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Experts: ‘Third vaccine dose for elderly might not help, but it won’t hurt either’

As Israel starts to offer vaccine booster shots to all elderly citizens, experts aren’t convinced they’ll help, but tend to agree that they won’t hurt.

“They may not benefit, but they won’t do any harm,” Bar Ilan University epidemiologist Prof. Michael Edelstein told The Times of Israel shortly after the government announced it would offer third coronavirus shots to everyone aged 60-plus.

Immunologist Prof. Jonathan Gershoni was “not convinced of the urgency,” but said that “if there’s availability of doses, added protection for people over 60 should be beneficial, and will increase their ability to face the Delta variant.”

Some Israelis expected such a decision to be met by criticism from experts on safety grounds, as their government seems to be going out on a limb, acting before boosters are approved by regulators like America’s Food and Drug Administration.

But even critics of the move, like Prof. Nadav Davidovitch, aren’t arguing about safety.

“We are going to have to make many decisions in the future, including for updated vaccines for variants, so we need solid data for decision making,” the Ben Gurion University epidemiologist and leader of Israel’s doctors union told The Times of Israel.

As for administering a third shot for the elderly, it is “not clear enough what the real benefit is,” said Davidovitch, adding that he considers the new booster policy a distraction from what should be Israel’s major priority today of vaccinating eligible people who have received no shots.

“I would prefer much more energy invested in the 1.1 million unvaccinated,” he said.

But Davidovitch stressed: “The vaccine is approved, and no special side effects, especially among the elderly, are expected.”

Gershoni, a vaccine expert from Tel Aviv University, said that after years spent analyzing inoculations, he is confident that boosters won’t prompt unusual reactions.

Boosters have already been given to immunocompromised people in Israel and France without hitches, and Edelstein pointed out that in Pfizer’s clinical trials, vaccines were given to people in various sizes of dose.

Even when people received large amounts of the vaccine in one administration, it didn’t cause negative effects, he noted.

While Davidovitch is skeptical and Edelstein agnostic about the potential of boosters, Gershoni has higher hopes.

“Adding another layer of protection, months after the second vaccination, when antibody levels have waned, can significantly increase antibody levels and therefore increase protection,” he said.

But this embrace falls short of the kind of enthusiasm that many Israelis will expect. Many members of the public see the decision to offer the shots as being driven by great urgency.

After all, they have been grappling in recent days with seemingly dramatic statistics, indicating that vaccine protection is quickly waning, due to a combination of the “super-contagious Delta variant” and time passed since inoculation.

A Health Ministry report even suggested that vaccine effectiveness in preventing infection has dropped to as little as 39%.

In large part, the dissonance stems from the fact that while statistics pointing to sharp drops in vaccine effectiveness generate many headlines, experts tend to treat them with caution, pointing to a range of weaknesses with the data.

Edelstein stressed that many of the calculations rely on comparing infection rates among vaccinated and unvaccinated Israelis, which is problematic as they tend to have very different profiles in terms of age, health, mindset and attitudes toward the coronavirus.

“This decision is based on what should be called limited evidence that immunity wanes,” Edelstein said.

Gershoni commented: “I agree with the decision, though I’m not convinced that the level of protection has deteriorated to a level we should be concerned [about].”

Source: Nathan Jeffay – TOI