Israel’s Leap of Faith on 4th Shot Puts Focus on U.S. Next Steps
(Bloomberg) -- Israel has long been a vaccine test case, with the U.S. and other countries following its lead, but its current push for fourth doses may be different.
Israel said this week it would begin giving a fourth shot to people age 60 and up, as well as medical personnel, at least four months after their third dose, saying it worries that protections fall off around then.
Israeli data have been predictive throughout the pandemic. For instance, the U.S. pushed more quickly for booster shots after seeing Israel’s data. But here’s a difference now: the data are incomplete.
Instead, Israel is gambling that the benefits of a fourth dose outweigh the risks, and is moving ahead despite objections from a top scientist that a key trial is ongoing.
The U.S., long hamstrung by a patchwork of incomplete and often delayed data, opened the door to again following Israel on fourth doses but says it will wait to see what the science shows.
“If there is science and when there is science that demonstrates that that is necessary, we will certainly be reviewing that,” Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, told CNN this week. “We will absolutely consider it. Right now, we are working to make sure that our vaccinated people get a booster.”
Israel raced ahead early in vaccination and keeps robust data, two factors that make it a test case. The U.S. has closely watched what’s happening there for a snapshot it can’t get at home. The U.S. has faced a data shortfall, and there are simmering calls to heavily overhaul it to give medical experts and policymakers a better handle on things.
In the meantime, they fill in gaps by looking elsewhere.
It was Israeli data that the U.S. pointed to in the summer, when all of President Joe Biden’s medical advisers issued a statement saying they thought boosters would be needed. That triggered a wave of discussion over who should be eligible, and questions about whether the top experts were getting ahead of their agencies.
In retrospect, booster eligibility has since been thrown open and is now a key line of defense against the omicron variant.
“They were right, and Fauci was right,” said Eric Topol, director of the Scripps Research Translational Institute. The Israeli data were “plain as day,” he said, but still it took weeks for U.S. regulators to begin shots, and they only did so at first in a narrow population. “The CDC and FDA were wrong on that. They ignored the evidence from Israel and we didn’t have data from the U.S.”
About 65.6% of people in the U.S. are fully vaccinated, and about 30.8% of people eligible for a booster shot have gotten one, CDC data show. However, those data may also be wrong. The agency has acknowledged shortfalls there that suggest the numbers of fully vaccinated are higher, because second and third shots have been miscounted as first shots.
Data revisions from some states suggest that the miscount is in the millions, meaning that millions more Americans have no shots at all, but millions more than thought have more than one. Walensky acknowledged the issue on Wednesday, saying the CDC data relies on inputs from around the country, but declined to say how big the error is. Part of the problem is people forgetting their CDC cards, which are used to record shots, she says.
“We work closely with those states and jurisdictions to update and provide us the best possible data that they can. And then we compile it to give you, the American people, the best reporting that we can,” she said. “We’d ask the American people to help us improve our data by bringing in their vaccination cards.”
The total number of shots is accurate, said Jeff Zients, Biden’s Covid-19 response coordinator. “What we know, most importantly, is getting more and more people vaccinated, more people boosted is the most important thing to do,” he said. “I know CDC is making progress on the data.”
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