TEL AVIV, Israel—Over the long course of the COVID-19 pandemic, Israel has consistently been a pioneer, almost always running a few weeks ahead of the United States: in shutting its borders, instituting a nationwide lockdown, vaccinating the population, and then fully reopening its economy.
Now, amid spiking infection rates due to the Delta variant and studies indicating a drop in vaccine effectiveness over time, Israel on Sunday became the first country to launch a third “booster” shot campaign for all citizens over the age of 60 who were vaccinated more than five months ago.
Thirty thousand elderly Israelis received their third jab on the first day of the rollout, with reports of phone lines crashing due to demand by others trying to schedule an appointment. The Israeli military was enlisted to support the campaign as Prime Minister Naftali Bennett urged the number of freshly inoculated citizens to be “five times” greater. “Our goal is to vaccinate everyone by the end of the month. This is ambitious but it is possible,” he added. “The vaccination simply works and saves lives.”
The move is not without controversy. The World Health Organization and the U.S. Food and Drug Administration have not yet approved the use of a booster jab, although Israeli health officials are confident that its deployment can curtail the number of seriously ill—especially among the elderly population who were inoculated at the start of the country’s vaccination campaign.
“The decision was complex and took a few weeks for us to make. We have no one else to rely on, only our own experience and our own data,” Health Ministry Director General Dr. Nachman Ash told Army Radio on Sunday. “We saw a decrease in vaccine [effectiveness] and an explosion in infections, so we can’t wait for a FDA decision that may only come in a few months.”
Israel rolled out one of the world’s fastest vaccination drives last December, spurred on by plentiful supply from Pfizer after striking a data-sharing agreement with the company. Over 5.3 million of Israel’s 9 million citizens have been fully vaccinated with two Pfizer/BioNTech shots, allowing the country to come out of lockdown in March. As recently as June, the Israeli government jettisoned all remaining COVID restrictions as daily infection rates dwindled to single digits. The general mood in the country was celebratory: restaurants and bars were packed, masks were a vague and weird memory, and life had returned to pre-pandemic normalcy.
Then the Delta variant began appearing, leading to rising infection numbers as more and more “breakthrough” cases were reported, even among those fully vaccinated. Infection rates now run at over 2,000 per day. As of Sunday, the country had nearly 19,000 active cases, although only some 200 are considered seriously ill—according to Health Ministry data, a five-fold increase for both metrics in less than a month.
Israeli health officials began openly calling it a “fourth wave” and the government followed suit, re-imposing new restrictions. Long-shuttered COVID testing sites have been reopened and indoor mask mandates reintroduced. Additional limits and quarantine requirements for international travel have been employed, and a “Green Passport” scheme dusted off for entry into large events and gatherings.
Unlike previous waves, however, authorities have not instituted another lockdown, nor do they plan to for now. Daily life, despite the new restrictions, has so far been left largely untouched.
“The easiest thing for me would be to close down the country,” Prime Minister Bennett said in a primetime address to the country late last month. “However, our compass is different at the moment: We want to have an open and safe country.” In addition to the new measures, the premier implored those not yet vaccinated to go do so, including children over the age of 12. According to official data, some one million Israelis have so far not gotten the jab.
“Those who refuse vaccines are endangering their health, those around them, and the freedom of every Israeli citizen,” Bennett added in his address. “They are endangering our freedom to work, the freedom of our children to learn and the freedom to hold celebrations with the family.”
Last month, Israel was one of the first countries in the world to formally offer third shots to organ transplant recipients and other immunocompromised adults. That program has now been expanded to the entire elderly population, with senior Israeli officials receiving boosters live on television last Friday as an example for the nation.
The first to do so was Israeli President Isaac Herzog, 60, saying, “At the end of the day, with this move, we’ll be able to uphold normal life in our country.” Opposition Leader Benjamin Netanyahu, 71, followed shortly thereafter, using the occasion to remind everyone that he had called for a third shot weeks ago.
The former prime minister, who was the first Israeli to get the jab back in December, had raised eyebrows by wearing two masks during parliamentary sessions in recent weeks. Reports in the Israeli press last week said a recent serological test he’d undergone showed low antibody levels.
Health Ministry studies have indicated that is very likely, with the vaccine’s effectiveness waning after several months. According to aggregated data from the last two months reviewed by The Daily Beast, the Pfizer vaccine is now estimated to be only 40 percent effective at stopping infection and symptomatic COVID-19 among those even fully vaccinated, although it still remains 88 percent effective in avoiding hospitalization and 91 percent effective against severe illness.
Most troubling to health experts, and the reason for the third jab, is the clear decrease over time in the vaccine’s robustness coupled with the more infectious spread of the Delta variant. According to the Health Ministry’s studies, those fully vaccinated in January had only 16 percent protection against infection, whereas in February it stood at 44 percent, rising to 67 percent in March and 75 percent in April.
Pfizer and BioNTech released their own data on a call with investors last week that closely tracked Israeli findings. The companies are set to push U.S. regulators to authorize a third jab in the coming weeks, adding to the nearly 200 million doses already administered to Americans (the majority of any vaccine type).
“We have good data regarding the decrease in antibody levels… and the vaccine seems to be less effective in people vaccinated in January and February who contracted the disease half a year later in June and July,” Dr. Eyal Leshem, an infectious disease expert at Sheba Medical Center, told The Daily Beast. The goal now with the third jab, Leshem added, was to boost immunity and increase vaccine effectiveness against, primarily, serious illness and hospitalization.
“The hope is that we blunt the number of severe cases with the booster, but we’re not certain the overall number of people infected will be substantially reduced.”
So far the elderly Israeli public appears ready to accept another jab. According to a Channel 12 poll last Thursday, some 72 percent of Israelis over the age of 60 are willing to receive a third shot. The Health Ministry has reported that in this first week of the new drive, 250,000 appointments have already been made.
“If my doctors recommend it and it’s accepted policy then I won’t argue with it,” Jeanne, 66, a musician and resident of central Israel, told The Daily Beast. Her HMO sent a text message on Sunday inviting her to schedule an appointment, which she easily set for later in the week. “I can’t say that my heart is in it like the first two [shots], but on the chance it’ll give me extra protection then it would be stupid not to.”
Some health officials have also floated the idea of having medical personnel, many of whom were vaccinated early in the year too, receive a booster, along with younger adults with preexisting medical conditions. The rest of the world will look on with keen interest and alarm, to see whether Israel’s latest pandemic response works.
“We hope these steps will be sufficient to stop the current situation,” Dr. Asher Shalmon, a senior Health Ministry official, told The Daily Beast. “But I can’t promise you that. Nobody knows.”
