How Israel became the world leader in vaccines

Dr. Ash is the second Covid tsar in Israel. He took office on November 12, after his less diplomatic predecessor resigned amid clashes with Mr Netanyahu and fights with ultra-Orthodox (often recalcitrant) Jews who clashed against blockades and other social restrictions.

Like all good officers, he is proud of his victories, but he quickly deserves others. He attributes Israel’s vaccination successes to its political leaders, who have shown foresight in concluding early contracts to store the Covid vaccine. Officials had “direct talks” with Pfizer,

in which they offered the company a scientific quid pro quo. Israel received the photos early and in the quantities it needed, and in return, Pfizer received access to vaccination results, tabulated by a country with a world-class medical system and a reputation for statistical and scientific integrity. Dr. Ash calls it a “win-win business” and thinks Pfizer would say the same thing.

The results are in line with previous smaller clinical trials. “We see about 95% efficiency in disease prevention,” says Dr. Ash. “So, in the analysis of real-life data, the results are as good as the research that Pfizer has done.”

Widespread vaccination has reduced infection rates and improved morale in a gregarious country that has endured three severe blockages in the past year. The last, much hated by the Israelis, lasted from January 8 to February 7, 2021. Citizens were imprisoned less than 1,000 meters from their homes. Schools have been closed.

Dr. Ash does not apologize for the difficulties. “I think it was absolutely necessary each of the three times we had to use the blockages.” He strongly disagrees with the Great Barrington Declaration, in which a group of epidemiologists plead for the “concentrated protection” of the vulnerable and the end of blockages.

“No No NO. I think this is a very dangerous way to deal with the pandemic,” says Dr. Ash. “They believe in stopping the pandemic by what I would call ‘natural herd immunity,’ which you achieve by allowing people to But this is wrong, because we will lose a lot of life. “A firm commitment to protect the lives of its citizens has been a hallmark of Israel’s civic pact since its inception. Israel’s civil defense against Hezbollah missiles can be seen in its cautious incremental approach to resuming normal life in the midst of the pandemic. The country is betting on vaccinations. “Once about 80 percent of Israel’s population is vaccinated,” he says, “we will be close. the immunity of the herd ”.

Dr. Ash speaks to me through Israel’s vaccination methods – and numbers – with quiet satisfaction. “We vaccinated those at risk first, but not in too narrow slots.” Israel began offering vaccines to anyone over the age of 60 in December – the age limit in most US states is 65 – as well as anyone with comorbidities. When the number of people over 60 who were vaccinated paid off, “I opened it to those over 50.”

Israel then extended the vaccine to 16- to 18-year-olds. “We wanted them vaccinated before they went back to school, once the blockage was closed,” says Dr. Ash. Children under the age of 16 are excluded because the US Food and Drug Administration – whose regulations comply with Israel – has not approved the Pfizer-BioNtech vaccine for that age group.

After the teenagers, the vaccination was opened to almost everyone who came. “We are not vaccinating anyone who has had Covid and recovered yet,” notes Dr. Ash – although they will soon receive a single shot to strengthen their natural immunity. By Friday, according to Dr. Ash’s spokesman, 3.1 million Israelis had received both shots and 5.1 million had received the first shot. For Israelis over 50, the full vaccination rate is 86%. When you exclude the ineligible from the denominator – children and the 738,000 people with immunity to previous infections – you reach a full vaccination rate of better than 80% for all ages 16 and up.

The vaccines were administered through Kupat Holim – Hebrew for “sickness funds” – the four insurance organizations that are the mainstay of Israeli health care. Every citizen is required by law to enroll in one of the four, and Dr. Ash was director of the Health Division at Maccabi Healthcare Services, the second largest, before becoming Tsar Covid. There are clinics even in the smallest cities. “Every Kupat Holim,” says Dr. Ash, “vaccinates his people.” This is an aspect of vaccination administration that would be impossible to replicate in the United States, with its mix of unconnected providers and health insurers.

What the two countries have in common is an observable pattern of skeptics against the Covid vaccine. In Israel, three groups stand out for their susceptibility to what Dr. Ash calls “fake news” about the vaccine: Arabs, Russian immigrants, and young women. At the request of the Israeli government, Facebook removed the “deliberately lying” content in Hebrew, saying the vaccine was a poison designed to eliminate the population and implant tracking chips in bodies. “Some young women,” he adds, “are afraid they may lose their fertility. This is baseless. ”

But the government could have turned a corner with another group – the ultra-Orthodox – who were also resistant to state leadership. “These groups are influenced by their rabbis,” says Dr. Ash, “and we have had good discussions with the rabbis about vaccinations. They encourage people to get vaccinated, so now we’re doing pretty well with them. “The key is to convince community leaders that vaccination makes sense. “There is no other way, either with the ultra-Orthodox groups or with the Arabs,” although with the latter group, the division is not religious: “We work with mayors and local leaders. They can get the message out to their people much better than I can. ”

One way to overcome vaccine resistance, he says, is to determine a Green Pass. Israelis can download an application that verifies that they have been vaccinated or have recovered from Covid. This allows passengers to enter gyms, hotels, concert halls and other spaces that are forbidden to those who are not immune.

What about the Palestinians? Israeli critics say he has not done enough. Dr. Ash responds that the Palestinian Authority has its own vaccination contracts and is part of the World Health Organization’s Covax initiative for low- and middle-income countries, but he also points to a pattern of contacts between his team and Palestinian territories. .

Israelis and Palestinians, he adds, “share a very small territory with many interconnections.” Many Arab Israelis go back and forth to the West Bank, and Palestinians come to Israel to work. So the disease binds us, for sure, and they will be vaccinated. Not just for their sake, but for ours. ”

Mr. Varadarajan, a contributor to the magazine, is a member of the American Enterprise Institute and the Classical Liberal Institute of New York University.