Israel is a world leader in the race to launch the COVID-19 vaccine. In this special article, Medical News Today looks at why the vaccine launch has been so successful in Israel and discusses controversies and equity issues related to the campaign.
Although the United States struggled to meet its COVID-19 vaccine deployment goals, in just 2 weeks, Israel vaccinated almost 15% of the country’s population of more than 9 million.
On January 19, 2021, 25.6% of the Israeli population received their first dose of vaccine and 550,000 people received both doses.
To give you some perspective, Israel is vaccinating residents at a rate of 32.4 people per 100, compared to 4.8 people per 100 in the United States and 7 per 100 in the United Kingdom.
But why exactly was the launch so successful in Israel? And what can we learn from this initial success? In this special article, we review what we know about the launch of the COVID-19 vaccine in Israel.
Israel’s success in launching the COVID-19 vaccine appears to be due to several factors that influence access and distribution of the vaccine.
The Israeli government started researching from the beginning a way to guarantee doses of the vaccine.
In June 2020, Israel became one of the first countries to sign an agreement to purchase a vaccine supply from Moderna. In November, the country announced additional vaccine deals with AstraZeneca and Pfizer.
The first doses of the Pfizer vaccine arrived in Israel on December 9, 2020, and vaccinations started on December 19, 2020. The country is still waiting for the other two vaccines.
The Israeli government has also agreed to pay more for vaccines and to buy millions of doses. Although the exact price is unknown, an official said the price was around $ 30 per vaccine – double the average price abroad.
The makers of the vaccine Israel is currently using – the American company Pfizer and the German partner BioNTech – declined to comment on the cost of the vaccine.
In exchange for an early and stable supply of the vaccine, the Israeli government also assured Pfizer that the country’s deployment would offer rapid and large-scale results, promising to provide the company with detailed information about the patients who received the vaccine in Israel.
Israeli officials hoped that the vaccine launch in Israel would be successful because the country is small, but has a vast health infrastructure. The country also has a well-developed universal health system that connects all residents to a national digital health network.
All residents also have insurance from semi-private health maintenance organizations (HMOs) that administer services across the country, even in remote rural regions.
Israel’s centralized and digitized system makes it easier to track and access information and implement national health agendas, such as vaccination campaigns.
“In a sense, Israel has become a major clinical trial,” said Hadassah Medical Center virologist, Dr. Rivka Abulafia-Lapid. The Times of Israel.
“As everyone in Israel belongs to an HMO and their records are kept with their historical data, this means that we will have a good picture of the responsiveness to the vaccine, in the context of existing age, sex and medical conditions,” Dr. Abulafia -Lapid added.
The successful launch of the vaccine in Israel is also partly due to the handling of the vaccine and its delivery to citizens.
Logistics officials stored the doses of the vaccine underground near Israel’s main airport. They are in 30 large freezers, with a capacity for 5 million doses.
The teams in Israel have also devised a way to repack the doses of large frozen frozen pallets into isolated boxes about the size of a pizza box. This facilitated the distribution of vaccine doses in smaller numbers and to remote locations.
The teams repack large vaccine pallets in packages containing at least 100 doses, which they then distribute to 400 vaccination centers. Healthcare professionals were also able to obtain more doses of vaccine from each vial than Pfizer had originally announced.
Pfizer approved both processes.
About 335 drive-through vaccination clinics also exist in Israel, allowing healthcare professionals to vaccinate larger groups of people quickly. On January 19, 2021, the country announced a new daily record of more than 210,000 vaccinations in 1 day.
Israel started vaccinating health professionals, teachers, people with health problems and people over 60. Now, the country is running to vaccinate the entire population over 16 – the equivalent of about 5.2 million people – by the end of March. On January 20, Israel began vaccinating residents over 40.
At the time of this writing, Israel has given at least one dose of the vaccine to more than 76% of the country’s inhabitants who work as teachers, are over 60 or present health risks.
Despite these achievements, some people in Israel are regularly speaking out against the way the government is dealing with the pandemic.
Hailed as a way to restore normalcy – and save the economy – the government calls the launch of the COVID-19 vaccine “Operation Back to Life”. Prime Minister Benjamin Netanyahu says that this will allow Israel to become the first country in the world to emerge from the pandemic.
However, it is less clear precisely how and when Israel will be able to return to what is called normal life.
On January 19, the country reported a record of more than 10,000 new cases of COVID-19 in a single day and a positivity rate above 10% for the first time in 3 months. In addition, 30-40% of new cases are linked to the new variant COVID-19 that scientists first recognized in the UK
Israel, currently in its third blockade, also faces high levels of unemployment and a recession, but authorities have extended the current national blockade until at least January 31.
Netanyahu’s political opponents also accuse the government of using the vaccine campaign for political gains before the next elections.
The country is on track to vaccinate all people over 16 just 3 days before the March 23 elections. In addition, the government is discussing postponing the election if infection rates remain high.
The government is also being criticized for not sharing enough details about what patient data will be shared or how Pfizer will use the information.
Government officials have only recently released some terms of the agreement, claiming that it will only share general data with Pfizer, such as data on the number of cases, serious cases, fatalities and vaccinations and the age and sex of each individual.
They also say the data will help researchers assess and track herd immunity, with the results to be published in a recognized medical journal.
But Tehilla Shwartz Altshuler, a senior researcher at the Israel Institute of Democracy, expressed her concern that anonymous patient data, including complete medical histories, would be shared.
Although they do not contain patient names or identification markers, she said it is not possible to discourage the files. Treating this personal data as if it belonged to the government in this way “is not ethically, legally, nor morally [right], “she added.
According to human rights groups, Palestinians living in the West Bank and Gaza Strip occupied by Israelis do not have access to the vaccine and will not have it for long. According to the 4th Geneva Convention, the occupying forces must provide health care to the populations of the territories they occupy.
Even so, Palestinian officials seem reluctant to make a formal request to Israel to provide the vaccine, probably because asking for help from Israel is politically sensitive.
In addition, the Oslo Peace Accords of the 1990s, which were supposed to be a temporary roadmap for the development of a Palestinian state, gave Palestinians responsibility for their health.
Israel’s health minister told Sky News that Palestinians simply need to “learn to take care of themselves”.
He said Israel offered advice, supplies and medicine to its neighbors, adding that it is in Israel’s interest to reduce the number of Palestinian cases, as many Palestinians work in Israel.
But some international organizations condemn Israel’s failure to provide the vaccine equitably.
According to Saleh Higazi, Amnesty International’s deputy regional director:
“Israel’s COVID-19 vaccine program highlights the institutionalized discrimination that defines the Israeli government’s policy towards the Palestinians. There could hardly be a better illustration of how Israeli lives are valued above Palestinian ones. “
The Palestinian government has provided vaccine shipments from four companies expected to arrive this quarter. The state may also start receiving doses in February of the World Health Organization (WHO) vaccine schedule for low to medium income countries.
Another issue that complicates the launch of the vaccine is the reluctance and fear among Arab and Orthodox populations in the country regarding the vaccine and restrictions on the pandemic.
Vaccination rates are low among the Arab community in Israel.
Ultra-orthodox communities are registering a record number of new cases of COVID-19. There are also reports of loose preventive restrictions in these communities, with some schools remaining open and several reports of large gatherings.
On January 20, the government announced the launch of a campaign to educate the ultra-orthodox community about the risks of a pandemic and the importance of following the rules.
Preliminary data from Israelis suggest that the vaccine was about 50% effective in preventing infection 14 days after receiving the first of two doses.
But some Israeli HMOs have announced very different rates of effectiveness. One HMO reported that the vaccine was 33% effective 14 days after administration, while another reported a 60% effectiveness rate.
The Israeli health minister also said that some of these initial reports were out of context and therefore inaccurate.
Pfizer says its vaccine is 52% effective 12 days after the first dose and 95% effective after the second.
Despite the discrepancies, so far, the two Israeli HMOs have analyzed data from about 800,000 people. Pfizer’s phase 3 trials included only 40,000 individuals.
Initial data also suggest that people may be contagious for some time after receiving the vaccination, even without a positive test for COVID-19. Israeli officials say 17% of new infections are in people who have received the first dose of the vaccine.
The successes of vaccine launches in Israel and their shortcomings can help vaccine developers adjust their product and offer insight into how to obtain and distribute the vaccine effectively.
“To paraphrase Star Trek, we are courageously going where no country has ever gone,” said the immunity expert, Prof. Cyrille Cohen, member of the Ministry of Health’s vaccine advisory committee, in an interview.
“Some countries are saying they will ‘wait and see’ before giving the vaccine. [Israel] we have taken a different approach and are now ready to provide vital, real-world results and observations that, hopefully, will provide a good basis for others to stop waiting and adopt the vaccine. ”
– Prof. Cyrille Cohen
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