Israel is risking an unnecessary increase in morbidity by issuing green passes shortly after vaccination and should instead make people wait another week, argues a health care provider, in a survey that could have global repercussions.
Meuhedet Healthcare Services reported on Monday, based on an analysis of more than 100,000 members, that the vaccine’s effectiveness reaches 96 percent on the fifteenth day after the full vaccination. From the 7th to the 14th day, it is 89%.
In view of this, the fact that Israel is giving green passes a week after the full vaccination, rather than after two weeks, “may help to cause additional waves of disease,” said Dr. David Mosinzon, director of the medical division of Meuhedet.
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The Ministry of Health did not respond to the call, but if the policy changes, countries around the world that are closely monitoring Israel’s green pass experience to decide their own strategies for reopening the pandemic may follow suit.
A Meuhedet chart showing the vaccine’s effectiveness among its members at various intervals (shown in days) after the members received their second injection (Meuhedet)
Israelis can now download an electronic green pass a week after their second injection of vaccine, and the license allows them to make the most of the country’s reopening, which even includes admission to restaurants and cafes starting on Sunday.
The green pass eligibility deadline is based on data from Pfizer – the supplier of almost all vaccines administered in Israel so far – which considers people to be completely immune within a week of receiving their second dose.
But Meuhedet said his research, which tracked 102,150 vaccinees for 35 days after receiving their second injection, found that 82 percent of all infections occurred in the first 14 days. Although the number of infections is small – only 459 – he argued that delaying green pass status makes sense.
The Director General of the Ministry of Health, Chezy Levy, during the announcement of the “Green Pass” certification on February 18, 2021 (Ministry of Health)
“Removing social distancing regulations and giving the green pass as soon as eight days after the second vaccine is too early,” said Mosinzon.
“Hundreds of vaccinees who have not yet passed two weeks from the date of vaccination will, according to the relaxation of their regulations, go in good faith to large indoor events,” he said. “They were careful to do a second injection and will leave without knowing that they may have contracted the virus before their body develops a high level of immunity and without thinking that they can be contagious.”
A Meuhedet chart showing how many members were confirmed to be COVID-positive in each of the first 35 days after receiving their second vaccine injection (Meuhedet)
Health care provider Clalit disagreed, arguing that the need to get more people back into routine outweighed the value of delaying the green pass to reduce infections.
“A balance needs to be found between reducing the risk of the most at-risk indoor environment and allowing a high enough proportion of the population to participate in green pass activities to make them economically viable,” said Clalit head of research, Ran Balicer , The Times of Israel.
“At this point, the seven-day period seems to strike the right balance. In the future, as well-designed peer-reviewed analyzes will reveal the real difference in the risk of infection between days 7 and 14 after the second dose, we will be able to reconsider the policy. “
An Israeli citizen receives a COVID-19 vaccine at a Meuhedet vaccination center in Jerusalem on December 21, 2020. (Olivier Fitoussi / Flash90)
Experts note that several studies show that people have high levels of antibodies seven days after the second application of the vaccine, and say that the onset of higher immunity after the 14th day may point to the protection achieved by other mechanisms.
“We don’t have much experience in how immune memory is established after challenging the immune system with mRNA vaccines,” Prof. Cyrille Cohen, head of the immunotherapy laboratory at Bar-Ilan University.
“We know that they work and that they can generate excellent antibody responses, but it is possible that at the cellular level, other mechanisms are accumulating during the second week that could explain the observed data.”
