JERUSALEM – Israel has quickly become the world leader in vaccinating its population against Covid-19, but almost all Palestinian residents of the occupied West Bank are still awaiting their first doses of vaccination.
That inequality led to the debate over Israel’s responsibilities as an occupying force in one of the world’s most protracted territorial feuds.
According to Israeli critics, international law obliges Israel to grant Palestinians access to vaccines comparable to those offered to their own citizens. But proponents of Israel’s policy argue that the Palestinians take responsibility for health services for their population when they signed the Oslo Accords in the 1990s.
While Palestinian vulnerability to the virus has declined somewhat this week – the Palestinian Authority has officially launched a vaccination campaign by giving drugs to the frontline doses of Israel, but the contrast with Israel is still striking. The inequality also partly reflects the inequality in access to vaccines between rich countries such as Israel and other areas of the developing world.
The Palestinian vaccination campaign is still far behind that of Israel, which with a population of about 9.2 million has already vaccinated more than 3.3 million people with a first dose. This represents a significant percentage of the approximately 450,000 settlers living with Palestinians in the West Bank, numbering between 2.5 million and three million.
It remains unclear exactly when the approximately two million Palestinians in Gaza, the blocked enclave controlled by the militant anti-Israel group Hamas, will begin receiving vaccinations.
For the small number of Palestinian doctors and nurses who received vaccinations on Wednesday, it was a moment of relief.
“Praise the Lord, I feel great,” said Ayman Abu Daoud, 49, a nurse in Bethlehem who has been administering coronavirus tests for the past 11 months. “The vaccines give us hope that we will overcome the pandemic, but we still have a long way to go.”
Mr. Abu Daoud was one of the top 100 medical workers in the Bethlehem region – where the first Palestinian cases were discovered on the West Bank – who received vaccinations on Wednesday and Thursday, local health officials said. Dozens of other health workers at the front in the Bethlehem area are still waiting for shots, they said.
Bassil Bawatneh, the director of an eye hospital near Ramallah that has been transformed into a coronavirus treatment center, says vaccinating medical teams is a very important step. ‘
The Palestinians sent their first major vaccine last Monday, when Israel gave the Palestinian Authority 2,000 doses of Moderna – a measure approved by the Israeli government after being recommended by public health experts. Israeli officials said they plan to hand over an additional 3,000 doses.
The Palestinian Authority’s health ministry said on Tuesday that the vaccination campaign would initially focus on health workers and then extend to people over 60, as well as those suffering from chronic diseases.
The Palestinians received 10,000 doses of Russian Sputnik V vaccine on Thursday. They expect to receive 37,440 doses of Pfizer in February and hundreds of thousands of doses of AstraZeneca in late February or early March through the global co-initiative Covax, according to Gerald Rockenschaub, head of the World Health Organization’s mission to the Palestinians. An additional two million doses of AstraZeneca will be planned during March, Palestinian officials said.
Palestinian Authority Health Minister Mai al-Kaila said vaccinations would be transferred to Gaza on Wednesday, but Israeli security officials said the Palestinians had not submitted a formal request for permission to send vaccines there. Officials said the Israeli government approved it.
The start of the vaccination campaign on the West Bank followed a heated disagreement between supporters of the Israelis and Palestinians over whether Israel was responsible for vaccinating Palestinians.
Human rights advocates have argued that under international law, Israel is obliged to give Palestinians access to vaccines at the same level as it makes available to its own citizens. Some also argue that Israel has a moral requirement to do so as a military occupier with the means to help.
Advocates pointed to the Fourth Geneva Convention, which states that occupying forces have a duty to ensure the full health of the people living under occupation, to the fullest extent possible, especially with regard to combating epidemics and diseases.
“After 50 years of endless occupation in sight, Israel’s duties go beyond offering extra doses,” Omar Shakir, director of Human Rights Watch for Israel and Palestine, said, referring to the vaccination scales that Israel used on Monday. Palestinians delivered.
Mr. Shakir stressed that Israel should vaccinate the Palestinians, despite the Palestinian Authority’s efforts to secure it independently, and said it was unfair to give the colonists greater access to vaccinations than their Palestinian neighbors.
But Israeli officials have said that while Israel has an interest in securing the vaccination of Palestinians, many of their workers who come into regular contact with Israelis have no legal responsibility to do so.
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Answers to your vaccine questions
At present, more than 150 million people can be vaccinated – almost half of the population. But each state makes the final decision about who goes first. The country’s 21 million health workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to be eligible for anyone 65 and older and for adults of any age with medical conditions at high risk of becoming seriously ill or dying of Covid-19 . Adults in the general population are at the back of the queue. If federal and state health officials can clear up bottlenecks in the distribution of vaccines, everyone 16 years and older will be eligible as early as spring or early summer. The vaccine has not been approved in children, although studies are underway. It can take months before a vaccine is available to anyone under the age of 16. Visit your health website for recent information on vaccination policies in your area.
You do not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you do not have insurance, you should still receive the vaccine free of charge. Congress passed this spring legislation that prohibits insurers from applying any cost sharing, such as a co-payment or deductible. It was based on additional protection that pharmacies, doctors and hospitals prevented from patients, including those who were not insured. Nevertheless, health experts are concerned that patients could end up in loopholes that make them vulnerable to surprising bills. This can happen to those who charge a doctor’s fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine at a doctor’s office or an urgent clinic, talk to them about possible hidden charges. To make sure you will not get a surprise bill, it is best to get your vaccine at a vaccination center or a local pharmacy at the health department as soon as the shots are more available.
It must be determined. It is possible that Covid-19 vaccinations will become an annual event, just like the flu shot. Or it could be that the benefits of the vaccine last longer than a year. We have to wait and see how durable the protection against the vaccines is. To determine this, researchers will be monitoring people who have been vaccinated to look for “breakthrough cases” – people who become ill despite being vaccinated with Covid-19. This is a sign of weakening of protection and will give researchers clues as to how long the vaccine will last. They will also monitor the levels of antibodies and T cells in the blood of vaccines to determine if and when a booster shot is needed. It is possible that people need boosters every few months, once a year or only every few years. It’s just a matter of waiting for the data.
“We want everyone in the area to be vaccinated, but the Palestinian Authority is the party responsible for providing for the health of Palestinians,” said Yoav Kish, Israel’s deputy minister. “Our responsibility is to vaccinate our own people,” he said, noting that Israeli health care providers are vaccinating Arab citizens of Israel and Palestinian residents of East Jerusalem.
The Oslo Accords, an interim agreement between Israel and the Palestinian Liberation Organization, state that the Palestinians will assume responsibility for health in the West Bank and Gaza, but also mention that Israel and the Palestinians must work together to fight epidemics and infectious diseases.
Defenders of Israel’s policy argued that Israeli officials moved faster than their counterparts in Palestine to obtain vaccine deals.
The Palestinian Authority initially did not lead public calls for Israel to vaccinate Palestinians.
Ahmad Majdalani, the Minister of Social Development, said that the Palestinians initially did not publicly demand that Israel give them vaccines because they thought they would get what they needed through international donations, contact with pharmaceuticals enterprises and private talks with Israeli officials.
When it became clear that their strategy was not producing immediate results, Mr. Majdalani said they had decided to start issuing statements demanding that Israel fulfill its “international duty” by providing vaccines.
Last week, Nabil Abu Rudeineh, a spokesman for Palestinian Authority President Mahmoud Abbas, said that international law required Israel to provide vaccines to the Palestinians, but that Palestinians were still “finding every way to get any vaccine.” possible to find – whether it is English or Russian or Chinese. ”
Ghassan Khatib, a political scientist at Birzeit University, argued that the Palestinians initially refrained from publicly calling on Israel to give them vaccinations because they hated to sound “self-defeating”.
Hussein al-Sheikh, the main Palestinian official responsible for coordinating with the Israelis, said the Palestinians had asked Israel for up to 10,000 doses in late December.
Israeli officials said that in addition to the thousands of vaccines that Israel delivered to the Palestinians this week, it also delivered 200 doses to the Palestinians in January, but Mr. Al-Sheikh denied this.
Public health experts said they were most concerned that Palestinians might be reluctant to be vaccinated.
“There is a lot of false information on social media that scares people to be vaccinated,” said Abdulsalam al-Khayyat, head of the public health department at An Najah University medical school in Nablus.
Mr. Al-Khayyat predicted that about half of the Palestinian public was unsure about receiving a vaccine, and he said achieving herd immunity would not be possible without convincing a wide section of Palestinian society to be vaccinated.
“Ensuring that the public is vaccinated is the biggest challenge we are currently facing,” he said.
Patrick Kingsley reported from Jerusalem and Mohammed Najib from Ramallah, West Bank.