In Israel’s ‘Living Laboratory’ – Vaccines Offer Hope At End Of Coronavirus Tunnel
Cafes in Jerusalem reopened fully exactly a week ago, inside for vaccinated “green pass” holders and outdoors for everyone. So far, COVID infection rates continue to drop.

JERUSALEM – One year after the COVID-19 global health emergency was termed a “pandemic” by the World Health Organization – new vaccines are showing their power and efficacy through sharp declines in case rates in Israel – as well as  in the United Kingdom and the United States – the second and third countries in terms of vaccine uptake. 

All three countries have also been among the world’s highest burden COVID places – time and again throughout the pandemic. But in recent months, they have also proven to be the fastest in getting vaccines to their populations – despite the bumps along the way – particularly in the United States.  

In Israel –  where more than 5 million of the country’s six million eligible adults have now received at least one dose of the Pfizer vaccine – and a couple of million people have already gotten the recommended two doses – the profound influence of the vaccines is becoming more and more evident, with the passage of every day – and sharply declining infection rates. 

Pfizer, in a joint press release released with Israel’s Ministry of Health, on Thursday cited the “dramatically lower COVID-19 disease incidence rates observed in individuals fully vaccinated with the Pfizer-BioNTech vaccine, based on real-world data gathered by the Israel Ministry of Health. 

In addition, the company said:  

  • Data suggest Pfizer-BioNTech vaccine prevents asymptomatic SARS-CoV-2 infection
  • Latest data analysis finds unvaccinated individuals were 44 times more likely to develop symptomatic COVID-19 and 29 times more likely to die from COVID-19

Those findings represent the most comprehensive real-world evidence to date demonstrating the effectiveness of a COVID-19 vaccine,” the company stated. “Data are of global importance to other countries as vaccination campaigns continue worldwide.

Good News Comes After Anxious Two Weeks 
Celebrating in Jerusalem – Rowdy ‘Purim” holiday celebrations in Israel in late February gave rise to fears of an infection surge – but thanks to the country’s comparably high rate of vaccinations, including among young people, that didn’t happen.

The reports are all the more significant insofar as they come two weeks after raucous, carnival-style  gatherings indoors and outside marking Israel’s annual “Purim” celebrations. 

Health authorities had feared that the spontaneous and largely uncontrolled mass gatherings of young people bent on celebrating after months pent-up inside – would usher in another spike in cases.

Instead, serious COVID cases in Israel continued their trend of decline, along with new cases.   

Adding to the pressures, Israel’s schools also reopened on Sunday. Wedding halls, sports and cultural events also resumed, with most entries limited to “green pass holders” of people vaccinated.  

Bars and restaurants were throbbing once more with life inside as well as on the pavements – with friends, family and work colleagues gathering and toasting each other – on the  belated “new” and hopefully “corona-free” year – as the disease is described locally. 

“It’s been a long time since we have been together” sighed Yoram, head of a small high-tech firm in the Tel Aviv area who was gathered with 12 young colleagues over pizzas and beers for the company’s first outing in over a year, at a scenic cafe perched over a nature reserve, mid-way between Jerusalem and Tel Aviv. “But we have all been vaccinated – at least with the first shot- by now.” 

Bourla: Important for Humanity to Show Real-World Results 
Albert Bourla, Pfizer CEO, interviewed on Israel’s channel N12 news on the vaccine results.

In his Israel TV interview, Bourla confirmed that Pfizer had deliberately chosen to provide Israel with almost an unlimited supply of the Pfizer vaccine – in order to rapidly demonstrate the vaccines effectiveness in real time. 

“We knew that this deployment of the vaccine will will take time around the world, and the anxiety will build the benefits of a vaccine and so we knew that it is very appropriate for humanity, to be able to select one country that we can demonstrate what the vaccination of the people can do to the health of the people and the economic index,” he said. 

With a population of only 9 million people, a strong public health system featuring universally digitalized medical records – Israel had the “right conditions,” he added. 

“We are so happy because the way that you executed it was beyond our imagination,” said Bourla,  “and now, a year from the declaration of the pandemic by the WHO, we were able today to issue a press release together with the minister of health of your country about the results. 

Bourla said that in the meantime, “I keep receiving calls from, from heads of state or follow the counters to congratulate me because they see the hope now.” 

Vaccine Adminstration – as well as Access – Key to Success

To a somewhat lesser extent, the sharp downturn in reported cases in the United Kingdom and the United States is also likely attributable to their comparatively higher levels of vaccination, observers say.  In the UK, some 35 vaccine doses have been administered for every 100 eligible adults, while in the United States there have been some 30 doses administered for every 100 people – although proportions actually getting vaccinated are still somewhat lower insofar all vaccines being used until now, require two doses.

The data is all the more striking since cases in Europe overall, as well as in Latin America, are currently rising – contrary to trends almost everywhere else in the world.  In Latin America, the increases are largely driven by Argentina and Brazil – whose government has flagrantly ignored the pandemic, if not denying it.  In Europe, increases in new cases are still being seen in France, Italy, Poland, German, Spain and Hungary.

Against that landscape, the Israeli and UK experiences may also be seen to illustrate how the able adminsitration of vaccines is also critical to the success of a campaign.

Both countries feature strong public health systems – with a hybrid mix of centralized command and control – and more localized service networks that could be deployed for the unprecedented vaccine drive.

In contrast, some of the same European countries that are seeing spikes in COVID cases, also have been criticized domestically for being too slow and awkward about vaccine rollouts.  While the root causes are mixed, more fragmented and decentralized public health systems are a factor, along with pure bureaucratic inefficiencies.  Widely publicized manufacturing hiccups leading to supply interruptions from major providers, including Pfizer, have also pleayed a significant role, however,  issues that have stimulated an EU-wide debate over vulnerable supply chains and lack of local manufacturing capacity.

Geopolitics of Vaccine Haves & Havenots

The Israel-as-laboratory story has, of course, also illustrated the geo-politics of vaccine access. The high-profile Israeli vaccine camapign – symbolizing the vaccine “haves” – has come against that of the vaccine “have-nots” – in this case some 5 million Palestinians who aren’t even on the vaccine data maps yet.

So far, Palestinians in the Israeli-occupied West Bank and Hamas-controlled Gaza have only received about 60,000 vaccine doses, in total, mostly of Russia’s Sputnik V.  And due to the complex political rivalries between Gaza’s Hamas-controlled government and the West Bank Palestinian Authority  –  most of those vaccines have gone to Gaza.

It comes against a hotly contested Israeli elections campaign in which Prime Minister Benjamin Netanyahu is trying to retain his grip on power – and another campaign between the West Bank Palestinian Authority and rivals in the Hamas-controlled Gaza.  So far, the vaccines that have been received by the Palestinians have been mostly donations from the United Arab Emirates – to Gaza’s Hamas-controlled enclave, while the West Bank Palestinian continues to wait.

Last month, the PA was supposed to be receiving tens of thousands of doses of the Sputnik vaccine from Russia – but those haven’t yet arrived. Nor have the AstraZeneca vaccines from the WHO co-sponsored COVAX initiative. On Friday, the Palestinian Authority’s (PA) Health Ministry in the West Bank announced yet another channel of supply -saying it would get a free donation of 100,000 Sinopharm vaccines from China.

Side by Side – Palestinian See Cases Rising While Israel’s Decline
Palestinian worker gets COVID vaccine at a West Bank checkpoint this week.

Meanwhile, the dearth of Palestinian vaccine access is painfully evident in the rising rates of new COVID infections, particularly in West Bank Palestinian communities that live uneasily side by side with half a million Jewish settlers – and also work in pre-1967 Israel.

While Israel’s new COVID case rate has dropped from a peak of nearly 1000 a day (per million people) in mid-January to about 344 cases, per million on 11 March, Palestinian case rates have moved in exactly the opposite direction.  New COVID cases among Palestinians rose from about 95 cases/ million in early February to about 349 cases/ million on Thursday, 11 March – overtaking Israeli rates for the first time in months.

The infection surge comes after weeks in which Israeli government officials have resisted giving the West Bank Palestinian Authority (PA), with which it has cooperated on other aspects of the pandemic, significant vaccine doses. The fact more supplies have reached Gaza than the West Bank is also more striking insofar as Israel has a former cooperation agreement with the Palestinian Authority – while it doesn’t recognize Hamas, or vice versa.

Israeli officials have maintained that under the Oslo accords of the mid-1990s, it is up to the PA to procure its own vaccines. This is despite the warnings from public health experts that infection reservoirs in Palestinian communities will inevitably spill over to pockets of under-vaccinated Israelis, including children and youths who cannot get vaccinated at all.

In belated recognition of the threats, Israel this week did finally begin vaccinating some 120,000 Palestinian workers employed in pre-1967 Israel or within West Bank Jewish settlements and industrial areas.

The free vaccine drive, using brand-new shipments of the mRNA Moderna vaccine, appeared to be meeting a positive response as Palestinian day labourers lined up for the vaccine at military checkpoints. Media images of average workers getting the vaccine have also resonated among some members of the Palestinian public – who are already resentful that, according to media reports, the PA’s own scarce initial doses went mainly to politicians, athletes and other VIPs.

Even so, the new Israeli vaccine drive among Palestinian workers won’t close the ever-growing chasm between Israel’s vaccine haves and Palestinian have-nots – or reach the most at-risk Palestinian groups – health workers, older people, and people living with chronic diseases.

On Friday, five United States senators, including Bernie Sanders and Elizabeth Warren, sent a letter Friday to US Secretary Antony Blinken asking the Biden administration “to urge the Israeli government to do more to help the Palestinians in Israeli-occupied territories receive adequate supplies of the COVID vaccine…

“The urgency of the moment, as both Israelis and Palestinians face the threat of COVID, demands immediate action,” the senators wrote, noting that while the West Bank Palestinian Authority has some responsibility for health under the terms of the 1990s- era Oslo Accords, the responsibilities of Israel, as the occupying power, supersede that under the terms of the Fourth Geneva convention.

“There is an increase in infections and a full occupancy in Palestinian hospitals in the West Bank and Jerusalem,” said Physicians for Human Rights in a post on Thursday. “And yet Israel is neglecting its responsibilities of supplying vaccines to the oPT (occupied Palestinian territories.”

Image Credits: N12, Health Policy Watch , Israel MFA .

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