Israel, which until a few months ago was considered a model country because of its highly effective vaccination campaign, is now experiencing a fourth wave that is currently overwhelming its hospitals.
The whole world looked on with envy at Israel. “Within a month, 2.25 million people have been vaccinated. We can recover from the coronavirus, rebuild our economy and do things that no other country in the world can do,” boasted Prime Minister Benjamin Netanyahu on 27 December. On 31 January, 36% of the Israeli population had already received a much higher rate than any other country at that time.
What is happening in Israel is a clear warning to the rest of the world.
In the last two weeks, the country recorded 10.402 new cases per 100 000 inhabitants, the fourth highest in the world after Georgia, the Dominican Republic and Cuba – small countries with low rates of vaccination. This is a 600% increase compared to July. More worryingly, the number of deaths has also risen exponentially, with 23 deaths recorded on 22 August, compared to zero in July. these numbers were not seen since February. Restrictions were reinstated last week as a result and the government is now considering even more restrictions. “This is a very clear warning sign to the rest of the world,” warns Ran Balicer, Innovation Manager at Israel’s largest health organization, Clalit Health Services (CHS).
If it can happen in Israel, it can happen anywhere.
It has to be admitted that, after a good start, the vaccination campaign in Israel slowed down dramatically because of people refusing to get vaccinated. Vaccination coverage only reached 62.9% (people who received both doses) well below the herd immunity threshold, estimated at 80-90% of the population. But this does not explain everything. Indeed, more than half (59%) of people admitted to intensive care are fully vaccinated. In this case, as elsewhere, the Delta variant has put every assumption made about the pandemic under review. “The lesson from Israel is that vaccines work, but not that well,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology (Technion).
The effectiveness of the Pfizer vaccine has been called into question
Indeed, the protection offered by vaccines against COVID-19, appear to be disappearing rather quickly. According to a preliminary study published in MedRxiv on 31 July, people vaccinated in January are 2.26 times more likely to be infected than those vaccinated in April. Another study from the University of Oxford found that the effectiveness of the Pfizer vaccine declined faster than that of the AstraZeneca vaccine for the Delta variant, falling by 12 percentage points over three months. Another study found that the Pfizer-BioNTech Delta vaccine had an efficacy of only 42%, compared with 76% for the Moderna vaccine. All Israelis were vaccinated with the Pfizer vaccine.
Can a third dose save the day?
Israel is now considering a third dose to combat the fourth wave. The Israeli Health Ministry announced on 29 July that all persons aged 60 and over who received the vaccine more than six months ago could receive a third dose of the vaccine, which has since been extended to persons aged 40 and over. According to the Health Ministry, more than one million Israelis had already received the third dose by 20 August. The strategy now appears to be effective: preliminary results show that people who received three doses have an 86% lower risk of infection than those who received two doses, and a 92% lower risk of serious illness. But for how long?
But the Israeli data should be treated with caution. In fact, the people who were vaccinated first were both the oldest and the weakest, which may explain why their immunity is declining faster and why they are now filling emergency wards. And even if the vaccine doesn’t prevent new waves, they should be less dramatic than previous ones.