Little Time, Limited Information for Israel's Committee on COVID Vaccine Distribution

Coronavirus vaccine could arrive in Israel as early as January, but the panel that has to decide who gets it first will face plenty of difficulties and dilemmas until then

Ido Efrati
Ido Efrati
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A lab technician sorts blood samples inside a lab for a Covid-19 vaccine study at the Research Centers of America (RCA) in Hollywood, Florida, August 13, 2020
A lab technician sorts blood samples inside a lab for a Covid-19 vaccine study at the Research Centers of America (RCA) in Hollywood, Florida, August 13, 2020Credit: Chandan Khanna/AFP
Ido Efrati
Ido Efrati

The countdown to the arrival of the first coronavirus vaccines in Israel has already begun, and the Health Ministry is starting to prepare for the challenge. With only limited information at this point, the working group that’s been set up – made up of people from the pandemic response team and Health Ministry staffers – will face plenty of difficulties and dilemmas.

The process of deciding who will get vaccinated first is particularly complex given the knowledge gaps that exist at this stage. Since the vaccines are still in the advanced testing stages and the findings aren’t final yet, the protocols and research material are not yet available – and of course, the vaccines still don’t have final approval. The the supply schedule is also unknown; the vaccines are expected to start arriving in Israel gradually starting in January, but it isn’t clear how many doses are expected or when.

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According to a professional familiar with the details, the first and perhaps most significant challenge of the working group will be managing the cost-benefit risks of using the new vaccines. This isn’t a simple dilemma; how does one give priority to populations that most need the vaccine while at the same time protecting those same people, who are usually in the most delicate states of health, from unknown side effects or impacts?

“There is a lack of information about the safety of the vaccine for various at-risk groups, like the elderly, those with suppressed immune systems or pregnant women,” said a source close to the team. “Some of them are not represented in the trials to date, or there is no information about them in the findings revealed so far. It also isn’t clear how the vaccine affects children.”

Both Pfizer and Moderna are reporting especially high success rates of around 95 percent for the vaccine with no significant side effects, but there is no information about the age groups and the extent to which people from various risk groups participated. While this information will presumably be revealed later, Israeli professionals must start making tough decisions now. The question also remains whether to start vaccinating immediately upon receiving the vaccines, or wait until more information its effects becomes available from elsewhere in the world.

“It’s crucial that the team gets complete information quickly about what’s observed in countries that will start vaccinating their populations before Israel,” a Health Ministry source said. “From that perspective, it might before preferable for Israel to wait with its vaccine campaign until the second quarter of 2021.”

Administering a new vaccine, certainly under the current circumstances, requires extreme attention to any impact or side effect that is discovered along the way. The team is therefore expected to discuss setting up a system for reporting and monitoring side effects. The assumption is that this system will first focus on health care workers, who will probably be among the first to receive the vaccine, and will expand over time. The introduction of the vaccine in Israel will also require worldwide monitoring and data gathering so as to accumulate information on the various effects of the different coronavirus vaccines, which over time will presumably include vaccines from other companies as well.

Another issue the team has to address will be how to present the information about the vaccine to the general public, including the fact that much about it is uncertain, and about the vaccine’s side effects when and if there is information about them. “This is crucial to creating public confidence and it must be conveyed solely by reliable professionals,” a senior health system source said, adding, “There must be preparation in advance to deal with anti-vaxxers, particularly on social media.”

Not much time remains for the team to make decisions. The optimistic scenario has the first shipment of vaccines arriving in Israel in around two months. With so little really known about the vaccine and a nervous public, any error, side effect or tragic outcome associated with the vaccine will have a critical impact. This is an entirely new and challenging chapter in dealing with the pandemic.

On Wednesday, Prime Minister Benjamin Netanyahu said he “believes we’re on the verge of signing” an agreement with Moderna to increase the number of COVID-19 vaccine doses Israel would acquire from the company. Israel’s existing contract with Moderna is for 2 million doses of the two-step vaccine, enough to vaccinate 1 million people, while the country’s population is roughly 9 million people.

“This is great news,” Netanyahu said in a video statement, adding that he spoke with top Moderna officials over the past few days.

On Monday, Moderna said its potential vaccine appears to be 94.5 percent effective, according to preliminary data from an ongoing study. This puts the company, alongside competitor Pfizer on track to seek permission within weeks for emergency use in the U.S.

Noa Landau contributed to this report.

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