I can understand why someone would look at this graph and think that they’re not working.

It wasn't supposed to work this way.
Cases got down to zero in June after one of the most aggressive vaccination campaigns in the world.
Then came Delta. pic.twitter.com/skbXX22h5n

— Eric Topol (@EricTopol) August 16, 2021

There are 50,000 active COVID cases in Israel right now. A few months ago there were 200. Delta is a beast.

Even in that highly vaccinated country, there are plenty of unvaccinated “sitting ducks” for the variant to target and drive cases upward. The rationale for the booster was that it was no longer just the unvaxxed who were driving community spread, though; senior citizens who’d gotten their shots early this year were beginning to get infected too as their immunity waned. They weren’t landing in the hospital at the same rate as the unvaccinated were, but having the immunized capable of spreading the virus meant there’d be many more vectors of transmission circulating in society than there were before. Recent unpublished Israeli reportedly shows that “the Pfizer vaccine’s efficacy against severe disease had dropped significantly for those 65 and older who got their first shots in January or February.”

The variant was set to spread and spread and spread, eventually reaching the unvaccinated and occasionally breaking through to cause a severe case in someone who’s had their shots. Israel gambled that asking people over 50, the first cohort to get vaccinated this year, to get a third shot might once again take some of those potential vectors of transmission out of circulation and provide some extra protection against severe illness for the older demographic that needs it.

Results: So far, so good.

Israel started administering a third dose to 60 y/o and above on July 30

By now, over half of this age group received the 3rd dose

In the two weeks that passed, the relative fraction of cases of 60 y/o and above who are vaccinated out of all cases dropped from ~12-14% to ~6% pic.twitter.com/wOQCRPr5BD

— Eran Segal (@segal_eran) August 15, 2021

Various data is floating around online over the past few days. Here’s the trend in cases among all Israelis who’ve had a third dose:

Here’s the trend in cases among the total 60+ age group, many (but not all) of whom have already had a third shot:

And here’s the reproduction rate among the 60+ group:

Same takeaway in each graph. Ever since Israel started dosing out third shots to the olds a few weeks ago, the virus is spreading less among that group while it continues to spread among the unvaccinated. And as for *severe* cases, the vaccine has been strong at prevention all along:

More than a million people have received the booster so far, a bit north of 10 percent of Israel’s total population. The expectation is that as more 50+ citizens get jabbed again, the fearsome upward trend in cases will begin to turn around and the trend in hospitalizations will soon follow.

In case the Israeli data isn’t convincing enough, Pfizer just submitted its own clinical trial data to the FDA as part of its application to authorize a booster here in the U.S. The third dose produced “significantly higher neutralizing antibodies” against Delta in people who had their first set of shots eight or nine months ago. Barring any worrying evidence about side effects, which is already being partly assuaged by Israel’s experiment, it’s a cinch that boosters will approved for much of the U.S. population soon-ish. How soon-ish? Not next week, but certainly seniors are going to want to get jabbed ahead of the expected fall wave:

With a stockpile of at least 100 million doses at the ready, Biden administration officials are developing a plan to start offering coronavirus booster shots to some Americans as early as this fall even as researchers continue to hotly debate whether extra shots are needed, according to people familiar with the effort.

The first boosters are likely to go to nursing home residents and health care workers, followed by other older people who were near the front of the line when vaccinations began late last year. Officials envision giving people the same vaccine they originally received. They have discussed starting the effort in October but have not settled on a timetable.

The WHO has been asking western countries not to use their available supply of doses for boosters but rather to send them to poorer countries to begin vaccinations there. That logic isn’t purely altruistic: The sooner the world is vaccinated, the lower the risk of a vaccine-resistant variant emerging somewhere becomes. But asking a country to leave its seniors in jeopardy while their immunity wanes is asking a lot. Israel blew off the WHO’s request. We’re going to blow it off too, with plenty of popular support.

Here’s Fauci yesterday pleading with Americans to put aside their silly obsession with freedom and unite in the cause of getting everyone immunized whether they want to be or not.

“Put aside all of these issues of concern about liberties and personal liberties and realize we have a common enemy, and that common enemy is virus,” Dr. Fauci says. “And we really have to all pull together to get on top of this, otherwise we're going to continue to suffer.” pic.twitter.com/TCCoC7rvhH

— Face The Nation (@FaceTheNation) August 15, 2021