More than six weeks after Israel launched an attack Covid-19 Launch a vaccine It left the rest of the world lagging in its wakePublic health experts are breathing a sigh of relief as the effects seem to have finally begun.
Early this week, with a clear and continuing decline in the number of people 60 years or older reporting severe illnesses, experts became confident they were seeing the effects of the vaccine. People over the age of 60 were prioritized in the early stages of the vaccine launch in Israel, so this was where the sign was expected to appear in the national COVID-19 statistics.
“We say with caution, the magic has begun,” chirp Data scientist Eran Segal of the Weizmann Institute of Science in Rehovot, Israel, on February 1, indicating that COVID-19 cases, hospitalizations, and severe disease were all located among people over the age of 60.
Moreover, follow-up studies by one of the largest HMOs in Israel, the Maccabi Healthcare Services, indicate that the Pfizer’s COVID-19 vaccine, which has been used in most of the shots given so far, works almost well in the real world. It did it in clinical trials, with more than 90% efficacy after two doses. This was not a guarantee: the performance of drugs and vaccines may differ slightly outside of the limits of controlled clinical testing.
This is good news for the United States and other countries that hope to emulate Israel’s success in getting COVID-19 vaccines to its people. But the data released by Israel also reveal the challenges that lie ahead.
The Israeli experts BuzzFeed News interviewed were hopeful that these positive results would emerge more quickly. They attributed the delay in large part to the fact that the Middle Eastern country is fighting hard to move B.1.1.7 Coronavirus variant It was first seen in the UK – it is now believed to account for over 70% of Israeli cases. And while both are Pfizer and Moderna Reported that their vaccines effectively block the B.1.1.7 variant, and the other variants that were first identified appear to be in South Africa and Brazil. Less likely For existing vaccines, so it could undermine further progress if they or new variants with similar mutations become prevalent.
Meanwhile, Israel has been criticized by human rights organizations for not extending the vaccination program to the occupied Palestinian territories. The spread was slower among the Palestinian Arab citizens of Israel and the ultra-Orthodox Jewish communities – which is of concern because these are the groups that have been hardest hit by COVID-19.
This relates to health experts who are monitoring the launch of the Israeli vaccine from the United States, because it is happening despite the fact that the Israeli government has launched a major communication effort, with the participation of religious leaders and other community leaders, to try to address the vaccine frequency among Arab and ultra-Orthodox communities.
In the United States, black Americans were as well Killed disproportionately And sickened by COVID-19, and they are Previously Fall behind In the US vaccination campaign. And although black Americans have good reason to distrust the medical establishment, given A. The legacy of racism In the healthcare system, there is nothing in the United States like the Israeli communications campaign to convince skeptical groups of the benefits of vaccination, Peter Hotez, a prominent vaccine researcher at Baylor College of Medicine in Houston, told BuzzFeed News.
Hotez fears huge losses among black communities if vaccine rollout remains low and more dangerous coronavirus variants persist. “We are losing a generation of mothers, fathers, brothers and sisters,” he said.
Israel owes the launch of the rapid vaccine to the healthcare system that requires every citizen to be a member of one of four HMOs, which collectively run clinics nearly everywhere in a small, densely populated country. After securing vaccine supplies from both Pfizer and Moderna, the nation has been able to use this robust healthcare infrastructure to advance vaccination faster than anything else: As of Wednesday, Israel has given nearly 59 shots per 100 people In the country, while the United States gave nearly 10.
The rules for who was eligible to receive vaccines in Israel were much simpler than in the United States, as decisions were left to states based on factors including age, occupational exposure to the virus, and pre-existing medical conditions. Instead, Israel has prioritized the elderly, encouraged everyone to get an injection, and opened call centers to simplify appointments. Even with its current infrastructure, it has opened huge outdoor vaccination centers.
“They made the registration process very easy,” said Ann Blake, a Hotez colleague at Baylor who trained as a physician and public health practitioner in Israel. “If there’s a vaccine left at the end of the day, you’ve got clinic secretaries blasting text messages.”
Launching the vaccine in Israel leads the world
The United States, with its largely fragmented healthcare system and many people without health insurance, faces significant challenges in line with the Israeli vaccination campaign. Blake argued that the nation needed to learn from what worked in Israel, opening more massive vaccination centers and simplifying vaccine eligibility rules.
“We need to open stadiums across the country,” she said. “We are starting to do this. We need to do it on a large scale.”
But Israel has been less effective in controlling the spread of the virus. The start of the vaccination campaign, on December 19, came in the early stages of a significant increase in cases driven by the now dominant B.1.1.7 variant. This was followed by a nationwide lockdown on December 27, making it difficult for scientists to distinguish the protective effects of the vaccine from the low transmission resulting from the lockdown.
“With all these strong winds pushing things in different directions, it is difficult to discern the effect of the vaccine,” Uri Shalit, a data scientist at the Technion in Haifa who specializes in the study of healthcare, told BuzzFeed News.
As recently as last week, Shalit and other experts were still looking anxiously for differences between trends in this close compared to the previous one that ended in October. But by this week, it was evident that Israel was witnessing a decline in the number of elderly people with severe COVID-19 that began even as severe cases continued to rise among the young.
Israelis infected with severe COVID-19, by age group
As the charts above and below show, the decline in severe cases began in mid-January, shortly after the sharp rise in the number of older Israelis who received the second vaccines. Currently, more than 75% of those over the age of 60 have received two shots, although the increase has slowed in recent days – something that alarmed some scientists. “It’s exhausted early users,” Yaniv Ehrlich, a computer scientist at the Interdisciplinary Herzliya Center who has been tracking data on COVID-19, told BuzzFeed News.
Percentage of Israelis who have been vaccinated by age group
Nevertheless, follow-up studies by the Israeli HMOs add to the hopeful picture. at Early research paper Posted online January 29 and not yet peer-reviewed, researchers with Maccabi Healthcare Services followed more than 350,000 Israeli adults 13-24 days after taking their first dose of the Pfizer vaccine, estimating it was 51% effective in Prevent infection.
In the as yet unpublished data, the The Times of Israel reported last week That researchers in Maccabi found the vaccine to be 92% effective after two doses, based on a comparison of 163,000 Maccabi patients who were fully vaccinated with a non-vaccinated group. If these results appear, it means that the Pfizer vaccine works almost well in the real world It also happened in clinical trials.
Erlich W. Others He warned that these results may overestimate the effects of the vaccine. One problem is that Israeli spouses usually receive the vaccination together, which provides additional protection within families that does not occur with volunteers in a clinical trial.
But Cyril Cohen, an immunologist and vice dean for life sciences at Bar Ilan University in Ramat Gan, was pleased with the reports. “It’s on par with what was expected,” he told BuzzFeed News. “I’m always careful, but that’s very good news so far.”
Less encouraging is the decrease in vaccination rates in ultra-Orthodox Jewish communities and in cities with a large Israeli Arab population. Many ultra-Orthodox Jews are skeptical about vaccines and oppose restrictions to curb the spread of the Coronavirus – highlighted by it. Thousands of mourners attended At the funeral of a prominent rabbi in Jerusalem on January 31, in defiance of the country’s current lockdown.
By the end of January, Less than 70% of those in their 60s are in Nazareth, Sometimes called the “Arab capital” of Israel, they were administered the initial vaccine dose – far behind the national average. In Nazareth and other Israeli cities with a large Arab population, the lack of vaccination is believed to be linked to a broader mistrust of the government of Israel.
Another controversial issue is the vaccination of Palestinians in the occupied territories. Israel emphasized that according to the Oslo Accords, health is the responsibility of the Palestinian National Authority It is reported that he plans to purchase 100,000 doses Sputnik V vaccine developed by the Russian Aesthetic Research Institute.
Pressured by groups including Human Rights Watch, Which says that the Fourth Geneva Convention requires Israel to provide medical supplies, Israel started Send a few vaccinations For the Palestinians. The move also stimulated concerns that the regular flow of unvaccinated people through checkpoints – tens of thousands of Palestinians working in Israel – would undermine the country’s vaccination campaign.
The loopholes in launching a vaccine in Israel mean that even the world’s leader in immunization against the new coronavirus will have elements from its own population as the coronavirus continues to spread freely. Includes children: The Pfizer vaccine is currently approved only for children 16 years of age or older. “We will not vaccinate children under 16 years old until we have the results of the clinical trials that Pfizer conducts,” said Cohen, a member of the Israeli Ministry of Health’s advisory committee on clinical trials of the COVID-19 vaccine.
As long as the virus is spreading, there is a potential for new variants to emerge, some of which may avoid current vaccines. Both Pfizer and Moderna are test options for responding to variants, including additional booster shots or brand new vaccine formulations. But this means that some social distancing measures will likely remain necessary, especially if the emerging variables cause mutations in the Coronavirus in the future.
This worries Haggai Rossman, a researcher with the Segal Group at the Weizmann Institute, who fears there will be weak compliance with more stringent restrictions. “The public will not accept another strict lockdown after the vaccination campaign,” Rossman said.