Israel’s Omicron response smacks of panic, 4th shots should wait, says immunologist

Day after PM announces ‘great news’ of additional doses for some, and as some experts applaud the move, Prof. Zvika Granot says mistake not to wait for research, updated vaccine

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

Medical scientists prepare to sequence COVID-19 omicron samples at the Ndlovu Research Center in Elandsdoorn, South Africa, December 8, 2021. (AP Photo/Jerome Delay, File)
Medical scientists prepare to sequence COVID-19 omicron samples at the Ndlovu Research Center in Elandsdoorn, South Africa, December 8, 2021. (AP Photo/Jerome Delay, File)

Israel’s government has unnecessarily unleashed a “panic response” against the Omicron coronavirus strain, and its decision to approve fourth shots for some citizens is “totally unacceptable,” an influential immunologist has said.

Speaking on Wednesday, a day after the government approved giving fourth shots to those who are deemed most vulnerable, Prof. Zvika Granot of Jerusalem’s Hebrew University said this should not be happening without focused research into the potential impact of fourth doses.

He also argued that the government is making a mistake by giving regular vaccines as fourth shots instead of waiting for updated shots that are more variant-proof.

“Why give a vaccine relevant to a variant we encountered a year ago when Pfizer can make and update it to the variants we encounter today,” Granot said, referring to a push by Pfizer and other companies to develop a new version of their vaccines.

“The coronavirus has changed and the vaccine is not as efficient as it could be if we had an updated vaccine,” he said.

Prime Minister Naftali Bennett said on Tuesday that the decision to selectively distribute fourth shots is “wonderful news that will assist us in getting through the Omicron wave that is engulfing the world.”

The move was recommended by a panel of health experts on a government body called the Pandemic Treatment Staff, 86 percent of whom backed it.

Prof Zvika Granot (Israeli Public Emergency Council for the Covid19 Crisis)

He declared: “The citizens of Israel were the first in the world to receive the third dose of the COVID-19 vaccine, and we are continuing to pioneer with the fourth dose as well.”

Fourth doses will be made available to over 60s, some at-risk groups and medical personnel.

Bennett spoke as Israel’s number of new daily COVID cases continues to rise, which is partly but not entirely due to Omicron. The number hit 1,400 on Wednesday according to Health Ministry data released Thursday, but hospital cases were still low, and there were just 83 patients in serious condition.

Prof. Galia Rahav, head of infectious diseases at Sheba Medical Center and a member of the expert panel that approved the fourth shots, said the decision was “not simple” given the paucity of data showing that the protection offered by the third shot was waning.

“But at the same time, there are terribly frightening numbers from what is happening in the wider world,” she told Army Radio, referring to Omicron.

Israeli prime minister Naftali Bennett holds a press conference at the Prime Minister’s office in Jerusalem on December 19, 2021. (Marc Israel Sellem/Pool)

Other experts are praising the fourth shot policy too. Immunologist Prof. Jonathan Gershoni of Tel Aviv University said when third shots were rolled out that he was “not convinced of the urgency” but thought it was a wise measure — and thinks it was proved right. And he takes a similar approach to the new round of shots, calling it a “very good idea,” and thinks it would be unwise to wait for updated vaccines.

He told The Times of Israel: “I think it makes sense to do a fourth round of shots even in the absence of clear data on their benefits. They won’t do any harm and could prove beneficial.”

Gershoni added: “The professionals who have a deep understanding of how viruses cause disease and how our immune system retaliates realize that after vaccinating large numbers of people with RNA vaccines, first and foremost they are safe, and they are relatively effective.

“From our experience of the first, second and third vaccines we know they are effective in increasing antibody levels and that Omicron is much more transmissible than previous variants. And even if severity of disease is relatively less than others variants, as cases rise so will hospitalizations,” he said.

Gershoni noted that the benefits would vastly outweigh any potential risks from a fourth dose.

“This is a professional and reasonable decision that the risk associated with a fourth dose is minimal or nonexistent, as against the potential risk from Omicron. This is especially the case for the elderly and for healthcare workers,” he said.

Dr. Amnon Lahad (Courtesy of Amnon Lahad)

Granot voiced his criticism of the policy at a press briefing alongside Hebrew University’s chairman of family medicine Prof. Amnon Lahad, who also said that the decision on fourth shots was hasty. “If we were in a disastrous situation it could be justified,” he argued, insisting that Israel is nowhere near a deep Omicron crisis.

In his assessment, “it will not be a wave without any fatalities, I’m sure, but the number will not be as high as it was with Delta and in the initial wave.”

He said: “I think that we have a catastrophe more in public opinion than what is happening more in emergency rooms or primary care clinics,” he said, arguing that impressions from South Africa, where the variant was first discovered, combined with immunization levels in Israel, suggest it won’t cause a major crisis.

“Yes, we should monitor what is happening, but should not be hysterical and should remember this is… not a disaster that will shut down the Israeli medical system,” Lahad opined.

In his reading, the situation in South Africa suggests that Omicron is highly infectious, but while there are some serious cases it tends to cause light symptoms and puts a relatively light burden on hospitals. The South African healthcare provider Discovery Health has calculated that adults infected early in the Omicron outbreak were roughly 30% less likely to be admitted to hospital than those infected in South Africa’s first wave.

A healthcare worker conducts a polymerase chain reaction (PCR) COVID-19 test on a traveler at OR Tambo International Airport in Johannesburg on November 27, 2021, after several countries banned flights from South Africa following the discovery of a new COVID-19 variant Omicron. (Phill Magakoe / AFP)

And while Omicron breaks through vaccines more than other variants, Lahad said that Israel is relatively highly vaccinated, which is still a strong line of defense against infection and against serious illness in those who are nevertheless infected.

In particular, he noted, most of those at greatest risk of infection are vaccinated.

“The reality is we just have to wait and see. The panic response by the government is not really justified by existing data,” Granot said.

He said that the government should “take a close look at what is going on around you and come up with a plan that is appropriate for the conditions as they are now.” He added: “We have to admit that conditions now, [medical] knowledge now, and capabilities now, are very different than what they were when we first encountered the coronavirus almost two years ago.” This suggests that the government is currently overreacting, he said.

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