The Biden administration’s push to roll out coronavirus vaccine booster shots this month has largely been shaped by unpublished data from Israel’s vaccination campaign, according to two individuals familiar with the matter.
The Israel data, which is set to be made public as soon as this week, shows that the Pfizer vaccine’s ability to prevent severe disease and hospitalization is waning over time — as is the shot’s protection against mild and moderate disease, the two sources said. The country began administering boosters to people over 60 in July and has now expanded it to people over 30, but it has released relatively little information so far about the effect of the booster campaign.
The Biden administration has long relied on data from Israel, which has one of the highest vaccination rates in the world, to inform its Covid-19 response. Top officials from the White House, the Centers for Disease Control and Prevention and the Food and Drug Administration have analyzed the latest Israeli data for weeks, concluding that the U.S. should begin administering boosters this fall, another senior administration official said.
Although the CDC has published a series of targeted studies that suggest Covid-19 vaccines’ effectiveness against infection is decreasing, particularly in the elderly, the Israeli data is more comprehensive and more alarming, three sources who have reviewed the data told POLITICO on Monday.
The administration’s focus on Israel's data underscores the extent to which the U.S. is leaning on other countries’ experiences to forecast the next phase of the pandemic here. That is partly because the highly contagious Delta variant swept through other parts of the world first, and partly because of better data tracking in countries like Israel that have national health care systems. The U.S. continues to struggle to collect and analyze reliable Covid-19 data because the federal government has long neglected the country’s public health infrastructure.
Senior administration officials working on the federal government’s response to the pandemic have for weeks debated whether to recommend booster shots for Americans. The White House and top health officials said in mid-August that they planned to roll out the shots for most adults beginning on Sept. 20. The move has sparked tensions between Biden’s top aides, the CDC and the FDA, amid questions about whether domestic data supported the goal. Two senior FDA vaccine scientists who are leaving the agency co-authored an analysis published Monday in the Lancet that found no evidence to support giving booster shots to the general population.
The FDA is examining the Israeli data as it reviews applications from vaccine makers to offer booster shots, three other senior administration officials said. One official stressed that no matter what the domestic or international vaccine data says, the final decision on whether to recommend boosters lies with the FDA. The agency's vaccine advisory committee is scheduled to meet Friday to discuss Pfizer's application for approval of its booster shot.
Asked about the extent to which the Israeli data showed vaccine efficacy waning, Biden’s chief medical adviser, Anthony Fauci, said it was “enough that you would be impressed.”
“I would be very surprised if the U.S. data don't turn out to be ultimately very similar to the Israeli data,” Fauci told POLITICO.
The CDC has published a series of studies on vaccine efficacy in the U.S., focusing on the shots’ performance after Delta rose to dominance this summer. The results suggest available vaccines still provide strong protection against severe disease for most age groups, and that breakthrough infections are still exceedingly rare. But the studies also show the shots are less effective at preventing infection from Delta than against older strains.
A CDC study published last week found that vaccines’ ability to prevent infection — including mild disease — decreased from 91 percent 78 percent after Delta took over this summer. The study included data on 600,000 Covid-19 infections from April through mid-July and compared the relative risks of infection, hospitalization and death based on age and vaccination status.
“If you look at it from the standpoint of trying to stay ahead of what could be an increase in suffering and death before it actually happens … and then you see those data from Israel, and the suggestion of our own data, we thought we at least need to plan and be ready to give vaccination doses of a third boost to people in a way that is expeditious,” Fauci said.