How Will Israel Decide Who Gets Which Coronavirus Vaccine?

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Vials of coronavirus disease (COVID-19) vaccine candidate BNT162b2 are sorted at a Pfizer facility in Puurs, Belgium in an undated still image from video.
Vials of coronavirus disease (COVID-19) vaccine candidate BNT162b2 are sorted at a Pfizer facility in Puurs, Belgium in an undated still image from video.Credit: Pfizer/Handout via Reuters

A team of experts tasked with recommending how to divide up the three brands of coronavirus vaccines that Israel expects to receive in the coming months is due to complete its work by next week.

Haaretz has also learned that based on agreements signed with the companies developing the vaccines – Pfizer, Moderna and AstraZeneca – the Health Ministry anticipates that most of the vaccines will reach Israel during the first half of 2021.

The panel is expected to hold its first meeting on Wednesday. Sources say its members have yet to receive an agenda for the discussion, but will have background information from the World Health Organization. In addition to the team tasked with setting priorities for dividing up the vaccines, the ministry has also set up joint teams with the health maintenance organizations to handle the logistics, budgets and information and the computerization side of the inoculation campaign.

Heading the team named by the ministry’s director general, Chezy Levy, is Prof. Shmuel Rishpon, head of Israel’s National Immunization Technical Advisory Group. Alongside him are Prof. Boaz Lev head of the ministry’s Epidemic Treatment Division. The team includes 25 top medical experts in a variety of fields including laboratory directors, infectious disease and virus specialists, epidemiologists and representatives of the public health system. Other members of the forum include representatives of the Epidemic Treatment Division, the Gertner panel on epidemics, the Israel Institute for Biological Research, the national center for disease control and senior ministry officials.

The legal and ethical issues will be covered by the ministry’s legal adviser, Talia Agmon, and the former chairman of the Israel Medical Association’s ethical board, Prof. Eran Dolev. 

The panel will look at a number of aspects of the immunization campaign. In the first stage it will need to determine the priority of at-risk groups in need of immunization once the vaccines arrive. The experts will also need to prioritize different vaccine technologies based on their effectiveness and safety, and determine which group is best served by which type of immunization.

They will also draw up recommendations regarding the conduct of the vaccination campaign on the legal and logistical sides. This includes tracking the data and side effects of the inoculations, advising on the guidelines for providing the vaccines and assessing the effectiveness that the inoculations provide. 

As for prioritizing at-risk groups, the experts will likely have to answer a series of questions to determine which Israelis would get immunized first – health workers, teachers, other workers based on their degree of contact with others, or those with chronic diseases.

The questions are complex, especially because the information they have is not complete. There are two still unknown variables: the pace at which the vaccines will arrive in Israel, and how responsive the public will be to the immunization campaign, especially in the first round.

If there will be a steady flow of vaccine doses from a number of sources from January, then prioritizing may be less of a need. Priority will still need to be determined for the HMOs organizing the logistics of their immunization operations and deciding how to call up patients to get their vaccines.

Surveys published recently by Haaretz show that a non-negligible portion of the population and the health system are hesitant about getting the vaccine. The ministry’s main difficulty may be a tepid response to the campaign, with a need to encourage people to immunize.

The companies Israel has signed contracts with have reported a high efficiency rate for the vaccines they’ve developed. In parallel, Israel has continued to develop its own vaccine at the Biological Institute in Nes Ziona, and its trials may also prove successful down the line. 

Assuming the vaccines developed by Pfizer, Moderna and AstraZeneca win U.S. Food and Drug Administration approval, these companies can be expected to provide Israel with more than 20 million doses of vaccine and the first shipment is anticipated to arrive in January at the very earliest.

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