Israel is a world leader in the fight to expand the COVID-19 vaccine. In this special feature, Medical News Today looks at why vaccination vaccines in Israel have been so successful and discusses the controversies and equity issues associated with the campaign.
While the United States has struggled to achieve COVID-19 vaccine targets, Israel has vaccinated nearly 15% of the country’s population of more than 9 million.
As of January 19, 2021, 25.6% of the Israeli population received their first dose of vaccine and 550,000 people received both doses.
To give some perspective, Israel is vaccinating residents at a rate of 32.4 people per 100, compared to 4.8 people per 100 in the US and 7 per 100 in the UK.
But why was the implementation so successful in Israel? And what can we learn from this early success? In this special feature, we look at what is known about the implementation of the COVID-19 vaccine for Israel.
Israel’s success in rolling out the COVID-19 vaccine appears to be due to several factors affecting the access to and distribution of the vaccine.
The Israeli government started looking early on for a way to ensure the vaccine dose.
In June 2020, Israel became one of the first countries to sign a purchase agreement for a Moderna vaccine supply. In November, the country announced additional vaccine agreements with AstraZeneca and Pfizer.
The first doses of Pfizer vaccines arrived in Israel on December 9, 2020, and vaccinations began on December 19, 2020. The country is still waiting for the other two vaccines.
The Israeli government has apparently also agreed to pay the highest dollar for vaccines and buy millions of doses. Although the exact price is unknown, one official said that the price is about $ 30 per vaccine – double the average price abroad.
The manufacturers of the vaccine currently used by Israel – the American company Pfizer and the German partner BioNTech – do not want to comment on the cost of the vaccine.
In exchange for an early, steady supply of vaccine, the Israeli government also assured Pfizer that the rollout of the country would provide rapid, large-scale results, promising to provide the company with detailed patient information about those receiving the vaccine in Israel.
Israeli officials expected the vaccine to be implemented successfully by Israel, as the country is small but has a large healthcare infrastructure. The country also has a well-developed, universal healthcare system that connects all residents to a national digital healthcare network.
All residents also have insurance from semi-private healthcare maintenance organizations (HMOs) that run services across the country, even in rural, remote regions.
Israel’s centralized, digitalized system makes it easier to locate and access information and set up national health care agendas, such as vaccination campaigns.
“In a sense, Israel has become like a very large clinical trial,” said Dr. Rivka Abulafia-Lapid, virologist at Hadassah Medical Center, said. The Times of Israel.
“Because everyone in Israel belongs to an HMO, and their records are kept up to date with their background data, this means that we will get a good picture of response to the vaccine, in relation to age, gender and existing medical conditions,” said Dr. . Abulafia-Lapid added.
Israel’s successful vaccination of vaccines is due in part to the handling of the vaccine and its delivery to citizens.
Those responsible for logistics stored the vaccine doses underground near Israel’s main airport. They are in 30 large freezers, which can hold 5 million doses.
Teams in Israel have also developed a way to pack doses of large, ultra-frozen pallets in insulated boxes about the size of a pizza box. By doing this, it is easier to distribute the vaccine doses in smaller numbers and in remote areas.
Teams pack large vaccine pallets in bundles containing as few as 100 doses, which they then deliver to 400 vaccination centers. Health workers have also managed to get more vaccine doses out of each vial than Pfizer initially advertised.
Pfizer has approved both of these processes.
About 335 transit vaccination clinics also exist throughout Israel, enabling health workers to vaccinate larger groups of people quickly. On January 19, 2021, the country announced a new daily record of more than 210,000 vaccinations within 1 day.
Israel has vaccinated health workers, teachers, people with medical conditions and those over 60 years of age. By the end of March, the country is vaccinating the entire population over the age of 16 – equivalent to about 5.2 million people. From January 20, Israel began vaccinating residents over the age of 40.
At the time of writing, Israel has given at least one dose of the vaccine to more than 76% of the country’s residents who work as teachers, are over 60 years old or have health risks.
Despite these achievements, some people in Israel regularly protest against the government’s handling of the pandemic.
Greeted as a way to restore normalcy – and save the economy – the government calls the deployment of COVID-19 vaccine ‘Operation back to life’. Prime Minister Benjamin Netanyahu claims that this will allow Israel to become the first country in the world to emerge from the pandemic.
However, it is less clear exactly how and when Israel will be able to return to so-called normal life.
On January 19, the country reported a record high of more than 10,000 new cases of COVID-19 in a single day and, for the first time in 3 months, a positive rate of more than 10%. Also, 30-40% of new cases are linked to the new COVID-19 variant that scientists first recognized in the UK
Israel, which is currently in its third exclusion, is also facing high unemployment and a recession, but the authorities have extended the current rural exclusion to at least January 31.
Netanyahu’s political opponents also accuse the government of using the vaccine campaign for political gain before the upcoming election.
The country is on track to vaccinate everyone over the age of 16, just three days before the March 23 election. In addition, the government is discussing postponing the election if the infection rates remain high.
The government is also receiving criticism for not sharing enough details about what patient data it will share or how Pfizer will use the information.
Government officials recently released some terms of the agreement, claiming that it will only share general information with Pfizer, such as information on the number of cases, serious cases, deaths and vaccinations and the age and gender of each individual.
They also say the data could help researchers assess and detect herd immunity, with the results in a recognized medical journal.
But Tehilla Shwartz Altshuler, a senior fellow at the Israel Democracy Institute, expressed concern that anonymous patient data, including full medical history, would be shared.
Although they will not contain patient names or markers, she said it is not possible to deonymize the files. Treating this personal data as if it belongs to the government in this way is ‘not ethical, not legal and not moral’ [right], ”She added.
According to human rights groups, Palestinians living in the Israeli-occupied West Bank and Gaza Strip do not have access to the vaccine and will not do so for a long time. Under the 4th Geneva Convention, occupying forces must provide health care to the population of the territories they occupy.
Yet Palestinian officials appear reluctant to make a formal request to Israel to supply the vaccine, probably because Israel’s demand is politically sensitive.
The Oslo peace agreements of the 1990s, which were intended to be a temporary roadmap for the development of a Palestinian state, also gave Palestinians responsibility for their health care.
Israel’s health minister has reportedly told Sky News that the Palestinians simply ‘need to learn how to take care of themselves’.
He said Israel had provided advice, supplies and medicine to its neighbors, adding that it was in Israel’s best interest to reduce the number of Palestinians, as many Palestinians work in Israel.
But some international organizations have condemned Israel’s failure to provide the vaccine fairly.
According to Saleh Higazi, Amnesty International’s Deputy Regional Director:
Israel’s COVID-19 vaccination program highlights the institutionalized discrimination that determines the Israeli government’s policy towards Palestinians. There can hardly be a better illustration of how Israeli lives are valued above Palestinians. ”
The Palestinian government has arranged for the transport of vaccines from four companies that would arrive this quarter. The state can also receive doses in February from the World Health Organization’s (WHO) vaccination scheme for low- to middle-income countries.
Another problem that complicates the explosion of vaccines is the reluctance and fear among the Arab and Orthodox population in the country regarding the restrictions on vaccine and pandemic.
Vaccination rates are low among the Arab community in Israel.
Ultra-Orthodox communities are registering a record high number of new cases of COVID-19. There are also reports of sluggish prevention restrictions in these communities, with some schools remaining open and several reports of large gatherings.
On January 20, the government announced the launch of a campaign to inform the Ultra-Orthodox community about pandemic risks and their importance in complying with the rules.
Preliminary data from people in Israel indicate that the vaccine was approximately 50% effective in preventing infection 14 days after receiving the first dose.
But some Israeli HMOs have announced very different efficiency rates. One HMO reported that the vaccine was 33% effective 14 days after administration, while another reported an efficacy rate of 60%.
The Israeli Minister of Health also said that some of these early reports were out of context and therefore inaccurate.
Pfizer claims that their vaccine is 52% effective 12 days after the first dose and 95% effective after the second dose.
Despite the contradictions, the two Israeli HMOs have so far analyzed data from about 800,000 people. Pfizer’s Phase 3 trials included only 40,000 individuals.
The early data also suggest that humans may be contagious for some time after receiving the vaccine, even without testing positive for COVID-19. Israeli officials claim that 17% of the new infections are in people who have received the first dose of the vaccine.
Israel’s successful vaccination of vaccines and their shortcomings can help vaccine developers refine their products and provide insight into how to obtain and distribute the vaccine effectively.
“To define Star Trek, we’re going boldly where no country has gone before,” Prof Cyrille Cohen, a member of the Ministry of Health’s vaccine advisory committee, said in an interview.
Some countries say they ‘wait and see’ before giving the vaccine. [Israel] has taken a different approach, and we now seem ready to provide the real world and important results and observations that will hopefully provide a good basis for others to stop waiting and accept the vaccine. ”
– Prof. Cyrille Cohen
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