Israel Produces Best Evidence Yet About Pfizer Vaccine – But Netanyahu’s Vaccine Politics & Airport Chaos Cast Shadow Over Success Health Systems 25/02/2021 • Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Israel has seen sharp declines serious COVID cases among people 60+ (yellow line) since the vaccine campaign began – but a parallel rise in cases among younger people (black line). The largest peer reviewed study to date of some 1.193 million Israelis – half of whom received the Pfizer COVID-19 vaccine – confirms the vaccine’s efficacy in preventing symptomatic COVID-19 as well as serious cases and deaths – even after the first dose is administered. The study, published in the New England Journal of Medicine, used data from Israel’s largest healthcare organization, Clalit Health Services (CHS), to evaluate the effectiveness of Pfizer’s BNT162b2 mRNA vaccine in a nationwide mass vaccination setting. Estimated vaccine effectiveness during the follow-up period, beginning 7 days after the second dose, was 92% for a documented infection, 94% in preventing a symptomatic COVID-19 case, 87% effective in preventing hospitalization and 92% in preventing severe disease. Even after the first dose, the vaccine was 72% effective in preventing serious illness or death, the study found. The study, led by researchers from Ben Gurion University of the Negev, matched, on a 1:1 basis Israeli’s diverse subpopulations of Israeli Jewish and Arab citizens, including people from a wide range of ethnic and religious backgrounds, in order to compare outcomes among those who had received the vaccines – and those who had not. “This is immensely reassuring … better than I would have guessed,” the Mayo Clinic’s Gregory Poland was quoted as saying in one local press report. Just One Dose Highly Effective Drop-in testing clinic outside a health clinic in the ultra-orthodox city of Bnei Brak – one of Israel’s virus hotspots The research may, however, provide an unintended incentive to countries struggling with vaccine supply shortages to delay the second Pfizer dose – despite the fact that the two vaccine jabs are recommended to be administered just 3 weeks apart. “Even after one dose we can see very high effectiveness in prevention of death,” said Dr Buddy Creech of Vanderbilt University. “I would rather see 100 million people have one dose than to see 50 million people have two doses,” Creech said. With just 9 million people, half of them already vaccinated with at least one dose of the Pfizer vaccine, Israel has become a living laboratory for the efficacy of the brand new mRNA vaccine preparations being rolled out by Pfizer as well as Moderna. The successful campaign has led to a sharp drop in serious cases and hospitalizations among people over the age over the age of 60 since a peak in the current COVID wave of mid-January. But Vaccines Alone Aren’t Enough Arrivals at “closed” Ben Gurion Airport – reported use of forged COVID tests by some ultra-Orthodox passengers to board “rescue” flights has provoked outrage among other Israelis, as thousands of people remain stranded abroad . However, cases among under-50 Israelis have sharply risen – as the so-called British variant of the virus, B.117 takes over among younger age groups – so that overall declines in new infections and hospitalizations has been much slower. In addition, the highly successful vaccine campaign has now met with resistance among some pockets of younger Israelis, ultra Orthodox Israelis and Arab Israeli citizens who tend to be more vaccine hesitant and suspicious of the government. In addition, despite closing its airport to all but 200 incoming passengers a day, Israel has been struggling with a wave of people returning on “rescue” flights with forged COVID-test documents- some even bragging about it. Thousands of Israelis meanwhile remain stranded abroad – due to the inability of the government to both effectively prevent sick passengers from getting onto planes and enforce quarantines on arrivals – who routinely ignore mandatory quarantine requirements. “A jarring story this week of people forging documents to return to Israel, despite the closure, raises alarm bells…. Israel bills itself as the Start-Up Nation – but the country can’t even affirm if a document is forged prior to boarding people on a plane?” opined the English-language Jerusalem Post. “The country that supposedly has the best security against terrorism in the world can’t spot a forged document? How can it be sure then that other people arriving are not forging their documents? Meanwhile, real Israelis with real-life problems are still stuck abroad without the option of getting home.” Israeli health officials also are issuing sharp warnings that new infections could rise again if Israelis gather for traditionally raucous parties and celebrations during this weekend’s Jewish holiday of Purim. In addition, Israel’s campaign has come in for sharp criticism by local and international human rights groups for the lack of vacccine-sharing with some 5 million neighboring Palestinians in the occupied West Bank and Hamas-controlled Gaza, which has been under a longstanding Israeli security barricade. Vaccine-Sharing Plan To Latin America & Europe Halted Over Sharp Criticism at Home & Abroad Israeli Prime Minister Benjamin Netanyahu kicked off the mssave vaccine campaign in December. Prime Minister Benjamin Netanyahu meanwhile had announced plans to share “symbolic” doses with countries with which Israel maintains close ties. On Thursday, Israel’s Attorney General halted the plan, which had not been fully disclosed – but was said to include the sharing of about 80,000 Pfizer vaccine doses with about 20 friendly nations in Europe, Latin America and Africa, including ones that have recognized Jerusalem as Israel’s capital – while Palestinians only received about 5,000 doses. The plan was halted, but not before some countries, such as Honduras, had already received a shipment. In a statement, published on Twitter Thursday,the centrist Defense Minister Benny Gant decried Netanyahu’s moves as “undemocratic”, saying it was an arbitrary decision by the prime minister – who is also seeking re-election next month. ”While the supply of vaccines to medical staff in the Palestinian Authority was transferred in an orderly fashion, paired with the need for the vaccines here in Israel, supplying vaccines to other countries around the world has never been brought up for discussion in the relevant forums,” Gantz said in a letter to Netanyahu and the Attorney General. Netanyahu’s moves, coming after a month in which Israel shared only a few thousand doses, at most, with the Palestinian Authority, was also decried abroad. “It’s understandable to vaccinate one’s own citizens – but only to a point. After that, failure to share is ethically grotesque. Vaccines have become more scarce & valuable than the dollar. It is the new currency of influence & diplomacy. Wield it ethically,” said Lawrence Gostin, a global health professor at Georgetown University and head of a WHO collaborating centre on health and human rights,” in a series of tweets criticizing Netanyahu and Israel’s policies. Israel has vaccinated >40% of pop, more per capita than any nation. It's a tribute to its digitized health system- a world model. Sharing the benefits of vaccines w/ the Palestinians would be morally right, but also smart. It's a win-win, protecting both Israelis and Palestinians — Lawrence Gostin (@LawrenceGostin) February 24, 2021 “It’s one thing for the Israeli gov to argue that it must prioritize vaccinating Israeli citizens over Palestinians living under Israeli occupation. But it’s morally indefensible to give surplus vaccines to Guatemalans, Hondurans, Hungarians and Czechs over Palestinians,” tweeted Dov Waxman, UCLA’s chair of Israel studies, in a post on Thursday. “Not only does Israel have a legal responsibility to help vaccinate Palestinians living under Israeli military rule (according to the Geneva Conventions, and notwithstanding the Oslo Accords), but Israel also has a moral responsibility to them. “And, as if that’s not sufficient, Israel also has a pragmatic self-interest in preventing widespread transmission of COVID among Palestinians in the West Bank and Gaza.” It's one thing for the Israeli gov to argue that it must prioritize vaccinating Israeli citizens over Palestinians living under Israeli occupation. But it's morally indefensible to give surplus vaccines to Guatemalans, Hondurans, Hungarians and Czechs over Palestinians. — Dov Waxman (@DovWaxman) February 24, 2021 Sharing Epidemiological Space & ‘Symbolic’ Quantities of Vaccines Palestinian health worker administers COVID test to young child – as the SARS CoV2 virus infects more young people on both sides of the poltiical divide In a brief comment, the Prime Minister’s office stated that at the moment only “symbolic”: vaccine quantities were being offered to anyone for the moment: “no ability to render significant assistance is anticipated at least until the vaccines campaign in Israel will have ended. “Nevertheless, over the past month, a limited quantity of unused vaccines was accumulated; therefore, it has been decided to assist Palestinian Authority medical teams and several of the countries that contacted Israel with a symbolic quantity of vaccines.” With less fanfare, Israel has set up mobile posts along the borders of east Jerusalem and the West Bank – in an effort to vaccinate more Palestinian residents of the city and its environs – which Israelis and Arabs share de-facto – regardless of political claims. On the other side of the political divide more nationalistic Israelis have sharply opposed delivering vaccines to Gaza, until two Israelis, one mentally ill, who are being held hostage are released, along with the remains of two deceased soldiers. However, Israel did finally permit the PA, headquartered in the West Bank, to transfer some 2,000 Russian supplied vaccine doses to Gaza – followed by another 20,000 Sputnik doses donated by the United Arab Emirates, which entered from Egypt. Along with purchasing supplies of Russia’s Sputnik vaccine, the Palestinian Authority is also expecting some 300,000 COVID vaccine doses from the WHO co-sponsored COVAX facility in coming weeks. But those will only begin to cover some of the highest-risk groups among the estimated 5 million people living in the West Bank and Gaza. Per capita, Palestinian COVID cases and deaths have in fact been somewhat lower than those in Israel – but Palestinians are now reporting a recent surge – possibly driven by the same variants to have infected Israel, and where over 5,685 people have now died. According to Palestinian authorities, some 2,261 Palestinians have died from COVID-19 – but those deaths also include several hundred Palestinians living in East Jerusalem – which Israel also claims and counts as its own COVID cases too. Image Credits: HPW , Israel Ministry of Health, Uri Misgav/Twitter , Youtube – Israeli PM, Alia Ameen/Twitter . Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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