How Israel became the world leader in vaccines

Dr. Ash is the second czar of Covid Israel. He took office on November 12, after his less diplomatic predecessor resigned amid clashes with Netanyahu and fights with (often recalcitrant) ultra-Orthodox Jews, who were irritated by blockades and other social restrictions.

Like all good officers, he is proud of his victories, but he is quick to give credit to others. He attributes the success of Israel’s vaccination to its political leaders, who showed perspicacity in concluding initial agreements to stock up on the Covid vaccine. Employees had “direct discussions” with Pfizer,

where they offered the company a scientific quid pro quo. Israel took the vaccines early and in the necessary quantities, and in return, Pfizer was given access to vaccination results, tabulated by a country with a first-rate medical system and a reputation for statistical and scientific integrity. Dr. Ash calls this “a win-win deal” and believes Pfizer would say the same.

The results correspond to those of previous clinical trials, much smaller. “We are seeing about 95% effectiveness in preventing diseases,” says Dr. Ash. “So when analyzing real-life data, the results are as good as the research that Pfizer did.”

Widespread vaccination has reduced infection rates and improved morale in a gregarious country that suffered three severe blockages in the past year. The latter, much hated by the Israelis, took place from January 8 to February 7, 2021. Citizens were confined about 1,000 meters from their homes. Schools were closed.

Dr. Ash does not apologize for the suffering. “I believe that each of the three times that we had to use the locks was absolutely necessary.” He strongly disagrees with the Great Barrington Declaration, in which a group of epidemiologists advocates “focused protection” of the vulnerable and an end to blockades.

“No no no. I think it’s a very dangerous way to deal with the pandemic,” says Dr. Ash. “They believe in stopping the pandemic through what I call ‘natural herd immunity’, which you get by to allow people to be infected, but that is wrong, because we are going to lose many lives. ”An unyielding commitment to protect the lives of its citizens has been a hallmark of Israel’s civic pact since its inception. marks Israel’s civil defense against Hezbollah rockets can be seen in its cautiously incremental approach to resuming normal life in the midst of the pandemic. The country is betting heavily on vaccines. , he says, “we will be close to collective immunity”.

Dr. Ash tells me about Israel’s vaccination methods – and numbers – with quiet satisfaction. “We vaccinated those at risk first, but not in very narrow cracks.” Israel started in December offering vaccines to everyone over 60 – the age limit in most states in the U.S. is 65 – as well as anyone with comorbidities. When the number of people over 60 vaccinated reached a plateau, “we open to 50 and above”.

Israel then extended the vaccine to those between 16 and 18 years old. “We wanted them to be vaccinated before they went back to school, as soon as the blockade was over,” says Dr. Ash. Children under 16 are excluded because the Food and Drug Administration – whose regulations Israel is adhering to – has not approved the Pfizer-BioNtech vaccine for this age group.

After adolescents, vaccination was open to almost all participants. “We are not yet vaccinating anyone who has already taken Covid and recovered from it,” notes Dr. Ash – although they will soon receive an injection to boost their natural immunity. On Friday, Dr. Ash’s spokeswoman said, 3.1 million Israelis received the two shots and 5.1 million the first. For Israelis aged 50 and over, the total vaccination rate is 86%. When you exclude the ineligible – children and 738,000 people with immunity from previous infections – from the denominator, you end up with a complete vaccination rate better than 80% for all ages 16 and over.

The vaccines were administered through Kupat Holim – Hebrew for “sickness funds” – the four insurance organizations that are the mainstay of Israeli health. Every citizen is required by law to apply with one of the four, and Dr. Ash was director of the Health Division of Maccabi Healthcare Services, the second largest, before becoming Covid’s czar. There are clinics even in the smallest cities. “Every Kupat Holim,” says Dr. Ash, “is vaccinating his people.” This is an aspect of vaccination application that would be impossible to replicate in the United States, with its hodgepodge of disconnected medical providers and insurers.

What the two countries have in common is an observable pattern of skeptics of the Covid vaccine. In Israel, three groups stand out for their susceptibility to what Ash calls “fake news” about the vaccine: Arabs, immigrants from Russia and young women. At the request of the Israeli government, Facebook removed “deliberately lying” Hebrew content, stating that the vaccine was a poison designed to wipe out the population and implant tracking chips on bodies. “Some young women,” he adds, “are afraid of losing their fertility. This is baseless. ”

But the government may have rounded the corner with another group – the ultra-Orthodox – who have also resisted the direction of the state. “These groups are influenced by their rabbis,” says Dr. Ash, “and we had good discussions with the rabbis about vaccines. They are encouraging people to get vaccinated, so now we are doing great with them ”. The key is to persuade the leaders of the united communities that vaccination makes sense. “There is no other way out, whether with the ultra-Orthodox groups or the Arabs”, although with the latter the division is not religious: “We work with mayors and local leaders. They can get the message across to their people much better than I can. ”

One way to overcome resistance to the vaccine, he says, is with the encouragement of a Green Pass. Israelis can download an application that checks whether they have been vaccinated or have recovered from Covid. This allows pass holders to enter gyms, hotels, concert halls and other spaces that are prohibited for those who are not immune.

What about the Palestinians? Israel’s critics argue that it has not done enough for them. Dr. Ash replies that the Palestinian Authority has its own vaccine contracts and is part of the World Health Organization’s Covax initiative for low- and middle-income countries, but he also points to a pattern of contacts between his staff and administrators in the country. territories.

Israelis and Palestinians, he adds, “share a very small territory, with many interconnections”. Many Israeli Arabs come and go to the West Bank, and Palestinians go to Israel to work. “Then the disease unites us, definitely, and they will be vaccinated. Not only for their sake, but also for ours. ”

Mr. Varadarajan, a contributor to the Journal, is a fellow at the American Enterprise Institute and the Classical Liberal Institute at New York University.