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The proposal is awaiting formal approval from the Ministry of Health, but questions have been raised about whether the recommendation was premature given the lack of data on the effects of a fourth shot. It was unclear whether the ministry would wait for the results of the hospital study to make its recommendation.

The advisory panel acknowledged uncertainty over the effects of Omicron, but pointed to evidence of decreased immunity in people who were among the first to receive a third dose in August. Israeli data showed a doubling of the rate of infection from the Delta variant, then dominant, among the 60-plus age group within four or five months of the third shot.

Israel, a relatively small country with an efficient public health system, was a leader in introducing the first round of Covid vaccinations and later in giving booster shots, putting it in position to assess early how effective the shots are and how quickly the protection wears off.

Most of the advisory panel argued that the potential benefits of a fourth dose outweighed any risks, and that there was no time to lose in making decisions to protect those most susceptible. But other experts argued that not enough was known about the effects of a fourth shot, and some scientists have raised concerns that too many shots might cause a sort of immune system fatigue, compromising the body’s ability to fight the virus, particularly among older people.

A senior Health Ministry official said last week that the ministry would gather more data from other countries, especially about the risk of severe illness from Omicron among older people, before deciding on whether to offer a fourth dose, and to whom.