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get into a fierce argument over booster dosesResearchers in Israel reported Wednesday that the third dose of the Pfizer-BioNTech coronavirus vaccine May prevent both infections and serious illness in adults over 60 shortly after injection.

The study, published in the New England Journal of Medicine, is the latest salvo in the controversy over whether additional doses are necessary for healthy adults and whether they should be given, as in many parts of the world, as the Biden administration plans to do. remains unvaccinated.

Several independent scientists said that cumulative data so far show that only older adults will need boosters, and perhaps not even need them.

Experts said that in all studies published so far, vaccination is a strong protector against severe illness and hospitalizations in the vast majority of people. But vaccines appear to be less effective against infections in people of all ages, especially those exposed to the highly contagious Delta variant.

What the Israeli data show is that a booster can increase protection in older adults over the course of several weeks – a result that wasn’t surprising and showed no long-term benefit, the experts said.

“What I predict is going to happen is that the immune response to this booster will increase and then contract again,” said Marion Pepper, an immunologist at the University of Washington in Seattle. “But is this three to four month timeframe what we’re trying to achieve?”

Federal health officials – President Biden’s chief advisor on the pandemic, Dr. They justified their plan to distribute booster vaccines, citing emerging evidence from Israel and other countries – including Anthony S. Fauci – to suggest that immunity from the vaccine diminishes over time.

The idea sent some Americans striving for booster shots It’s a step the FDA can take as soon as Friday, even before it’s officially authorized. But even among government scientists, the idea was met with skepticism and anger.

Two scientists leading the FDA’s vaccine branch said they will leave the agency this fall, in part because of their unhappiness with the administration’s push for booster doses before federal researchers review the evidence.

On Monday, an international group of scientists, including departing FDA officials, denounced the crackdown on boosters. In their review, published in The Lancet, the scientists analyzed dozens of studies and concluded that the world could be better served by using doses of vaccines to protect billions of unvaccinated people around the world.

WHO chief scientist and co-author of The Lancet review, Dr. “Our primary goal in this pandemic was above all to prevent and end all preventable deaths,” said Soumya Swaminathan. “And because we have the tools to do this so effectively, we should use it to prevent deaths around the world.”

Experts said the more pressing need is to protect the unvaccinated, both in the United States and elsewhere, to prevent the virus from transforming from the Delta variant to more dangerous forms, and perhaps to one that completely evades the immune response.

WHO has asked world leaders to refrain from rolling out boosters, at least until the end of the year, with the aim of vaccinating 40 percent of the global population. But some high-income countries have started offering boosters to their residents, and others may follow in their footsteps.

British scientists on Tuesday recommended that adults over 50 and other medically vulnerable people in that country be given a third dose. France, Germany, Denmark and Spain are also considering or starting to implement promoters for older adults. Israel has allowed boosters for anyone over the age of 12 and is already considering a fourth dose for its population.

In the new study, the Israeli team gathered data on the effectiveness of booster vaccines based on the health records of more than 1.1 million people over the age of 60. At least 12 days after supplementation, infection rates were eleven times lower and rates of serious illness were present. The researchers found that those who received a booster were almost twenty times lower than those who received only two doses.

The researchers agreed that their results were preliminary. “At this point we can’t say what will happen in the long run,” said Micha Mandel, a professor of statistics and data science at the Hebrew University of Jerusalem.

The question is scientifically complex, in part because protection against infection is a significantly different goal from protection against hospitalization and death.

Antibodies are the body’s front line defense against infection. Scientists say vaccines are unlikely to reliably protect against infections over the long term, as the antibodies that vaccines stimulate the body to produce inevitably decrease over time.

But the cellular branch of the immune system is the body’s heavy weapon against hospitalization and death. It may take several days for the pseudo-immune memory encoded in this branch to kick in, but remains intact months after the first vaccination.

Herein lies the problem with booster strategy: The tools to prevent hospitalization and death are already at hand, some scientists say. If the goal is to prevent infections, the country will be stuck in a never-ending cycle of booster shots.

Infectious disease specialist at the University of California at San Francisco, Dr. “As a result, if you’re really using the infection, you probably need an unrealistic and unattainable booster every six months,” said Peter Chin-Hong. “I don’t care about symptomatic illness – I don’t care about serious illness.”

He added that the only vaccinated patients he saw at the hospital were adults over the age of 70 who were immunocompromised or had other health problems.

Dr. Fauci and other health officials referred to Israeli data when talking about the need for supplements. shows an increase in severe disease among vaccinated people of all ages. But adding all age groups together can inflate the rates statistically.

When Israeli figures are released separated by ageInfectious disease specialist at Bellevue Hospital Center and former advisor to the Biden administration, Dr. Celine Gounder noted that only people over the age of 60 showed a notable decrease in effectiveness against serious diseases.

Dr. “We’ve known for some time that vaccines elicit less robust immune responses in the elderly,” Gounder said. “It is not controversial to recommend additional doses of vaccine for the elderly.”

There are other differences in the vaccination campaigns in Israel and the US, which raises questions about whether the new results apply to citizens of both countries. For example, more than 90 percent of Israelis over 50 have been vaccinated, and older adults are more likely to be hospitalized for Covid-19.

FDA scientists acknowledged this limitation Wednesday, saying US-based studies “may most accurately represent vaccine efficacy in the US population.”

Studies so far in the US also show a decline in vaccine efficacy against severe disease only in older adults. Three studies published last week by the CDC found the ability of vaccines to prevent hospitalizations. barely moved Even after the arrival of the Delta variant, excluding adults over 75.

An ongoing analysis of the Pfizer-BioNTech vaccine shows that efficacy against symptomatic infection drops from 95 percent in the first two months to 84 percent four to six months after the second dose.

But other data from Pfizer, also released Wednesday, showed that the vaccine was effective against serious diseases. remained steady at 97 percent.

“We remain confident in the protection and safety of the two doses of vaccine,” Pfizer said in a statement. “However, we continue to believe that a booster dose could be used to provide as much protection as possible over time.”

Some scientists said a decrease in protection against infection for older people is a compelling argument for boosters. Dr. “One always wants to be proactive rather than reactive in this group,” Chin-Hong said.

Michel Nussenzweig, an immunologist at Rockefeller University, said he wanted the booster vaccine (66 years old) but at the same time supports their use in the general population to interrupt the chains of transmission.

He said that while immunity in young people is not yet diminished, an extra dose of preventing infections would reduce the spread of the virus to unvaccinated people around them.

“It will eventually prevent others from going to the hospital and ultimately benefit the way the country is going,” he added.

Other experts have questioned this premise and said there is no data to suggest that the drop in transmission would be significant enough to justify the supplements.

In younger people, authorities need to balance the limited benefit of a third dose with the risk of side effects such as blood clots or heart problems, the researchers said. Dr. Repeatedly stimulating the body’s defenses can also lead to a phenomenon called “immune depletion,” Pepper said.

“There are some risks to constantly trying to boost an immune response,” he said. “If we get into this augmentation cycle every six months, it’s possible that it will work against us.”