And now it’s a third vaccine

In a world first, Israel has begun administering third doses of the COVID-19 vaccine to Israelis 60 years and over. Those eligible are receiving phone calls and SMS messages alerting them to go to their nearest health office. To date, no-one who has received the jab has reported any side effects.

That’s the good news. The bad news is that for the first time in five months, new coronavirus cases in the country are nearing 4 000. Daily new infections have spiked to more than 2 000, up from a handful of cases per day a few months ago, and about 160 people are currently hospitalised with severe symptoms. More than 6 400 people have died from the virus in the country.

The latest data suggests that people vaccinated in January appear to have just 16% protection against infection now; while in those vaccinated in April, the effectiveness is 75%. Some experts have questioned the veracity of the data, but most agree that there’s no harm in administering a third dose even if it may not end up boosting protection. In other words, the risk from a third dose is no greater than the risk of getting coronavirus itself.

It wasn’t an easy decision to reach. Israeli experts were divided over whether the initial two doses of the Pfizer vaccine were effective against the highly contagious Delta variant. As it turns out, seemingly not.

This third dose is expected to increase patients’ immune systems’ awareness of the coronavirus, creating a vaccine-based “memory” in the body that allows it to identify and more strongly respond to the virus. But this isn’t necessarily true when it comes to the Delta variant, which is more contagious than previous strands. This means a smaller quantity of virus is necessary to cause infection. The assumption is that giving a third dose of the vaccine to older adults can boost the immune system in the event that immunity weakens over time, as well as boosting the vaccine’s response even if it hasn’t waned, among populations at increased risk of serious illness if they are infected.

The demand for the third booster has been relatively high among Israelis 60 years and older, so much so that phone lines to health organisations crashed due to the number of people calling to schedule appointments. Still, not everyone is thrilled. According to a survey released on 30 July by the Social Policy Institute at Washington University and the Interdisciplinary Center in Herzliya, Israel, only 52% of Israelis who received two shots of the COVID-19 vaccine say they will have a third shot. Among those under the age of 60, only 47% said they would take the shot.

The main concern is that the long-term impact of the vaccine is still unknown, and as the Delta variant spreads across the country, including re-infecting a high percentage of vaccinated individuals, more people believe that the vaccine doesn’t work. According to the health ministry, more than half of all new cases are people who were fully vaccinated.

It’s believed that in order for the dose to be effective in halting the rising rate of serious cases, at least one million Israelis need to receive it. Even afterwards, it will still take several weeks to determine exactly the effects of this third dose.

Israel is the first country to launch a COVID-19 booster campaign, effectively becoming a testing ground before approval by the United States Food and Drug Administration (FDA). Israelis are concerned about this, as they are that they might not be receiving accurate information about the pandemic or the vaccines. Since the start of the coronavirus pandemic, accusations have been levelled at the Israeli media for exaggerating the risk of the virus.

The FDA has also been unwilling to approve Ivermectin, a drug used to fight parasites in third-world countries, to reduce viral shedding among non-hospitalised patients with mild to moderate COVID-19. But now, the Sheba Medical Center in Tel Hashomer has released the results of a study, finding that the drug could help reduce the length of infection for people who contract coronavirus – for less than $1 (R15) a day.

In the study, about 90 volunteers over the age of 18 who were diagnosed with coronavirus and were staying in state-run COVID-19 hotels were divided into two groups – one received Ivermectin while one received a placebo. Nearly 72% of those treated with Ivermectin tested negative for the virus by day six. In contrast, only 50% of those who received the placebo tested negative. There were no significant side effects among the Ivermectin users.

Still, the World Health Organization continues to recommend against using the drug except in clinical trials.

As Israel prepares for another lockdown during the upcoming September Rosh Hashanah holiday period, more Israelis are more afraid of the economic impact of the virus than of contracting it. The list of countries regarded as “red” – in other words, no-go zones – has increased, as has the requirement to enter into mandatory quarantine when arriving from abroad. South Africa has been on the red list for some time for travellers to and from Israel – and this is unlikely to change any time soon.