Israel vaccine
Israeli Prime Minister Minister Benjamin Netanyahu gets his second dose of the coronavirus vaccine on January 9, 2021.

  • Israel has vaccinated more people per capita than any other country: nearly a third of Israelis have gotten at least their first shot.
  • Only 63 out of 428,000 Israelis — less than 0.02% — contracted the coronavirus after receiving their second doses.
  • Experts expected to see Israel’s new daily cases drop by now, but like many countries, it is struggling with variants that appear to spread more easily.
  • Visit Business Insider’s homepage for more stories.

Israel has immunized more people per capita than any other country. As of Thursday, nearly a third of Israel’s population – 2.8 million out of 9 million residents – had gotten a first shot, and more than 1.6 million people had received the full two-dose regimen.

As expected, the vaccinated group is already seeing fewer coronavirus infections. Only 63 out of 428,000 Israelis – less than 0.02% – contracted the virus one week after receiving their second doses, the Israeli Health Ministry said Monday.

Anat Ekka Zohar, a vaccine statistics analyst at Israel’s Maccabi Healthcare Services, told The Times of Israel on Thursday that the Pfizer vaccine so far has been 92% effective in Israel. The data comes from a group of 163,000 Israelis tested 10 days after their two-dose regimen.

“There’s no reason to believe that we won’t see the same thing among groups that are vaccinated in other countries, including the United States,” Dr. Emily Gurley, an associate scientist at Johns Hopkins Bloomberg School of Public Health, told Insider. “But of course, that decrease in risk is only for groups that have been vaccinated, so getting more people vaccinated is going to be the key for reducing risk overall in the population.”

Average daily cases in Israel have decreased 14% in the last two weeks, but the country still recorded 7,800 new cases on Thursday. Israel also recorded 75 deaths on Thursday, its highest-ever daily count.

‘A clinical trial where the whole country is the patient’

israel vaccine worker
A healthcare worker administers a COVID-19 vaccine to an ultra-Orthodox Jewish man at Israel's Clalit Health Services in Jerusalem on January 6, 2021.

The world is looking to Israel as the first real-world demo of how vaccinations bring a nationwide outbreak under control.

“It’s really a clinical trial where the whole country is the patient,” Dr. Eyal Zimlichman, deputy director general at Sheba Medical Center, Israel’s largest hospital, told Insider. “Science is looking at Israel right now to study and learn.”

Maccabi Healthcare Services recently compared the average weekly hospitalization rate among more than 50,000 vaccinated people ages 60 and up with the rate among people in the same demographic who hadn’t been vaccinated. Researchers found infections and hospitalizations for the vaccinated group were 60% lower by mid-January – two days after they had received their second shots – than in late December, when the group had only received their first shots.

Another report from Israel’s largest state health organization, Clalit, compared 200,000 vaccinated people ages 60 and older with the same number of unvaccinated individuals of the same ages. The organization found that vaccinated patients were 33% less likely to be infected 14 to 18 days after receiving their first shot.

The data is a hopeful sign, though some experts anticipated faster downward trends in Israel’s overall case counts.

“Probably in our most optimistic hopes, we thought that we’d see a bigger impact by now,” Zimlichman said. “It might take longer than the original clinical trials have shown for people to actually be immune to the virus.”

Like many countries, Israel’s vaccine rollout is being challenged by the emergence of new coronavirus variants that appear to spread more easily than the original. Zimlichman said widespread vaccinations may also be encouraging Israelis to relax their mask wearing.

“Once you realize that a large percent of the population have been vaccinated, you’re saying, ‘Well, you know, I’m safe now to take my mask off from time to time,'” he said. “And from that relaxation, you’re likely to see another rise in new cases.”

These factors may explain why average daily coronavirus cases in Israel haven’t dipped considerably since the start of January. Average daily deaths there have continued to rise, though deaths are a lagging indicator, reflecting cases diagnosed two to three weeks prior.

The recipe for Israel’s successful vaccine rollout

Israel vaccine
A man receives a COVID-19 vaccine at a health services center in Rehovot, Israel on January 14, 2021.

Israel’s speedy vaccine rollout was a testament to a few factors.

In November, Israel agreed to purchase 8 million vaccine doses from Pfizer – enough for most Israelis to receive their first shot. The nation’s universal healthcare system made it easy to distribute those doses quickly, since all Israelis must register with an insurance agency backed by the government. The system gives most residents access to free care at community health centers within about 10 minutes of their homes.

Since Israeli healthcare providers keep digital records of each patient, Zimlichman said, “it’s very easy from there to decide who needs to get vaccinated first, second, and third and so on.” Residents who are eligible to get vaccinated receive a text message with their appointment time at a nearby community center.

Earlier this month, Netanyahu signed a deal with Pfizer to share Israel’s medical data in exchange for a steady vaccine supply. At the time, he predicted that Israel would be “a global model state” for vaccinations and “the first country in the world to emerge from the coronavirus.”

But Israel’s vaccinations don’t extend to Palestinians living in the West Bank and the Gaza Strip. These individuals have yet to receive any doses. Palestinians in East Jerusalem have access to Israeli health insurance.

United Nations human rights experts recently called on Israel to ensure that Palestinians within its borders had “swift and equitable access to COVID-19 vaccines.” 

Variants pose a new challenge 

israel vaccine
A healthcare worker administers a shot at a COVID-19 vaccination center in Tel Aviv, Israel on January 6, 2021.

Gurley said researchers still need more detailed data from Israeli healthcare providers to accurately assess the impact of the nation’s vaccinations, since social behavior could potentially skew the results. It’s possible, for instance, that people who recently got vaccinated were also more concerned about the virus to begin with, and therefore more likely to wear masks or practice social distancing. Elderly individuals might also be more likely to abide by Israel’s strict lockdown, which was reinstated in early January. 

Still, Gurley added, it’s encouraging to see vaccinations “play out as we would expect.” 

“If you vaccinate everyone, you end the epidemic in your country,” she said. “Hopefully that will be inspiring for other places.”

But Israel still faces a major hurdle: The country’s coronavirus czar, Nachman Ash, recently estimated that 40% to 50% of new daily coronavirus cases in Israel are being caused by B117, the more transmissible variant discovered in the UK. 

“The model in Israel that we’ve run predicted that by this time we should have seen smaller numbers” of infections, Zimlichman said. That’s likely because of the variants, he added, though he noted that researchers “can’t factor the variants into the models because we don’t know enough about them.” 

For now, it seems, coronavirus vaccines are effective against the variant found in the UK, but new research suggests that vaccines may not work as well against B1351, the variant first identified in South Africa. Both Pfizer and Moderna, however, say their vaccines protect against that strain. Israel has recorded just 30 cases of B1351 so far. 

But even in the nation with the most vaccinations per capita, there’s still a race against the clock.

“The more we suppress opportunities for the virus to transmit, the fewer opportunities it has for variants to develop,” Gurley said.

Lessons for the United States

COVID Vaccine Line
People wait in line at the Disneyland COVID-19 vaccination site in Anaheim, California.

In theory, Zimlichman said, vaccinating around 70% of a population should bring new cases to a standstill – as long as vaccines continue to vanquish new strains.

The United States recorded its first two cases of B1351 on Thursday and has already identified at least 315 cases of B117. As of Thursday, the nation had vaccinated less than 8% of its population: around 25 million people.

Gurley said the shots already given out are undoubtedly preventing some COVID-19 cases already, though.

“The actual effect we absolutely expect to be there, whether anyone is measuring it today or not,” she said. 

The US put states and individual healthcare providers in charge of getting shots into arms, a process that created delays, and many states faced demand that far exceeded supply. The Biden administration has unveiled several initiatives to address these challenges: It plans to purchase another 100 million COVID-19 vaccine doses each from Pfizer and Moderna. That would bring the total US vaccine supply to 600 million doses – enough to vaccinate most Americans.

Biden has also pledged to enlist the National Guard and Federal Emergency Management Agency to establish 100 additional vaccination sites within the next month.

“At the end of the day, I think we’re all realizing that our one way out of this pandemic is probably through mass vaccinations,” Zimlichman said. “Once you understand that this is your way out, you need to focus 100% on your vaccination program.”

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