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In world first, COVID boosters rolled out for some at-risk Israelis

Decision to give third shot to those with weakened immune systems comes after government weighs ‘accumulating evidence’ that immunocompromised aren’t well enough protected

Nathan Jeffay is The Times of Israel's health and science correspondent

A man receives a booster dose of the coronavirus vaccine at Sheba Medical Center outside of Tel Aviv on July 12, 2021. (Courtesy Sheba Medical Center)
A man receives a booster dose of the coronavirus vaccine at Sheba Medical Center outside of Tel Aviv on July 12, 2021. (Courtesy Sheba Medical Center)

As the Delta variant spreads, Israel started offering third dose COVID vaccine shots to all adults with impaired immune systems, based on “accumulating evidence” indicating they aren’t well enough protected after their initial doses.

This made Israel the first country to roll out Pfizer booster shots to all immunocompromised people, and the second country to give boosters to the at-risk, after France which uses a variety of vaccine brands.

Israel’s Health Ministry issued a statement to healthcare providers on Monday, saying they are free to start giving the boosters — clearing up confusion created on Sunday when minister Nitzan Horowitz said they were available, but doctors weren’t told.

“There is accumulating evidence that patients with immunosuppression do not develop a satisfactory antibody response after two doses of the coronavirus vaccine, and some of them may develop antibodies after a third dose,” wrote Dr. Emilia Anis, head of the ministry’s epidemiological unit.

Israel’s largest hospital, Sheba Medical Center, immediately invited dozens of its heart transplant patients for boosters on Monday afternoon.

The Health Ministry decision was based on deliberations by Israeli doctors and officials. It was made before regulators like the US Food and Drug Administration has authorized boosters for such people. This is not the first time Israel has moved head of US or European regulators: in early 2021, Jerusalem authorized vaccines for immunocompromised children before the FDA embraced shots for kids.

The medical community has been largely supportive of the decision despite the absence of an okay from regulators, since it is a special provision for those who are at-risk, not a sweeping population-wide policy.

It is a “very important” move, Prof. Nadav Davidovitch, a Ben-Gurion University professor and leader of Israel’s doctors’ union, told The Times of Israel.

It comes on the heels of Pfizer’s announcement that it will ask US and European regulators to authorize a booster dose of its COVID vaccine for the general population. Nearly all Israelis have been vaccinated with Pfizer’s shot.

It also comes as the Delta variant spreads quickly in Israel, causing an increase in infections, and prompting the return of compulsory mask wearing indoors and a rise in voluntary mask wearing outdoors.

Israelis wear protective face masks as they walk in the streets of Tel Aviv, on July 12, 2021. (Miriam Alster/FLASH90)

Experts are warning Israelis against interpreting Monday’s decision as a sign that vaccines aren’t working or as a signal that Israel wants boosters for everyone.

Tel Aviv University professor Jonathan Gershoni (courtesy)

Horowitz said on Sunday that the Health Ministry was evaluating the possibility of boosters for all, but vaccine researcher Prof. Jonathan Gershoni told The Times of Israel that decision making for the immunocompromised has been very different.

“This is a good decision, responding to the unique needs of those who are immunocompromised,” said Gershoni, a biochemist from Tel Aviv University. “My concern is that people will read between the lines and think that we all need booster shots.”

That is not the case for people with general medical conditions that don’t weaken the immune system, nor is it true for the general population, he said.

Thailand also became one of the first countries to offer boosters Monday, announcing that health workers who got two doses of the Chinese Sinovac shot will receive booster doses of the AstraZeneca vaccine.

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