next wave of infections.
These are crucial lessons not only for Israel, but for many countries. The initial success of the covid-19 vaccination does not guarantee full immunity against subsequent waves and new variants. Protection levels need to be monitored and, over time, strengthened. The third booster vaccine has been shown to be effective against the Delta variant.
According to a recent study, the third dose reduced the risk of those vaccinated and over 60 years of age of developing severe cases of covid-19 by 90% compared to those who received only two doses. If we had only waited three more weeks before starting to administer them, Israeli medical centers would have been overwhelmed with the number of seriously ill people. Acting quickly has increased immunity levels and saved lives in Israel, and it can save lives in other countries as well. We have shared our data with other countries and have included it among other recommendations.
As to whether third doses can be justified when many developing countries have yet to receive their first dose, we believe it is crucial to do what we can to save lives in our own. countries, while working together as a global community to help developing countries fight the virus. Global vaccine production must continue to grow in order to meet the needs of all nations; the pandemic knows no borders. But as the global supply grows steadily, we must recognize that vaccine availability is not the only concern. We are constantly learning how to best use vaccines against an evolving threat and it is crucial that the gains already made are not wasted with the consequent loss of public confidence in vaccines.
There are those who publicly try to undermine the need for and the success of vaccinations. If we allow the defenses of those who did the right thing and got vaccinated early to weaken, just as new waves of infection are on the rise, we will not only put them in danger, but we will provide fodder for anti-vaccines and conspiracy. theorists. This is why it remains crucial that countries that have introduced early and effective vaccines are able to roll out boosts, so that vaccines can both continue to work and appear to work.
Scientific ingenuity and innovation have delivered a vaccine against the coronavirus at unprecedented speed. But we have to remain both vigilant and flexible to make sure we use it to the best of our ability. We believe that we are proving that right now in Israel with the appropriate recall shots and that other countries will follow suit. ■
Naftali Bennett is the Prime Minister of Israel.