Alvin M. Keeling 
Israel has been at the forefront of the roll-out of immunization for adults and adolescents, pioneered a vaccine passport, and in recent months has spearheaded the use of booster shots. .
Now, a person is not considered fully vaccinated in Israel until they have received a third dose of the vaccine, once they are eligible for it.
More than three months later, Israeli health officials say the data is clear: The booster injections helped bring down the fourth wave of the virus that swept through the country in August and September.
At its peak, this wave saw more than 8,000 new cases of Covid-19 per day and more than 500 people hospitalized at a time in serious condition.
The current seven-day average is between 450 and 500 cases per day, and there are 129 people hospitalized in serious condition with the virus.
The data highlights stark differences between those who have the vaccine – and the booster – and those who don’t: Several days over the past month, more than 75% of positive cases were among the unvaccinated, according to data from the Ministry of Health.
Among those hospitalized with Covid-19, it is even clearer: Israeli officials say that in October, the rate of people over 60 in serious condition who had received only two doses of the vaccine was 5 times that of those who received three injections.
And although the number of cases has globally declined since then, the differences remain: On Sunday, there were four times as many people over 60 in severe condition who had only received two injections, compared to those considered. as fully vaccinated with three doses, according to the health ministry.
Lessons from Israel
Dr Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, cited the data as a reason he believes it will soon be recommended that everyone receive boosters once they are eligible.
“If you look strictly at the data from Israel, it’s very clear that the differences in waning immunity are much deeper among the elderly, but it goes across the board,” Fauci told NBC last week.
Israel’s lesson is one that more and more nations are learning, especially as cases reach troubling levels in parts of Europe.
Health experts say the rollout of booster vaccines in many Western countries highlights the inequity of vaccine rollout in other parts of the world.
In contrast, only 10% of people in African countries received a first dose, on average, according to Our World In Data; only 7% of Africa is fully immunized, data shows.
Fifth wave of fears
But the news from Israel is not all good: although the number of cases has declined since September, the decline has stabilized. And, more worryingly still, the R rate – the average number of people infected by each person with Covid-19 – has returned above 1, according to data from the Department of Health – a worrying sign that the virus could spread. again.
Health experts, such as Professor Eran Segal of Israel’s Weizmann Institute, say it is too early to say whether the country is entering a fifth wave of the virus. But they point to the fact that nearly 1.5 million people who received two doses of the vaccine have not returned for their booster.
“There are more people whose vaccine has worn off over time, relative to the number of new vaccinations and booster shots, which has resulted in the total slowly decreasing. [population’s] immunity, ”Segal tweeted last week.
Now Israel is working to curb this potential fifth wave: Authorities are encouraging the unvaccinated to get vaccinated, and those eligible for booster doses to get them. They also vaccinate children and follow preventive measures.
Many new infections in Israel affect children between the ages of five and 11, according to Israeli health officials. A vaccination campaign for this age group began on Monday.
“About 50% of our daily infections occur in this under-11 age group,” Dr Ran Balicer, chairman of Israel’s National Covid-19 Expert Advisory Group, told CNN last Friday. “We think this vaccination campaign could actually turn the tide and maybe put us back on a downward slope if we have a good rise. [in vaccinations], as we hope. ”
But even with a highly vaccinated population, health experts say it is essential that anti-Covid measures remain in place, especially in winter, as activities take place indoors.
Nachman Ash, director general of Israel’s Ministry of Public Health, told Israel’s Channel 13 that the increase in the number of cases is partly due to the fact that people do not adhere to rules such as wearing masks .
“Enforcement is not enough,” Ash said. “And I see the audience relaxing as time goes by and the infection rate goes down, so people are less careful. Therefore, yes, we have to increase the application.”
Balicer warned that ignoring the waning immunity of those who have received two doses of the vaccine “may, in fact, put people at risk with false assurances.”
“There is no quick fix that would be enough to ensure surge prevention, especially in winter,” Balicer said. “It’s a combination of measures: indoor masks, behavior of the population, restrictions on indoor events and green certificates, and an effective recall campaign.
