Israel has surpassed the world in Covid-19 vaccinations. Now it sees results.

Israel has surpassed the world by vaccinating its population against Covid-19. Now the results are starting to come in. And so far the news is good for both Israel and the world.

Data indicates that the pandemic in Israel is beginning to decline. Infections and the number of seriously ill are declining, especially among those over 60, one of the groups targeted in the early implementation of the vaccination campaign.

The vaccine, in nature, also reflects the results of clinical trials, which found that the Pfizer / BioNTech vaccine (the dose most Israelis have received so far) was approximately 95 percent effective in reducing infections.

Maccabi Health Services, one of Israel’s four health maintenance organizations (HMOs), tracked down 163,000 Israelis who both received the two required doses of Pfizer vaccine; only 31 of the people tested positive for Covid-19, compared to a sample that was not vaccinated, in which about 6,500 did so.

According to the Israeli Ministry of Health, 531 out of 750,000 people over the age of 60 tested positive for Covid-19 – which is only 0.07 percent. Of the people who tested positive, only 38 were admitted to the hospital, with symptoms ranging from moderate to critical. Another Israeli HMO, Clalit, found that the positivity of Covid-19 decreased by 200% among 200,000 people, 14 days after they received only the first dose of Pfizer compared to the same number of unsafe persons.

This is all very promising, especially as the world uses a vaccine as the best way out of this pandemic and as new variants of the virus emerge. “We say with caution, the magic has begun,” Eran Segal, a scientist at the Weizmann Institute, posted on Twitter, accompanied by data showing a decline in hospitalizations and critical illnesses over the past 60 weeks among the 60 -year-old group was.

But scientists warn that there is still a long way to go. Experts have noted that severe cases are declining, but overall infections are not decreasing as rapidly. And many of these studies rely on preliminary data, and these findings may change over time, especially with these new coronavirus variants.

Israel also entered into a strict closure in early January, just as the vaccination campaign was underway, which may also have helped move things down.

Who is vaccinated, and how people can act once they get the shots, can also affect the findings. Those who were vaccinated early and received their full two doses were possibly very motivated; now comes the more challenging part of grafting hesitant or more marginalized communities. Israel has also been criticized for failing to expand its vaccination program to Palestinians, which could also make it harder to achieve herd immunity.

Israel offers lessons to quickly vaccinate a population, but it is also beginning to show the challenges – and how difficult the global vaccination effort will be. “Israel is the canary in the coal mine,” said Bruce Rosen, director of the Smokler Center for Health Policy Research at the Myers-JDC-Brookdale Institute (MJB) in Jerusalem.

How Israel’s Vaccination Program Presented a Real Vaccination Test Case

Israel began its vaccination program in December. Since then, about a third of the country’s population (about 3 million people) has received at least one dose of Pfizer / BioNTech vaccine. Nearly 1.8 million people also received their second dose of the vaccine. It is in a country of just over 9 million, according to recent figures from the Israeli Ministry of Health.

The rates are even higher for those in the group over 60; for example, more than 90 percent of people between the ages of 70 and 79 received the first vaccine dose, and nearly 80 percent the second. The vaccination program has since been expanded so that anyone over the age of 16 is now eligible for a shot.

Our world in data

Israel has achieved this primarily because of its existing health infrastructure, a universal, digitalized system that has given the country a ready-made way to track and communicate people.

All Israeli citizens is enrolled in one of the four health enterprise organizations (HMOs) for their care. Everyone has an ID number that allows easy access to electronic records.

This system also allows health professionals to update the person’s vaccination status, monitor side effects, and schedule an appointment for the next dose. Many Israelis said they got their appointment for the second dose shortly after injecting the first dose, usually exactly 21 days later.

This public health infrastructure has meant that massive vaccination sites are popping up fast, places that were accessible and large enough to evacuate people and keep them as social as possible. Experts told me in January that Israel’s ability to respond in emergencies means that it is particularly suited to the logistical and rapid challenges of a vaccination campaign.

Israel also benefits from being a small country, and word of mouth helped with the vaccination. Although Israel prioritized people over 60 and health workers in the first phase of the campaign, it adopted a “no waste” policy, meaning vaccine providers prioritize doses above all else. If there are extra jabs at the end of the day or week, they can call in the pizza guy or the lady standing at the bus stop.

“We are well prepared for a vaccination campaign, but we are also flexible,” Hagai Levine, an epidemiologist at the Hebrew University-Hadassah School of Public Health, told me in January. ‘If you are planning, for example, you do not know what the cold chain will look like, how many vaccines you will get; therefore, you need to adapt quickly. And we’re fine with that. ”

Prime Minister Benjamin Netanyahu (who, with the forthcoming election, has much to gain from a successful vaccination campaign) said that Israel’s population could be fully vaccinated by the end of March.

Experts have said it is still feasible, but it is far from being as simple as it sounds.

Important questions remain about Israel’s vaccination program – and the world’s

Israel’s data indicate that the vaccines work on an individual level; the outcomes of those vaccinated compare favorably with those not vaccinated. Israel’s streamlined health infrastructure makes it very easy to know who has been vaccinated and how they are responding, and compares it to those who have not.

But the system also helps to win the vaccine race in a different way: in a world where there are not many vaccines, Israel gets a regular stream in part because the country has promised to provide the large collection of vaccine data to Pfizer. can monitor the effects of the vaccine. (Israel, however, apparently also paid a premium for the vaccine doses.)

But experts have said that from now on it will only get more complicated, especially as it achieves the goal of herd immunity – if enough of the population is immune to the virus, it will provide indirect protection to all.

New variants of the virus are a challenge, especially as the mutations can better protect the virus from the protection afforded by the vaccine. At present, it appears that the available vaccines are in effect against these variants, but this may change.

There are other questions that scientists and public health experts want to answer. Brian Wahl, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said the vaccines are effective against the disease, and that they still know what the impact is on transmission. This is how likely it is that a vaccinated person who does not get sick from Covid-19 can still spread it.

Another question is how long the protection against the vaccine will last. “We need to continue to look at how well the vaccine protects a few months out of administration,” Wahl said.

It is also a new vaccine, and not everyone is enthusiastic about getting it. Often people want to be there for the first time in their doses; it does not take much to get them to their appointments. This is not always the case for people who are vaccine-skeptical or hesitant, and getting the people vaccinated is a challenge facing Israel and other countries.

Israel’s Arab and Orthodox Jewish communities are showing greater reluctance to get the vaccine, and the latter has been particularly hard hit by the pandemic.

But Ann Blake, a postdoctoral fellow at Baylor College of Medicine who has studied Israel’s efforts, said she feels optimistic about Israel’s ability to overcome some of this hesitation.

“Israel’s vaccination campaign shows a coordinated and organized communication campaign using local community leaders and credible messengers, along with a synchronized message from the highest levels of government, with the specific aim of encouraging vaccination among the vaccine that is hesitant,” she said in wrote an email. addition that it can serve as a model for other countries, also here in the United States.

Aside from hesitation, experts have pointed out that, at present, only people aged 16 or older are eligible for the Covid-19 vaccine, and scientists are not sure when children will be approved for Covid-19 vaccinations. . All this leaves a part of the population that is not vaccinated and can still transmit the virus. ‘If you had 100 percent [of people] vaccinated, it would be one thing, ”Rosen said. “But you do not. So it’s a lot more complicated in reality. ”

Israel has also been criticized for excluding Palestinians living in the West Bank and Gaza Strip from its vaccination campaign, despite the fact that the shots were made available to Israeli settlers living in the West Bank.

Israel says that the Palestinian Authority, under the terms of the Oslo Accords, the 1990s agreements between Israel and the Palestinian Liberation Organization (PLO), is responsible for health care in the Palestinian territories. But human rights and health groups have put Israel under pressure to ‘ensure that quality vaccinations are provided to Palestinians living under Israeli occupation’, arguing that the restrictions imposed by the occupation limit the purchasing and distribution capacity of the Palestinians restrict.

The Palestinian Authority has nowhere near the resources that Israel has. The areas have just received 10,000 doses of Russian Sputnik V vaccine (which appears to be safe and effective); they must also receive doses through the Covax facility, the WHO-linked international consortium, but distribution will only begin later this month.

Israel did send about 2,000 doses of Moderna to the Palestinian Authority this week, with a promise of another 3,000. But that is not nearly enough to serve the entire population of more than 4.5 million.

If Palestinians do not have safe and effective vaccines, it could also undermine Israel’s efforts to secure herd immunity, especially as many Palestinian workers move back and forth into Israel every day.

“We must insist that Israel is responsible for Palestinian health as an occupier, especially during pandemics, and that infectious diseases know no borders,” Rita Giacaman, a professor of public health at the Institute of Community and Public Health at the Birzeit University in the West Bank, told me.

Indeed, the uneven distribution of vaccines will eventually prolong the coronavirus crisis everywhere. Israel’s example shows how a rapid campaign can work, but also the limitations of just one country succeeding against the pandemic.