Israel’s decision to move forward with its third shot COVID campaign while the majority of countries around the world have not even inoculated their healthcare workers could prolong the pandemic.
According to Dr. Dorit Nitzan, European Regional Emergency Director for the World Health Organization (WHO), as rich countries buy up the world’s scarce supply of vaccine doses leaving poor- and middle-income countries without, “those that are left behind can actually drive the pandemic forward. The virus will not go away in any way, shape or form and we will not find a way to live alongside the virus.”
To date, according to WHO, 75% of vaccines have been administered by 10 countries, while low-income countries have received only 1%.
In Israel, 5.4 million Israelis are fully vaccinated and another 1.4 million have already received a third dose, while these poorer countries have “nowhere near enough [doses] to fully vaccinate their health workers, older populations and others at highest risk of severe disease and death,” said WHO Director-General Dr. Tedros Adhanom.
“The situation is horrible,” Prof. Dan Turner, deputy director-general for Research & Development and Intellectual Property Shaare Zedek Medical Center in Jerusalem, told The Jerusalem Post.
Tedros wrote in a column for Time magazine last week that giving booster doses to populations that have already received a full course of vaccination, “not only is this ethically objectionable … the scientific data to support such a major policy intervention, which will have dramatic effects on global vaccine supply, is still being gathered.”
The WHO has called for a “global moratorium on COVID-19 booster shots, at least until the end of September, to enable progress toward vaccinating at least 10% of the population of every country," Tedros said.
Israel has chosen not to listen – and the country says that it has data to back its decision.
A preliminary report published last week by Maccabi Health Services showed that the Pfizer vaccine was 86% effective in preventing infection among those ages 60 and older after a third dose. Recall, a previous study by the Health Ministry had shown that the vaccine had become only 39% effective at halting Delta variant transmission.
A separate study by Tel Aviv's Sourasky Medical Center found that Individuals under the age of 65 who are immunosuppressed developed 43% more antibodies after receiving a third shot of the Pfizer coronavirus vaccine than they did after getting the second shot. For those over the age of 65 there was a 36% increase.
Moreover, Health Ministry Director-General Nachman Ash has said that the third dose is expected to have a longer-lasting effect than the previous two – likely at least nine to 12 months.
“The data is very encouraging,” said Prof. Cyrille Cohen, head of the immunology lab at Bar-Ilan University. “We know the vaccine effectiveness decreases overtime and therefore the more [antibodies] you start with, the longer the protection might be effective.”
However, as Nitzan said, “no one is safe until everyone is safe.”
That is because while so many people worldwide remain unvaccinated there is a higher risk of new variants appearing – potentially variants even more vaccine-resistant than the Delta variant and the dozen variants of the Delta variant that have emerged.
The Delta variant was first found in India, where the vaccines were not available.
“Who knows what will be the next variant,” Nitzan said. “Being a good Samaritan is the right way to do things in general, but there is something above and beyond it: the health security of humanity as a whole.”
To help facilitate equitable access to and distribution of COVID vaccines, WHO has partnered with UNICEF, GAVI and CEPI to create the COVAX Global Vaccine Facility. WHO has also made a global recommendation that initial vaccination should prioritize groups at highest risk of exposure to infection and those most likely to develop severe disease.
While Turner said that he is not opposed to Israel distributing the third dose because “vaccines are very important for COVID, they are lifesaving,” he said that the country must do whatever is in its power to “close the gap, at least a little bit.”
First, he said, Israelis can take part in private initiatives, such as the social media campaign that is currently circulating calling on everyone who gets a vaccine for free in Israel to donate $5 or $6 - the cost of a cup of coffee – to COVAX.
Second, Israel should donate doses to COVAX.
“Because of the history of the Jewish people, we need to be altruistic, not only on the individual level, but also on a national level,” Turner said. “We need to be one of the first nations on the list of support countries through COVAX and not the last. We gave nothing to COVAX until now although we are a rich country.”
He recommended that Israel give 5% of the 36 million doses recently purchased from Pfizer to the COVAX program, ideally earmarked for the Palestinian Authority.
The vaccination rate among Palestinians living in the West Bank is at 9%. In Gaza, the situation is even worse.
“We are all in the same epidemiological net,” Nitzan explained of Israel and the Palestinians. “It makes absolutely no sense to have not included them already. We should at least do it now.”
In March, a senior Health Ministry official told the Post that Israel planned to vaccinate the entire Palestinian population aged over 16, once it has inoculated its own citizens and received surplus doses. He said that Health Ministry professionals were almost unanimous in agreement that there is both an epidemiological and humanitarian obligation to vaccinate Palestinians.
Israel tried to exchange 1 million doses of Pfizer vaccines that were about to expire in June, but they were rejected by the PA.
Since then, Israel has been asking Pfizer for early deliveries to administer the booster shots.
Nitzan confirmed that if Israel wanted to vaccinate its neighbors, it would not have to directly negotiate the distribution of those vaccines with the Palestinians, but could donate them via COVAX.
Cohen, however, said that Israel is already contributing to the world – even without buying a single dose for another country.
“Israel is a pioneer in vaccination,” he said. “We are being termed the laboratory of the world and that in itself is a huge contribution to our fight to this pandemic. Sure, we can always do more. But countries are relying on our lab results all around the world.”
Nitzan said she understands that it is the government’s job to take care of its own citizens first. She said that some have even justified Israel’s stance by comparing it to when cabin pressurization is lost when an aircraft is flying and passengers are instructed to put on their own oxygen mask first and then assist the child sitting next to them.
“Unfortunately, the virus is much more sophisticated,” she said. “The virus does not differentiate between nationality, race, gender. It knows only humanity."
Turner said that "COVID gave us two things: a huge challenge and an opportunity. The challenge is very clear.
“The opportunity is about showing global solidarity and trying to have global responsibility – to teach countries to stop just thinking about themselves and to start thinking globally," he said.