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On February 1, a health worker injected a dose of the Pfizer-BioNtech COVID-19 vaccine in Petah Tikva, Israel.
Six weeks after Israel started the war Coronavirus disease Vaccines available Left the rest of the world, The effect seems to have finally begun, and public health experts breathed a sigh of relief.
Earlier this week, as the country reported that the number of severely ill patients over 60 had continued to decrease significantly, experts were confident that they would see the effects of this vaccine. In the initial stage of the vaccine launch in Israel, priority is given to people over 60 years old, so this is where the signal is expected to appear in the national COVID-19 statistics.
“We are careful to say that the magic has already begun,” Tweet On February 1, Eran Segal, a data scientist at the Weizmann Institute of Science in Rehovot, Israel, pointed out that COVID-19 cases, hospitalizations and serious illnesses are all in their 60s.
In addition, follow-up studies conducted by Maccabi Healthcare Services, one of Israel’s largest HMOs, show that Pfizer’s COVID-19 vaccine (which has been used in most injections so far) has played almost the same effect in the real world. It did in clinical trials, and the efficacy after two doses exceeded 90%. This is not a guarantee: the performance of drugs and vaccines may be beyond the control of clinical testing.
This is good news for the United States and other countries that hope to emulate Israel’s success in providing COVID-19 vaccines to their populations. However, data from Israel also reveals future challenges.
The Israeli experts interviewed by BuzzFeed News had hoped that these positive results would emerge sooner.They attribute the delay to the fact that Middle Eastern countries have been battling highly contagious countries B.1.1.7 Coronavirus variants First appeared in the UK-now considered to account for more than 70% of Israeli cases.Although both Pfizer and Moderna According to reports, their vaccine effectively blocked the B.1.1.7 variant. The other variants first discovered in South Africa and Brazil seem to be Less sensitive Compared to current vaccines, if they or new variants with similar mutations become dominant, they may disrupt further development.
At the same time, human rights groups criticized Israel for not expanding its vaccination program to the occupied Palestinian territories. Moreover, among the Palestinian Arab citizens and extreme Orthodox Jewish communities in Israel, deployment has been slower-which is worrying because these are the groups most hit by COVID-19.
This makes health experts concerned about Israel’s deployment from the United States, because despite the Israeli government’s large-scale communication efforts involving religious and other community leaders to resolve the vaccine hesitation between Arabs and ultra-Orthodox communities, the situation continues occur.
In the United States, black Americans have always Killed disproportionately And feel sick with COVID-19, and already behind In the vaccination campaign in the United States. Although black Americans have good reasons to distrust medical institutions, Legacy of racism Peter Hotez, a principal vaccine researcher at Baylor College of Medicine in Houston, told BuzzFeed News that there is nothing in the healthcare system that can use propaganda to convince skeptical groups of the benefits of vaccination like in Israel.
Hotez is concerned that if the vaccine penetration rate remains low and the more dangerous variants of the coronavirus continue, the black community will suffer very heavy casualties. He said: “We are losing a generation of mothers, fathers, brothers and sisters.”
If the actual incidence of vaccine hesitation in the African-American community remains the same as the results we found in @socscimed or @kff, it heralds the disaster of the new British, Brazilian, and ZA variants in the spring: the history of black communities in the United States Sexual decline
Israel attributes the rapid promotion of its vaccines to a medical system that requires every citizen to be a member of one of the four HMOs, which jointly run clinics in almost all parts of this small, densely populated country.After obtaining vaccine supplies from Pfizer and Moderna, the country was able to use this solid medical infrastructure to advance vaccination faster than any other vaccine: as of Wednesday, Israel had provided approximately 59 shots per 100 people In this country, the United States has donated nearly 10 pieces.
In Israel, the rules for who is eligible for the vaccine are much simpler than those in the United States. The decision-making power in the United States depends on the state, including age, occupational exposure to the virus, and existing medical conditions. Instead, Israel prioritizes the elderly, encourages everyone to shoot, and opens call centers to simplify dating. Even with existing infrastructure, it has opened a large-scale outdoor immunization center.
“They are easy to sign,” said Ann Blake, a colleague of Baye Hotez’s Hotez, who has been trained in doctors and public health in Israel. “If the vaccine is left at the end of the day, then your clinic secretary will explode the text message.”
Israel’s vaccine promotion leads the world
The medical system in the United States is more fragmented, and many people do not have medical insurance, so they are faced with a huge challenge that matches the vaccination campaign in Israel. Blakes believes that the country needs to learn from Israel, learn from it, open larger vaccination centers, and simplify vaccine eligibility regulations.
She said: “We need to open stadiums across the country.” “We started to do this. We need to do this on a large scale.”
But Israel is less effective in controlling the spread of the virus. The vaccination campaign began on December 19, and in the early stages, there was a surge in cases driven by the currently dominant B.1.1.7 variant. A nationwide lockdown was subsequently implemented on December 27, which made it difficult for scientists to distinguish the protective effect of the vaccine from the reduction in transmission caused by the lockdown.
“Because all these strong winds are pushing in different directions, it is difficult to tell the effect of the vaccine,” Uri Shalit, a data scientist at the Haifa Institute of Technology who specializes in healthcare, told BuzzFeed News.
Just last week, Shalit and other experts were still anxiously looking for the difference between this lock-in trend and the lock-in trend that ended in October. But by this week, it is clear that the number of elderly people with severe COVID-19 in Israel has begun to decline, although severe cases continue to rise among young people.
Israelis with severe COVID-19 in age group
Peter Aldhous/BuzzFeed News/via the Israeli Ministry of Health/ github.com
As shown in the graphs above and below, severe cases began to decline in mid-January, shortly after the number of elderly Israelis who received the second shot of the vaccine increased dramatically. Currently, more than 75% of people over 60 have two shots, although the increase has slowed in recent days-some scientists are shocked. “You have exhausted early adopters,” Yaniv Erlich, a computer scientist at the Herzliya Interdisciplinary Center who has been tracking COVID-19 data, told BuzzFeed News.
Percentage of Israelis vaccinated by age group
Peter Aldhous/BuzzFeed News/via the Israeli Ministry of Health/ github.com
Nevertheless, follow-up research on Israeli HMOs is still full of hope.in Early research papers Published online on January 29 but has not yet been peer-reviewed, Maccabi Healthcare Services researchers tracked more than 350,000 Israeli adults 13-24 days after their first vaccination with Pfizer. It is estimated that the effective rate is 51% in preventing infection.
Of the unpublished data so far, The Times of Israel reported last week Maccabi researchers found that after comparing 23,000 fully vaccinated Maccabi patients with the unvaccinated population, the effective rate of the vaccine after two doses was 92%.If these results stand up, it means that Pfizer vaccine performs almost as well in the real world Just like in a clinical trial.
Ehrlich and other It warns that these results may overestimate the effects of vaccines. One problem is that Israeli couples usually get vaccinated together to provide additional protection for patients within the family, which does not happen in clinical trials like volunteers.
However, immunologist Cyrille Cohen, deputy director of life sciences at Barat Ilan University, is pleased with these reports. He told BuzzFeed News: “This is on par with expectations.” “I have always been cautious, but so far, this is good news.”
Jaafar Ashtiyeh/Getty Images
On February 2, a barber was working while watching a live broadcast of the West Bank city of Nablus, where Palestinian health workers were being vaccinated.
Encouragingly, vaccination rates are lower in ultra-orthodox Jewish communities and Arab-Israeli cities with large populations. Many ultra-Orthodox Jews are skeptical of vaccines and oppose restrictions on the spread of the coronavirus. Thousands of mourners attended The famous rabbi’s funeral in Jerusalem on January 31 ignored the country’s current blockade.
By the end of January, In Nazareth (over 60 years old), less than 70% of peopleIsrael, once known as the “Arab Capital” of Israel, has received the initial dose of vaccination-far behind the national average. In Nazareth and other Israeli cities with large Arab populations, insufficient intake of vaccines is believed to be related to widespread distrust of the Israeli government.
Another controversial issue is the vaccination of Palestinians in the occupied territories. Israel insists that according to the Oslo Agreement, health is the responsibility of the Palestinian National Authority. According to reports, plans to purchase 100,000 doses The Sputnik V vaccine developed by the Gamaleya Institute in Russia.
Under pressure from various groups, including Human Rights Watch, Which believes that the Fourth Geneva Convention requires Israel to provide medical supplies, and Israel has already started Send a small amount of vaccine To the Palestinians. There are concerns that the regular flow of unchecked people through checkpoints (thousands of Palestinians working in Israel) will undermine the country’s own vaccination momentum, which has also spurred this operation.
The gap in the launch of Israeli vaccines means that even the world’s leading COVID-19 immunization leader will have a population whose coronavirus is still circulating freely. This includes children: Pfizer’s vaccine is currently only available to children 16 years of age and older. “We will not vaccinate children under the age of 16 until we obtain results from the clinical trials conducted by Pfizer,” said Cohen in the committee that advises the Israeli Ministry of Health on clinical trials of the COVID-19 vaccine.
As long as the virus is spreading, new variants may emerge, some of which may evade current vaccines. Both Pfizer and Moderna are testing options to deal with these variations, including additional booster injections or brand new vaccine formulations. But this means that some measures to keep away from society may still need to be taken, especially if new mutations lead to a surge in future coronaviruses.
This worries Haggai Rothman, a researcher at the Siegel Research Group at the Weizmann Institute, who is concerned that compliance with further strict restrictions will be poor. Rothman said: “After the vaccination campaign, the public will not accept another hard ban.”
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