SACHA PFEIFFER, HOST:
The world has been watching Israel's handling of COVID-19 very closely since the beginning of the pandemic. Israel was one of the first countries to administer vaccines and assess their efficacy. And now, with the omicron surge and Israel's approval of a fourth vaccine dose, we wanted to know what the U.S. can learn and expect from developments there. So we're joined by Dr. Manfred Green. He's a professor of epidemiology at the University of Haifa. Dr. Green, thank you for coming on the program.
MANFRED GREEN: Hi, Sacha. Nice to see you.
PFEIFFER: Would you give us an overview of what stage Israel is in when it comes to the omicron surge?
GREEN: We're basically seeing a very rapid expansion of the epidemic in Israel, and omicron is by far the dominant strain.
PFEIFFER: Is that taxing hospitals? Are you seeing the same thing the U.S. is seeing with overwhelmed health care systems?
GREEN: We're not seeing that the health system is being overwhelmed, but there's certainly been a large increase in the number of severe cases and those who are on respirators. But it's still at levels that are somewhat lower than they were, like, in the first wave. The main reports from the field are that most of the cases are mild.
PFEIFFER: So because of that, there's a lot of talk about treating COVID as endemic, especially as it becomes so widespread. And here in the U.S., many people are now basically treating it that way, as something we simply have to live alongside while society functions as normally as possible.
GREEN: The term being endemic basically means that we're not seeing unusually high rates of disease, but we're seeing continual low rates of disease. We still far from that situation. I think the other point that has to be emphasized is that we talking about a virus which mutates. It changes. So that we'll see omicron right now, but the next variant may emerge in the next couple of months or whenever. So we can't really talk about a situation which is stable at this stage.
PFEIFFER: A couple weeks ago, Israel approved a fourth vaccine dose for some people, a second booster basically. But some studies suggest that too many vaccines or boosters in short succession could have a reverse effect on immunity. What can you tell us about that?
GREEN: I think the best way to look at it is the safety and the efficacy, or the effectiveness. If you talk about the safety, there's no good evidence that repeated vaccinations are going to actually be problematic. In other words, it's not going to actually depress the immune system. The whole idea of a vaccine is that when you're exposed to the actual virus, you actually respond appropriately, and that's repeated, shall we say, exposures to the immune system. So that's not a problem. The problem really is whether it's actually giving you an added benefit. In terms of efficacy, the additional doses may be less beneficial and even reach a stage where there's no real purpose in giving an additional dose.
PFEIFFER: And to that point, a question for you about variants and immunity. If people catch omicron naturally, could that make them immune to other variants, including possible future variants?
GREEN: Getting immune to omicron should at least give you some immunity against the variants that would emerge that are in the same family. Again, we dealing with a virus where the actual infection with the virus doesn't necessarily give you long-term immunity. It may give you immunity for a limited period of time.
PFEIFFER: There are some people arguing that because they have been vaccinated but still caught COVID, that must mean vaccines aren't effective. But do you view the goal of COVID vaccines more to stop transmission of the virus or to provide protection against serious illness from it?
GREEN: I think primarily the vaccine is intended to prevent, you know, serious illness. That's pretty much what we do, for example, with the influenza vaccine. We know that the influenza vaccine is far from 100% effective in preventing transmission or preventing actual infection, but it does seem to have a very good record as preventing severe disease. It's obviously nice to have a vaccine that's going to prevent transmission, but that, I think, is something in the future.
PFEIFFER: In general, Dr. Green, what do you think the U.S. can learn from the developments in Israel or maybe take as a warning sign?
GREEN: Well, first of all, I think we can learn from each other. (Laughter) I'm not sure I'd like to say that the U.S. can learn only from us and it's a one-way, particularly when the vaccines have been developed in the U.S., and the U.S. has a much stronger scientific community. So, you know, the main information that's coming out of Israel is that we've been pretty proactive in vaccinating. And so we are providing a lot of data on the second dose and then on the third dose, and we are now generating data on the fourth dose. So I think this does help other countries to actually judge what is going to be best for their population.
PFEIFFER: And at this point, would you advise other countries, go for that fourth dose?
GREEN: I think we have to be a little cautious now about whether the fourth dose is really necessary for the whole population at this time. I would suggest it would be of limited use amongst people who have responded poorly to the earlier doses - those who have some kind of immune suppression and the elderly and the very elderly. You know, whatever - over 80, although we've been giving it to over 60. But, in fact, we now have good evidence that this vaccine is best given in a three-dose schedule. And we should be focusing on making sure that everyone gets at least the third dose.
PFEIFFER: Dr. Manfred Green is a professor of epidemiology at the University of Haifa. Thanks for sharing your thoughts and knowledge with us.
GREEN: Thanks very much, Sacha.
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