JERUSALEM – Israel, which leads the world in vaccinating its population against coronavirus, has produced some encouraging news: The first results show a significant drop in infection after just one injection of a two-dose vaccine, and better-than-expected results after the two doses.
Public health experts warn that the data, based on the Pfizer-BioNTech vaccine, are preliminary and have not been subjected to clinical tests. Even so, Dr. Anat Ekka Zohar, vice president of Maccabi Health Services, one of the Israeli health care organizations that released the data, found this “very encouraging”.
In the first preliminary report, Clalit, Israel’s largest health fund, compared 200,000 people aged 60 and over who received the first dose of the vaccine with an equivalent group of 200,000 who had not yet been vaccinated. He said that 14 to 18 days after their vaccinations, partially vaccinated patients were 33 percent less likely to be infected.
Almost at the same time, Maccabi’s research arm said it found an even greater drop in infections after just one dose: a reduction of about 60 percent, 13 to 21 days after the first injection, in the first 430,000 people receiving it -over there.
Maccabi did not specify an age range or compared the data with a compatible non-vaccinated cohort.
On Monday, the Israeli Ministry of Health and Maccabi released new data on people who received both doses of the vaccine, showing extremely high rates of effectiveness.
The ministry found that of 428,000 Israelis who received their second dose a week later, only 63, or 0.014 percent, contracted the virus. Likewise, Maccabi data showed that, more than a week after receiving the second dose, only 20 of the approximately 128,600 people, about 0.01%, contracted the virus.
In clinical trials, the Pfizer vaccine has been shown to be 95% effective after two doses in preventing coronavirus infection in people with no evidence of previous infection. Israeli results, if confirmed, suggest that the effectiveness may be even greater, although rigorous comparisons with unvaccinated people have not yet been published.
“This data is very encouraging,” said Zohar. “We will monitor these patients closely to see if they continue to suffer only from mild symptoms and do not develop complications as a result of the virus.”
Both Clalit and Maccabi warned that their findings were preliminary and said they would soon be followed by more in-depth statistical analysis in peer-reviewed scientific publications.
Israel, where more than 40% of the population has already received the first dose of the vaccine, has become something of an international test case for vaccination effectiveness.
With its small population, highly digitized universal health care system and rapid deployment of military aid vaccines, Israel’s real-world data provides a useful supplement for clinical testing for researchers, pharmaceutical companies and legislators.
Israel entered into an agreement with Pfizer in which the pharmaceutical company guaranteed the country a fast and stable supply of vaccines in exchange for data. The Ministry of Health made public a drafted version of the agreement.
Despite its race to vaccinate, Israel is suffering a devastating third wave of coronavirus. The government imposed a strict national blockade this month, after weeks of increasing infections and deaths.
Israel was scheduled to stop most air travel to and from the country as of midnight on Monday, in an effort to block the arrival of emerging variants of the virus that could threaten the country’s vaccination campaign. Two vaccine manufacturers said on Monday that their vaccines were somewhat less effective against one of the new variants.
While real-world data like Israel’s are useful, they are subject to variables that can skew results and that clinical trials try to account for.
Vaccines for covid19>
Answers to your vaccine questions
While the exact order of vaccine recipients may vary by state, most will likely put doctors and residents of long-term care facilities first. If you want to understand how this decision is being made, this article will help you.
Life will only return to normal when society as a whole obtains sufficient protection against the coronavirus. Once countries authorize a vaccine, they will only be able to vaccinate a few percent of their citizens, at most, within the first two months. The unvaccinated majority will still remain vulnerable to infection. An increasing number of coronavirus vaccines are showing robust protection against disease. But it is also possible for people to spread the virus without even knowing they are infected, because they have only mild symptoms or none at all. Scientists still do not know whether vaccines also block coronavirus transmission. For now, even vaccinated people will need to wear masks, avoid crowds indoors and so on. Once enough people are vaccinated, it will be very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we, as a society, achieve this goal, life may begin to approach something normal in the fall of 2021.
Yes, but not forever. The two vaccines that will potentially be authorized this month clearly protect people from getting sick with Covid-19. But the clinical tests that provided these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. This remains a possibility. We know that people naturally infected with the coronavirus can transmit it as long as they have no cough or other symptoms. Researchers will be studying this issue intensively as vaccines are launched. In the meantime, even vaccinated people will need to consider possible spreaders.
The Pfizer and BioNTech vaccine is given as an injection into the arm, like other typical vaccines. The injection will be no different than the one you took before. Tens of thousands of people have already received the vaccines and none have reported serious health problems. But some of them experienced short-term discomfort, including pain and flu symptoms that usually last for a day. People may need to plan a day off from work or school after the second injection. Although these experiences are not pleasant, they are a good sign: they are the result of your own immune system facing the vaccine and developing a potent response that will provide lasting immunity.
No. The Moderna and Pfizer vaccines use a genetic molecule to prepare the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inward. The cell uses mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any given time, each of our cells can contain hundreds of thousands of mRNA molecules, which they produce to make their own proteins. As soon as these proteins are produced, our cells fragment the mRNA with special enzymes. The mRNA molecules that our cells make can survive just a matter of minutes. The mRNA in vaccines is designed to resist the cell’s enzymes a little more, so that cells can produce extra proteins from the virus and stimulate a stronger immune response. But mRNA can only last a few days at most, before being destroyed.
The first Israeli figures are based on the first people to receive the vaccine. These people, experts say, tend to be more concerned or informed about the virus and therefore more careful about social detachment and wearing masks. They can also be different from those who did not rush to take the photo by location and socioeconomic status.
In addition, experts say, the disease changes over time. Professor Ran Balicer, director of innovation at Clalit and a leading Israeli epidemiologist, said the two-week data could be evidence of a different time or “about a million vaccines ago in Israeli terms”.
Maccabi said it would release more weekly data. “The main message,” said Maccabi in a statement, is that even the first dose of the vaccine “is effective and reduces morbidity and decreases hospitalizations by many tens of percent.”
The danger of releasing raw data, experts warned, is that it can be misinterpreted.
After Clalit released its first figures two weeks ago, many people heard of a 33% drop in cases, not the expected 95%, and came to the erroneous conclusion that the Pfizer injection did not work.
There was an uproar in Britain, where authorities delayed the administration of the second dose by up to 12 weeks, as opposed to the 21-day interval on which Pfizer based its tests.
Professor Balicer considered the results to be good news and was dismayed at the way they were interpreted.
“We were calm enough to tell everyone that we were seeing what we should be seeing right after Day 14,” he said. “I don’t know how it turned into a ‘My God, it doesn’t work’ message.”
Professor Balicer, who is also the chairman of the team of experts advising the Israeli government in its response to Covid-19, hopes that the positive results could be related to an imminent government decision on a third blockade.
“Covid has turned us all into amateur scientists,” said Talya Miron-Shatz, associate professor and medical decision-making specialist at Ono Academic College in central Israel. “We are all analyzing data, but most people are not scientists.”
Israel, which started vaccinating people on December 20, gave the first injection to more than 2.6 million Israelis and the two vaccines to more than one million people.
After starting with people aged 60 and over, health professionals and others at high risk, Israel is now offering vaccines to people over 40 and high school students aged 16 to 18 to allow them to go back to school. The military is helping with the effort and 700 doctors from the army reserve are helping in the vaccination centers.
Prof. Jonathan Halevy, president of the Shaare Zedek Medical Center in Jerusalem, did not study the findings of the HMOs, but said that two weeks after the first dose was released he began to notice a drop in severe cases.
“I know several people who were infected near the time they got the vaccine, but they took it lightly,” he said.
Still, Israel remains under a national blockade and the authorities are concerned about the emergence of new highly contagious variants. It remains to be seen how effective vaccines are against the new variants.
Despite what appears to be the initial success of the vaccine, the virus continues to wreak havoc in Israel. Professor Halevy said his hospital’s Covid wards were still full and he hoped it would take another two or three weeks to see a decline.
The virus has killed more than 1,000 Israelis so far this month alone, almost a quarter of those who died from the pandemic virus in general.
Health officials and experts attributed much of the recent rise in infection to the rapidly spreading variant first detected in Britain.