More than a week after starting a project in Israel Coronavirus disease Vaccine has been launched Leave the rest of the world, The public health expert breathed a sigh of relief, because the effect seems to be finally beginning to show.
Earlier this week, as the country reported a markedly continuous decline in the number of critically ill patients aged 60 and above, experts were convinced that they had seen the effects of the vaccine. In the initial stage of the vaccine launch in Israel, people over 60 are given priority, so this signal is expected to appear in the national COVID-19 statistics.
“We are cautious to say that the magic has already begun,” Tweet On February 1, Eran Segal, a data scientist at the Weizmann Institute of Science in Rehovot, Israel, pointed out that COVID-19 cases, hospitalizations, and serious illnesses are all over 60 years old.
In addition, a follow-up study conducted by Maccabi Healthcare Services, one of Israel’s largest HMOs, showed that Pfizer’s COVID-19 vaccine has been used in most of the injections so far, and its effect in the real world is almost the same as that in clinical trials Achieved, more than 90% of the curative effect after two doses. This is not a guarantee: drugs and vaccines may perform slightly differently outside the controlled range of clinical testing.
This is good news for the United States and other countries that hope to follow Israel’s success in providing COVID-19 vaccines to their citizens. But data from Israel also reveals the challenges ahead.
The Israeli experts interviewed by BuzzFeed News had hoped that these positive results would emerge sooner. They attribute the delay largely to the fact that Middle Eastern countries have been fighting the highly spreading virus. B.1.1.7 Coronavirus variants First appeared in the UK-now considered to account for more than 70% of Israeli cases.Although both Pfizer and Moderna It has been reported that their vaccine effectively blocked the B.1.1.7 variant, and other variants first discovered in South Africa and Brazil seem to be Not too sensitive If they or new variants with similar mutations become an advantage, then further progress may be disrupted.
At the same time, Israel has been criticized by human rights organizations for failing to extend its vaccination program to the occupied Palestinian territories. Among Palestinian Arab citizens and the ultra-orthodox Jewish community in Israel, the speed of promotion has been slower-this is worrying, as these groups are the ones hardest hit by COVID-19.
This is related to the concern about Israel’s launch of health experts from the United States, because although the Israeli government initiated a large-scale communication effort involving religious and other community leaders in an attempt to resolve the vaccine hesitation between Arab and ultra-orthodox communities, this situation Still happening.
In the United States, black Americans have always Killed disproportionately And got sick from COVID-19, and already behind In the vaccination campaign in the United States.Although black Americans have good reasons to distrust medical institutions Legacy of racism Peter Hotz, a leading vaccine researcher at Baylor College of Medicine in Houston, told BuzzFeed News that in the healthcare system, there is nothing in the U.S. that can persuade skeptical groups of the benefits of vaccination more than Israel’s propaganda.
Hotez is concerned that if the vaccine rollout rate remains low and the more dangerous coronavirus variants prevail, the black community will suffer terrible losses. “We are losing a generation of parents and brothers and sisters,” he said.
Israel’s rapid vaccine promotion is attributed to the health care system, which requires every citizen to become a member of one of the four HMOs, which jointly operate clinics almost everywhere in this small, densely populated country.After obtaining vaccine supplies from Pfizer and Moderna, the country is able to use this solid healthcare infrastructure to advance vaccination faster than any other country: as of Wednesday, Israel has provided approximately 59 times per 100 people In this country, the United States has provided nearly 10 of them.
Israel’s rules on who is eligible for vaccination are also much simpler than those in the United States. The United States makes decisions based on factors such as age, occupational exposure to the virus, and past illnesses. Instead, Israel prioritizes the elderly, encourages everyone to be vaccinated, and opens a call center to simplify appointments. Even with the existing infrastructure, it has opened a large outdoor immunization center.
“They made registration very easy,” said Hotez’s Baylor colleague Ann Blake (Ann Blake), who had received training in doctors and public health in Israel. “If there is a vaccine at the end of the day, the secretary of the clinic will send a text message.”
Israel’s vaccine launch leads the world
The health care system in the United States is more fragmented. Many people do not have medical insurance and face huge challenges that match the Israeli vaccination campaign. Black believes that the country needs to learn from Israel’s successful experience, open more large vaccination centers and simplify vaccine eligibility rules.
“We need to open stadiums across the country,” she said. “We started to do this. We need to do this on a large scale”
But Israel has been less effective in controlling the spread of the virus. The vaccination campaign began on December 19, and in the early stages, there was a surge in cases driven by the now dominant variant of B.1.1.7. A nationwide lockdown was subsequently implemented on December 27, making it difficult for scientists to distinguish between the protective effect of the vaccine and the reduction in transmission caused by the lockdown.
Uri Shalit, a data scientist specializing in healthcare at the Haifa Institute of Technology, told BuzzFeed News: “Because all these strong winds are pushing things in different directions, it is difficult to discern the effects of vaccines.”
Just last week, Shalit and other experts were still anxiously looking for the difference between this lock-in trend and the previous lock-in trend that ended in October. But by this week, it is clear that the number of elderly people with severe COVID-19 in Israel has begun to decline, even as the number of severe cases among young people continues to increase.
Israelis with severe COVID-19 by age group
As shown in the graphs above and below, the decline in severe cases began in mid-January, when the number of elderly Israelis receiving the second shot of the vaccine increased sharply. Currently, more than 75% of people over the age of 60 have been vaccinated twice, although the rate of increase has slowed in recent days-which shocked some scientists. “You have exhausted early adopters,” Yaniv Erlich, a computer scientist at the Herzliya Interdisciplinary Center who has been tracking COVID-19 data, told BuzzFeed News.
Percentage of Israelis vaccinated by age group
Nevertheless, follow-up research on Israeli HMO is adding a promising picture.in Early research papers Researchers at Maccabi Healthcare Services published an as yet peer-reviewed article on the Internet on January 29. They followed up more than 350,000 Israeli adults 13-24 days after their first dose of Pfizer vaccine. An estimated 51% In terms of infection prevention.
Among the undisclosed data so far, The Times of Israel reported last week Based on a comparison of 163,000 patients who were fully vaccinated with Maccabi vaccine and the unvaccinated group, Maccabi researchers found that the effective rate of the vaccine after two doses was 92%.If these results are true, it means that Pfizer vaccines perform almost the same in the real world As done in clinical trials.
Ehrlich and other It warns that these results may overestimate the effectiveness of the vaccine. One problem is that Israeli couples usually get vaccinated together to provide extra protection for the family, which is not available to volunteers in clinical trials.
But Cyril Cohen, an immunologist and associate dean of life sciences at Ramat Gamba Ilan University, is pleased with these reports. “This is in line with what was predicted,” he told BuzzFeed News. “I’m always cautious, but so far this is very good news.”
What is less encouraging is that vaccination rates are lower in ultra-orthodox Jewish communities and cities with large Arab Israeli populations. Many ultra-Orthodox Jews are skeptical of vaccines and oppose restrictions on the spread of coronavirus – Thousands of mourners attended At the funeral of a famous rabbi in Jerusalem on January 31, ignoring the country’s current blockade.
By the end of January, Less than 70% of people over 60 in NazarethSometimes referred to as Israel’s “Arab Capital”, the initial dose of vaccine has already been vaccinated-far behind the national average. In Nazareth and other Israeli cities with large Arab populations, the low vaccination rate is believed to be related to wider distrust of the Israeli government.
Another controversial issue is the vaccination of Palestinians in the occupied territories.Israel insists that according to the Oslo Agreement, health is the responsibility of the Palestinian National Authority and the Palestinian National Authority According to reports, plans to purchase 100,000 doses Sputnik V vaccine developed by the Gamaliya Institute in Russia.
Under pressure from the group, including Human Rights Watch, Claiming that the Fourth Geneva Convention requires Israel to provide medical supplies, and Israel has already started Send a small amount of vaccine To the Palestinians. The move was also raised by fears that unvaccinated people frequently passing through checkpoints — tens of thousands of Palestinians working in Israel — would disrupt the country’s own vaccination campaign.
The gap in Israel’s vaccine launch means that even the world leader in COVID-19 immunization still has a population whose coronavirus is still spreading freely. This includes children: Pfizer’s vaccine is currently only authorized for use in children 16 years and older. “We will not vaccinate children under 16 years of age until the results of the clinical trials conducted by Pfizer,” said Cohen, who is a member of the committee that provides recommendations for clinical trials of the COVID-19 vaccine to the Israeli Ministry of Health.
As long as the virus is still spreading, new variants may emerge, some of which may avoid current vaccines. Both Pfizer and Moderna are testing options that respond to mutations, including additional booster injections or brand new vaccine formulations. But this means that some social distancing measures may continue to be necessary, especially if new mutations lead to future coronavirus surges.
This worries Hagai Rossman, a researcher in the Segal team at the Weizmann Institute, who is concerned that compliance with further strict restrictions will be poor. Rothman said: “After the vaccination campaign, the public will not accept a strict lockdown.”