Delta frustrates ‘end of pandemic’ in Israel, but third dose rekindles hopes

TEL AVIV — Covid-19 has returned to haunt Israel. After months without masks on the streets, they are again seen on the faces of shoppers and fruit sellers at Machane Yehuda Market in Jerusalem and in other urban centers across the country. The “end of pandemic” mood ended with the arrival of the Delta variant, calling into question the world’s first successful vaccination campaign against the coronavirus. When Israel was approaching a new peak in cases, the government decided to apply a third dose of the vaccine. Preliminary data on the effects of the reinforcement rekindle the hope of a country that had already become accustomed to ballads and football matches in crowded stadiums.

Israel even registered fewer than ten cases of Covid-19 a day in June of this year. With the entry of Delta, the variant became dominant, and the numbers exploded. In July, there were already more than a thousand cases a day. According to the government, the effectiveness of Pfizer’s vaccine — the only one applied in the country — to prevent infections fell from 91% in March to 39% in July.

“When we look at the level of protection for people over 60, those who were vaccinated first, we see that there was a real drop in protection against infections, albeit less against severe cases,” says Cyrille Cohen, a professor at Bar Ilan University and a member of the committee for testing coronavirus vaccines.

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Fewer deaths

The number of serious cases also grew. On June 30, there were only 22 in total. Today there are 687 — even though these infections have begun to stabilize and even fall among the fully vaccinated, which account for 62.3% of the total population, while growing among the unvaccinated.

Delta’s impact was so strong that today the number of cases has already surpassed the level of the previous peak in January, when the first vaccination cycle was just beginning. On Sunday, there were more than 8,700, against about 8,600 at the height of the third wave.

In Israel, the daily average of cases already surpasses the peak of January Photo: Editoria de Arte / O Globo
In Israel, the daily average of cases already surpasses the peak of January Photo: Editoria de Arte / O Globo

The difference is that the current fourth wave “post-vaccine” has, so far, fewer serious cases and deaths. If today the number of seriously ill patients is close to 700, at the height of the previous peak it was 1,200, with the same number of cases. The average of daily deaths stands at 22.7. The previous peak was 64, although the peak of deaths comes after the peak of cases, and the number could still grow.

According to government data compiled by researcher Yair Lewis, a former member of the national working group to fight the coronavirus, there were 358 serious cases of Covid-19 among the unvaccinated population and 325 among those vaccinated on 25 August. Although the numbers seem similar, the researcher points out that there are more vaccinated than unvaccinated in Israel: more than 80% of the adult population is immunized.

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Lewis’ analysis of population-proportional data by age group concluded that the vaccine maintained good efficacy. For every 100,000 Israelis under the age of 60 who did not get vaccinated, there were 4.4 serious cases, while for every 100,000 vaccinated in the same range, the number was only 1.4: one-third.

In the most vulnerable age group, the difference is even greater: 263 serious cases for every 100,000 unvaccinated Israelis over 60 years of age and only 20 for the same vaccinated population. Unvaccinated elderly people are more than ten times more likely to develop a severe case than those who are immunized.

– The effectiveness of the vaccine to prevent infections and deaths is still very high, it may not be the 87% or 90% of the initial studies, but it remains around 80% to 90% – says the researcher.

The numbers are explained not only by the successful vaccination campaign, which reached more than half of the population in March, but also by the government’s decision, in July, to administer a third dose.

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Reinforcement over 12 years

More than 2 million have already taken the new dose, in a country of just over nine million inhabitants. The campaign started with the elders and progressed rapidly. Today, those who took the second dose more than five months ago and are over 12 years old can already seek the booster — that is, the entire population eligible to take the vaccine.

The race for the third dose was so fast-paced that Premier Naftali Bennett even spoke with directors of the health network to convince them to continue the vaccination during shabbat, a day of rest for the Jewish religion when most services stop working. completely across the country—not even buses run in most cities.

Bennett justified the request saying that prioritizing vaccination was respecting the “pikuach nefesh”, a religious principle that says that one person must do everything to save the life of another.

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There are two explanations for the loss of vaccine effectiveness that resulted in the fourth wave in Israel even after vaccination. The first is that it may be less effective against Delta. Another is that effectiveness may decrease more quickly with time elapsed than expected.

“Delta is more contagious and more troublesome,” says Professor Cohen. “But we have enough data to conclude that immunity declines over time. If you were vaccinated in January and February, you are 2.5 times less protected than if you were vaccinated in March or April.

The new wave brought into debate the effectiveness of the vaccine, especially the initially celebrated Pfizer. Studies showed that AstraZeneca maintained higher immunity rates longer and that Moderna could better prevent infections. Preliminary data on the effectiveness of the third dose suggest that it is not yet time to end Pfizer’s celebration, as the new dose appears to return immunity to high levels. After 16 days of administration, it is again 95% effective in preventing new infections and 97% in preventing severe cases, according to data from the Ministry of Health.

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Israel may be reaching the peak of this wave. The contamination coefficient, the so-called “R rate”, dropped and reached the lowest level in two months, suggesting a slowdown in the growth of cases. Even so, experts urge caution with predictions, since in September comes the return to school, after holidays and children away from the school crowds.

— We have to continue wearing masks, making social distance, taking care of hygiene. Unfortunately, I think we’re going to have to keep that up even if the cases fall, because winter is going to start, kids are going back to school, we’re going to have holidays and people getting together, more interactions. We will have to change the way we live,” says Professor Cohen.