A recent study conducted by researchers from Northwestern University suggests that the United States could have saved a significant number of lives by authorizing COVID-19 booster doses earlier, accompanying it with stronger public health messaging. The study compares the U.S. with Israel, using Israel as an example of what the U.S. could have achieved.
Since the availability of COVID-19 vaccines in early 2021 and booster doses in late 2021, the U.S. has faced challenges in convincing its citizens to get vaccinated and obtain booster doses. On the other hand, countries like Israel have achieved higher rates of vaccine uptake. In the case of boosters, the U.S. struggled with unclear public health messaging, which resulted in many older individuals, who needed the booster dose the most, not receiving it.
Titled “COVID-19 Boosters: If the U.S. Had Matched Israel’s Speed And Take-Up, An Estimated 29,000 U.S. Lives Would Have Been Saved,” the study was published in the journal Health Affairs.
According to the researchers, authorizing boosters earlier and matching Israel’s uptake level and speed could have saved an estimated 29,000 lives among those already vaccinated by June 30, 2022. Not acting promptly on boosters, as some suggested, would have resulted in even more lives lost. Every week was crucial in saving lives, emphasized Bernard Black, the lead researcher. Comparatively, authorizing boosters contributed to saving 41,000 lives in the U.S. by June 2022, whereas no booster authorization would have resulted in more casualties.
To make a comparison between the two countries, the researchers used national vaccination and mortality rate data from the U.S., vaccine effectiveness data from Milwaukee County, Wisconsin (where they linked vaccination and mortality records), and vaccination rate data from Israel.
Initially, the mRNA vaccines administered in two doses demonstrated high effectiveness. However, their efficacy diminished over time against both COVID-19 infection and severe cases. Due to Israel’s early vaccination efforts in 2021, the effects of vaccine waning were observed earlier than in other countries.
By mid-2021, Israel experienced a significant surge in infections, hospitalizations, and deaths, even among the fully vaccinated population. In response to this, Israel authorized a booster dose of the Pfizer-BioNTech vaccine in late July 2021, accompanied by a strong public health messaging campaign promoting the importance of the booster.
The country became a global example of the benefits of boosters in reducing hospitalizations and mortality rates among individuals aged 60 and above. The evidence from Israel demonstrated the effective and safe nature of booster doses.
In contrast, the U.S. lagged behind in authorizing boosters. It granted authorization almost two months later, primarily restricted to individuals aged 65 and older or those with major health complications. Although senior U.S. policymakers were in favor of a quicker authorization process, the U.S. regulatory system mandated FDA approval before the availability of vaccinations and boosters. However, the FDA faced internal opposition to approving boosters promptly.
According to Black, the FDA is a scientific agency accustomed to a cautious approach in evaluating the safety and efficacy of new drugs and vaccines before approval.
This study highlights the risks associated with regulatory caution in the midst of a pandemic. Israel had strong and credible data, which they shared with U.S. regulators. However, the FDA preferred to rely more on U.S.-based data and wanted to see further evidence before making a decision. Unfortunately, the U.S. data was not readily available due to the slower vaccination rate compared to Israel and the lack of real-time data collection capability.
In conclusion, the study suggests that if the U.S. had authorized COVID-19 boosters earlier, along with more effective public health messaging, a significant number of lives could have been saved. The experience of Israel serves as a valuable lesson in the importance of prompt booster authorization and clear communication to protect public health during a pandemic.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it