Children, pregnant women and recovering coronavirus patients will be the last to be vaccinated against the virus once Israel obtains the vaccine, sources on the committee making the decision said.
Primarily, that's because these groups were not included in the clinical trials conducted so far on the coronavirus vaccine, although they are said to be part of future studies.
Israel is expected to get its first 200,000 doses of vaccine in January, assuming a vaccine is approved by the U.S. Food and Drug Administration. Vaccinations will then begin immediately.
The FDA is in the final stages of approving two vaccines, made by Pfizer and Moderna, and vaccinations are expected to start in the United States later this month. Britain has already granted Pfizer’s vaccine emergency approval and is slated to start vaccinating members of the public next week.
Even if the FDA approves the vaccines, Israeli regulators must approve them for use in Israel. During this process, the Health Ministry’s medical technology, information and research department will examine the full results of the clinical trials, which haven’t yet been published, in addition to the FDA’s decision. In general, however, medicines that are approved by the FDA are approved in Israel as well.
It’s not yet clear whether vaccinations will be handled by Israel's health maintenance organizations or designated centers where people covered by any HMO can go. The decision is likely to depend on how soon the vaccines arrive and how many doses each shipment contains.
The government has also started setting up mechanisms to monitor the vaccination process, including establishing a national coronavirus registry and a special agency jointly run by the ministry and the Israel Center for Disease Control. The agency will monitor the safety and efficacy of the vaccine and any side effects or complications. It will also conduct tests to see how long antibodies remain in people who are vaccinated and whether anyone who is vaccinated contracts the virus.
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The panel making decisions on who should be vaccinated first, a committee headed by Prof. Shmuel Rishpon, has drafted a proposal that largely aligns with the World Health Organization’s recommendations. The proposal suggests that the first to be vaccinated be people age 80 or older, medical staffers with high exposure to the virus and people with risk factors.
The Health Ministry’s Magen Avot V’imahot administration, which is responsible for managing the coronavirus crisis in nursing homes and assisted living complexes, said it expects that residents and staffers at these facilities will also be at the top of the list. “A system for vaccinating 160,000 residents and workers already exists and is ready, including all the necessary databases,” an administration official said.
However, not all the country’s elderly live in such facilities. Altogether, there are around 250,000 people aged 80 or older in Israel.
Dr. Tal Brosh, who heads the infectious disease unit at Assuta Hospital in Ashdod and is a member of Rishpon’s committee, said everything depends on how many doses of the vaccine Israel receives.
“Nobody knows exactly what will happen – how many doses will arrive and when,” he said. “If 50,000 doses arrive in January, vaccinating 50,000 elderly people is meaningless. In any case, the first doses that arrive, even if there are 200,000, aren’t going to substantially affect the pandemic in Israel.”
Another issue the panel has been considering is whether recovered coronavirus patients should be vaccinated.
“As of now, the World Health Organization’s recommendation is to vaccinate anyone who wants to be vaccinated, regardless of prior incidence of the coronavirus,” Brosh said. “But our approach at the moment says that anyone who has been ill with the coronavirus and recovered won’t be vaccinated in the first stage and should be a low priority. At this stage, it’s more important to vaccinate people who still haven’t gotten sick.”
As for whether the vaccine is even necessary for or effective in recovered patients, Brosh said, “We don’t know. There’s a knowledge gap on this issue. We don’t know if people who got sick and recovered are protected against infection, or for how long.
“At the moment, we know that documented incidents of reinfection are very rare,” he added. “But we can’t know what will happen if we wait a year or two, when these people lose their protection and become able to get infected again.”