JERUSALEM – In the most extensive real-world test to date, Israel has demonstrated that a robust coronavirus vaccination program can have a rapid and powerful impact, showing the world a plausible way out of the pandemic.
Covid-19 cases and hospitalizations have dropped dramatically among people who were vaccinated in just a few weeks, according to new studies in Israel, where a rapid launch of the vaccine has made it a kind of testing laboratory for the world. And the first data suggest that vaccines are working almost as well in practice as in clinical trials.
“We say carefully, the magic has started”, tweeted Eran Segal, quantitative biologist at the Weizmann Institute of Science and co-author of a new study on the impact of the vaccine in Israel.
Promising vaccine news is hardly a clear path to a post-pandemic future.
As the world races to contain the virus before more dangerous mutations spread, the dire shortage of vaccines may prevent other countries from replicating Israel’s success or preventing the emergence of new variants.
Even Israel, which surpassed all other nations in vaccinating its people, is far from out of danger. The country extended its third national blockade on Thursday.
Still, the researchers found hope in the vaccine’s ability to rapidly reduce cases among Israelis taking the vaccines.
“I find it very convincing that we are seeing the real effects of vaccination at the population level,” said William Hanage, an epidemiologist at the Harvard School of Public Health TH Chan, who was not involved in the Israeli study.
Real-world news from Israel raises other signs of hope after months of desolation. An increasing number of vaccines are showing strong efficacy against Covid-19 and are particularly protective against serious illnesses. Some studies suggest that vaccines may even have the potential to delay transmission of the virus.
The new Israeli study looked at national health statistics for people aged 60 and over who received the Pfizer-BioNTech vaccine first because of their high risk. Looking at data six weeks after the vaccination campaign began, when most people of that age had been vaccinated, they found that the number of new cases of Covid-19 dropped 41 percent compared with three weeks earlier.
This group also experienced a 31% drop in hospitalizations for coronavirus and a 24% drop in those who became seriously ill.
The study is important, in part, because the authors were able to isolate other factors, including blockages, which also reduce the number of infections. The researchers found that even taking these factors into account, vaccines had a significant impact.
The size of the impact is yet to be determined.
But new data released on Thursday by one of Israel’s largest healthcare networks suggests that protection of the vaccine in practice could be almost as good as it was in the clinical trial.
The vaccine had a 95 percent effectiveness rate in clinical trials. The researchers warned in November that these numbers may not hold up in the real world.
People who volunteer for trials may not represent the population as a whole, for example. In addition, the Pfizer-BioNTech vaccine is challenging to administer on a national scale because it must be kept frozen until just before it is administered.
But Maccabi Healthcare Services reported on Thursday that of the 416,900 people vaccinated, only 254 received Covid-19 a week after the second dose. Furthermore, all cases were mild. Comparing these rates with unvaccinated people, the researchers estimated that the vaccine is 91 percent effective.
The results are even more impressive, experts say, because Israel is battling a worrying new variant of the coronavirus. Variant B.1.1.7 now accounts for up to 80 percent of samples tested in Israel.
First identified in Britain in December, the variant has spread to 72 other countries and can be up to 50% more transmissible than other variants.
Israel leads the world in vaccinating its citizens. So far, more than a third of its population of more than nine million people have received the first dose of the Pfizer-BioNTech vaccine and almost two million people have received a second dose.
The first target was citizens over 60, an age group responsible for 95 percent of the more than 5,000 Covid-19 deaths in Israel. According to the Ministry of Health, 84% of this age group has already been vaccinated.
As a relatively small country with a highly digitized universal health care system, Israel has become an attractive testing ground for Pfizer. As a result, Israel made a deal with the company, offering data in exchange for a steady supply of vaccines.
Despite its successes, Israel remains vulnerable. After a drop in the number of new cases in late January, the average rate is rising again. The contagiousness of variant B.1.1.7 may be partly to blame, along with the lower compliance with the current block compared to the previous ones. And all but a handful of Palestinians in the occupied territories are still waiting for vaccines, leaving them and the Israelis less protected in any new outbreak.
There is also no way of saying what would happen if a more worrying variant started to spread in Israel. A variant first identified in South Africa is not only more contagious, it can also make vaccines less effective.
At the same time, Israel’s much-touted vaccine program appears to have hit an obstacle, as the number of vaccinees has dropped dramatically in the past week, suggesting that the country’s initial enthusiasm may be waning. The slowdown has left some vaccination centers deserted this week.
The vaccination program met with resistance among some groups, particularly ultra-Orthodox Jews and Arab citizens, two communities that were hard hit by the virus.
The government and health networks are launching new efforts to bring more people to be vaccinated. Israeli health networks have made vaccines available to anyone aged 16 and over this week. Experts who advised the government recommended allowing only vaccinated teachers to return to the classroom.
As an added incentive, once blocking restrictions are eased, they are recommending limiting participation in cultural or religious meetings to people who have been fully vaccinated, have recovered from Covid-19 or may have a recent negative test.
Galia Rahav, head of the Infectious Diseases Unit and Laboratories at the Sheba Medical Center in Tel Aviv, said the main result of the new research was that it was “very critical” to vaccinate almost half a million Israelis over 50 that have not been inoculated ” ASAP”.
Experts also pointed to gaps in the Weizman Institute study that still need to be filled.
Hagai Levine, an epidemiologist at the Hebrew University-Hadassah in Jerusalem, warned that researchers only observed general trends in the country, rather than tracking people who were vaccinated.
As a result, the study raises a series of questions that it cannot answer. It is not clear, for example, why researchers only saw a drop in cases, serious illnesses and hospitalization three weeks after the campaign began. In the clinical trial of the Pfizer-BioNTech vaccine, the researchers observed the first signs of protection about 10 days after the first dose.
It is possible that the impact was slower in Israel because the vaccination campaign was aimed mainly at older people, whose immune system may have taken longer to mount a defense.
“The message to the world is that even if you are vaccinating at a crazy pace like Israel, you still have to be patient,” said Hagai Rossman, co-author of the Weizmann study. “There is no magic wand.”
Other countries may not experience the benefits Israel has seen with its vaccine. Keeping the vaccine cool – it must be stored at temperatures below -76 degrees Fahrenheit to remain effective – during transport can be difficult in some places.
Still, Dr. Hanage said that other countries should be encouraged by Israel’s results and see them as an incentive to vaccinate as many people as possible as soon as possible.
“In fact, I think the recent results should be quite comforting,” he said. “Overall, I think it is good news.”
Isabel Kershner reported from Jerusalem and Carl Zimmer from New Haven, Connecticut.