How Israel became the world leader in vaccinations

Dr. Ash is Israel’s second Covid Tsar. He took the post on Nov. 12, after his less diplomatic predecessor retired amid clashes with Mr. Netanyahu and struggles with (often unruly) ultra-Orthodox Jews, who shied away from lockdowns and other social restrictions.

Like all good officers, he is proud of his victories, but he is quick to give credit to others. He attributes Israel’s vaccination successes to its political leaders, who were forward-thinking in making early deals to stock the Covid vaccine. Officials had “direct talks” with Pfizer

in which they offered the company a scientific consideration. Israel got the shots early and in the amounts it needed, and in return, Pfizer got access to the results of the vaccinations, prepared by a country with a first-class medical system and a reputation for statistical and scientific integrity. Dr. Ash calls it “a win-win deal” and believes Pfizer would say the same.

The results are consistent with those of earlier, much smaller clinical studies. “We see about 95% effectiveness in preventing disease,” says Dr. Ash. “So in real-life data analysis, the results are just as good as the research Pfizer had done.”

The widespread vaccination has cut infection rates and improved morale in a cozy country that has endured three rigorous lockdowns in the past year. The last, much hated by Israelis, ran from January 8 to February 7, 2021. Civilians were confined within 1,000 feet of their homes. Schools were closed.

Dr. Ash makes no apologies for the hardships. “I believe every one of the three times we had to use the lockdowns it was absolutely necessary.” He strongly disagrees with the Great Barrington Declaration, in which a group of epidemiologists advocate “targeted protection” of the vulnerable and an end to lockdowns.

“No no no. I think that’s a very dangerous way to deal with the pandemic,” says Dr. Ash. You achieve by infecting people, but this is wrong, because we will lose a lot of life. ”An unwavering commitment to protecting the lives of its citizens has been a hallmark of Israel’s Citizen Pact since its inception. The same aversion to the loss of life that characterizes Israel’s civil defense against Hezbollah’s missiles can be seen in the cautiously incremental approach to resuming normal life amid the pandemic. The country is betting heavily on vaccinations. “Once about 80% of Israel’s population is vaccinated,” he says, “we will be nearly inviolable to the flock.”

Dr. Ash tells me with quiet satisfaction about Israel’s methods of vaccination – and numbers. “We vaccinated the people at risk first, but not in too narrow slots.” Israel began offering vaccines to anyone over 60 in December – the age limit in most US states is 65 – as well as anyone with comorbidities. As the number of people over 60 getting vaccinated declined, “we opened it up to people over 50 and above.”

Israel then expanded the vaccine to those between the ages of 16 and 18. “We wanted them to be vaccinated before they could go back to school once the lockdown was over,” says Dr. Ash. Children under the age of 16 are excluded because the U.S. Food and Drug Administration – whose regulations Israel adheres to – has not approved the Pfizer-BioNtech vaccine for that age group.

After the teens, vaccination was opened up to almost everyone. “We are not yet vaccinating anyone who has had Covid and has recovered from it,” notes Dr. Ash on – although they will soon be getting an injection to boost their natural immunity. Friday, Dr. Ash, 3.1 million Israelis received both shots and 5.1 million received the first shots. For Israelis 50 and older, the full vaccination rate is 86%. If you exclude the ineligible children – children and the 738,000 people with immunity to previous infections – from the denominator, you get a full vaccination rate of over 80% for all ages 16 and older.

Vaccines have been administered through Kupat Holim – Hebrew for “health insurance funds” – the four insurance organizations that are the mainstay of Israel’s health care system. Every citizen is required by law to register with one of the four, and Dr. Ash was director of the health department of Maccabi Healthcare Services, the second largest, before becoming Covid Tsar. There are even clinics in the smallest cities. “Elke Kupat Holim,” says Dr. Ash, “vaccinate his people.” This is one aspect of vaccine delivery that would be impossible to replicate in the US, with its mishmash of unrelated medical providers and insurers.

What the two countries have in common is an observable pattern of skeptics about Covid vaccines. In Israel, three groups are notable for their sensitivity to what Dr. Ash calls “fake news” about the vaccine: Arabs, immigrants from Russia and young women. At the request of the Israeli government, Facebook has removed “intentionally lying” Hebrew content claiming that the vaccine was a poison designed to wipe out the population and implant scavenger chips into bodies. “Some young women,” he adds, “fear that they are at risk of losing their fertility. This is unfounded. ”

But the government may have turned the corner with another group – the ultra-Orthodox – who have also resisted the direction of the state. “These groups are influenced by their rabbis,” says Dr. Ash, “and we have had good discussions with the rabbis about the vaccinations. They are encouraging people to get vaccinated, so we’re doing pretty well with them now. “The key is to convince leaders of close-knit communities that vaccination makes sense.” There is no other way, be it the ultra-Orthodox groups or the Arabs, “although in the latter group the divide is not religious:” We work with mayors and local leaders. They can get the message across to their people much better than I can. ”

One way to overcome resistance to the vaccine, he says, is to encourage a green pass. Israelis can download an app that verifies they have been vaccinated or recovered from Covid. This allows pass holders to enter gyms, hotels, concert halls and other areas that are inaccessible to people who are not immune.

What about the Palestinians? Israel’s critics claim it has not done enough for them. Dr. Ash replies that the Palestinian Authority has its own vaccine 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 administrators in the Palestinian territories. 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 is definitely connecting us, and they will be vaccinated. Not only for them, but also for us. ”

Mr. Varadarajan, a journalist, is a fellow at the American Enterprise Institute and the Classical Liberal Institute of New York University.