More than six weeks after Israel began to COVID-19 vaccine rollout that has he left the rest of the world on track, Public health experts breathe a sigh of relief as the effects appear to finally subside.
Earlier this week, with the country reporting a sharp and sustained decline in the number of people aged 60 and over who were seriously ill, experts were confident they would see the effects of the vaccine. People over the age of 60 were given priority in the early stages of Israel’s vaccine development, so it was here that the signal was expected to present itself in the national COVID-19 statistics.
“Let’s be careful, the magic has begun,” he tweeted data scientist Eran Segal of the Weizmann Institute of Science in Rehovot, Israel, on February 1, noted that COVID-19 cases, hospitalizations and serious illnesses had all fallen among the over-60s.
In addition, follow-up studies conducted by one of Israel’s largest HMOs, Maccabi Healthcare Services, suggest that Pfizer’s COVID-19 vaccine, which has been used for most of the shots given so far, works almost well in the real world as it did in clinical trials, with more than 90% effectiveness after two doses. This was not a guarantee: Drugs and vaccines may behave a little differently outside the controlled limits of clinical trials.
This is good news for the United States and other countries hoping to emulate Israel’s success in delivering COVID-19 vaccines to its populations. But data emerging from Israel also highlights the challenges that lie ahead.
Israeli experts interviewed by BuzzFeed News hoped that these positive results would show up more quickly. They attributed the delay largely to the fact that the Middle Eastern nation has fought against the highly transmissible ones. B.1.1.7 coronavirus variant seen for the first time in the UK – now thought to contain more than 70% of Israeli homes. And while the two Pfizer is Modern reported that their vaccines effectively block variant B.1.1.7, other variants previously identified in South Africa and Brazil appear susceptible menu to current vaccines, so they could undermine further progress if they or new variants with similar mutations become dominant.
Meanwhile, Israel has been criticized by human rights organizations for not extending its vaccination program to the occupied Palestinian territories. And implementation has been slower among Palestinian Arab citizens of Israel and ultra-Orthodox Jewish communities – which is worrying because they are the groups that have been most affected by COVID-19.
This concerns health experts who are watching the Israeli launch from the United States, because it happens despite the fact that the Israeli government has launched a major communication effort, involving religious and other community leaders, to try to address the hesitation of the vaccine between the Arab and ultra-Orthodox communities.
In the United States, Black Americans have been disproportionate tomb and sickened by COVID-19, and are already falendu daretu in the U.S. vaccination campaign. And while Black Americans have good reasons to be wary of the medical establishment given a legacy of racism in the healthcare system, there has been nothing in the United States as Israeli communications push to convince skeptical groups of vaccine benefits, Peter Hotez, one of Baylor College of Medicine’s leading vaccine researchers in Houston , he told BuzzFeed News.
Hotez fears a terrible backlash among black communities if vaccine launches remain low and more dangerous coronavirus variants gain strength. “We lost a generation of moms and dads and brothers and sisters,” she said.
Israel owes its rapid implementation of vaccines to a health system that requires every citizen to be a member of one of the four HMOs, which collectively run clinics almost everywhere in the densely populated small country. After securing the supply of vaccines from both Pfizer and Moderna, the nation has been able to use this solid health infrastructure to move forward with vaccination faster than any other: As of Wednesday, Israel had given in to pressure 59 shots per 100 people in the country, while the United States had given nearly 10.
The rules for who is eligible for vaccines in Israel have also been much simpler than in the United States, where decisions have been left to states based on factors including age, occupational exposure to the virus. is and pre-existing medical conditions. Instead, Israel has given priority to the elderly, encouraged everyone to receive blows, and has opened call centers to simplify appointments. And even with its existing infrastructure, it has opened up massive outdoor immunization centers.
“They made it very easy to sign up,” said Ann Blake, a Hotez’s colleague at Baylor who trained as a doctor and in public health in Israel. “If there is vaccination remaining at the end of the day, you have clinic secretaries exploiting text messages.”
The development of Israel’s vaccines is leading the world
The United States, with a much more fragmented health system and many people without health insurance, faces enormous challenges that correspond to the Israeli vaccine. Blake argued that the nation needs to learn from what has worked in Israel, opening up huge vaccination centers and simplifying the rules for vaccine eligibility.
“We need to open stadiums across the country,” he said. “I started doing that.” We need to do this on a large scale. ”
But Israel has been less effective in controlling the spread of the virus. The beginning of the vaccination campaign, on December 19, reached in the early stages a large source in cases led by the now dominant variant B.1.1.7. December 27 followed a national shutdown, making it difficult for scientists to distinguish the protective effects of the vaccine from the reduced transmission resulting from the closure.
“With all these strong winds pushing things in different directions, it’s hard to discern the effect of the vaccine,” Uri Shalit, a Technion data scientist in Haifa who specializes in studying the vaccine, told BuzzFeed News. health care.
Recently last week, Shalit and other experts were still anxiously looking for differences between trends in this block compared to the previous one which is the end of October. But this week, it was clear that Israel was seeing a decline in the number of older people with severe COVID-19 that began even as severe cases continued to grow among younger people.
Israel with severe COVID-19, by age group
As the graphs above and below show, the decline in serious cases began in mid-January, shortly after a sharp rise in the number of elderly Israelis who had had their second vaccine. At the moment, more than 75% of those over 60 have had two strokes, although the increase has slowed in recent days – to the alarm of some scientists. “We have exhausted the first adopters,” Yaniv Erlich, a computer scientist at the Herzliya Interdisciplinary Center, who tracked data on COVID-19, told BuzzFeed News.
Percentage of vaccinated Israelis, by age group
However, follow-up studies by Israel’s HMO add to the promising picture. In a first research work published online on January 29 that has not yet been evaluated by peers, researchers with Maccabi Healthcare Services followed up with more than 350,000 Israeli adults 13-24 days after receiving their first dose of the Pfizer vaccine, estimating that it was 51% effective in preventing infection.
And in the data so far unpublished, the Times of Israel reported last week that Maccabi researchers had found that the vaccine was 92% effective after two doses, based on a comparison of 163,000 fully vaccinated Maccabi patients with an unvaccinated group. If these results are to rise, it means that the Pfizer vaccine works almost well in the real world as in clinical trials.
Erlich is others warned that these results may overestimate the effects of the vaccine. One problem is that Israeli couples are usually vaccinated together, giving additional protection in families that does not happen with volunteers in a clinical trial.
But Cyrille Cohen, immunologist and vice dean of life sciences at Ramat Gan’s Bar-Ilan University, was happy with the relationship. “It’s on par with what was expected,” he told BuzzFeed News. “I’m still cautious, but so far that’s good news.”
Less encouraging are lower vaccination rates in ultra-Orthodox Jewish communities and in cities with large Israeli-Arab populations. Many ultra-Orthodox Jews are skeptical about vaccines and oppose restrictions to limit the spread of the coronavirus – highlighted by the presence of thousands of grief at the funeral of a renowned rabbi in Jerusalem on January 31, challenging the country’s current closure.
And at the end of January, less than 70% of those over 60 in Nazareth, sometimes called the “Arab capital” of Israel, had received its initial dose of vaccination – lagging far behind the national average. In Nazareth and other Israeli cities with large Arab populations, the low intake of vaccines is thought to be linked to a wider distrust of the Israeli government.
Another controversial issue is vaccination for Palestinians in the occupied territories. Israel has argued that under the Oslo Accords, health is the responsibility of the Palestinian National Authority, which it is expected to buy 100,000 doses of the Sputnik V vaccine, developed by the Gamaleya Research Institute of Russia.
Pressed by groups included Human Rights Watch, which argues that the Fourth Geneva Convention requires Israel to provide medical supplies, Israel has begun send a small number of vaccines to the Palestinians. The move was also fueled by concerns that a regular flow of unvaccinated people through checkpoints – tens of thousands of Palestinians working in Israel – would undermine their vaccination action.
Gaps in the development of Israeli vaccines mean that even the world leader in COVID-19 vaccination will have elements of its population where the coronavirus is still in free circulation. This includes children: The Pfizer vaccine is currently only authorized for children 16 years of age or older. “We will not vaccinate children under the age of 16 until we get results from clinical trials conducted by Pfizer,” said Cohen, who is part of the advisory committee to the Israeli Ministry of Health on clinical trials of Pfizer. COVID-19 vaccine.
Until the virus circulates, there is the potential for new variants to emerge, some of which could bypass current vaccines. Pfizer and Moderna are both testing options to respond to variants, including additional reinforcement strokes or completely new vaccine formulations. But this means that some measures of social disengagement will continue to be necessary, especially if emerging variants cause future coronavirus outbreaks.
This worries Hagai Rossman, a researcher in the Segal group at the Weizmann Institute, who fears that there will be little respect for tighter restrictions. “The public will not accept another hard lockdown after the vaccination campaign,” Rossman said.