The Health Ministry has asked the cabinet to approve the procurement of over 30 million COVID-19 vaccine doses at the cost of 3.5 billion shekels ($1 billion). The acquisition was slated to be approved on Monday during a cabinet meeting, which was called off.
The purchase, if approved, would be in addition to 25 million doses acquired at a cost of more than 2 billion shekels, expected to arrive later this year. All in all, Israel will purchase more than 60 million doses of COVID vaccines for 2021 and 2022.
Defense Minister Benny Gantz cancelled the cabinet meeting after Prime Minister Benjamin Netanyahu’s Likud party refused to discuss the appointment of a permanent justice minister. Attorney General Avichai Mendelblit on Friday urged Netanyahu and Gantz, who is also acting justice minister, to fill the position. Mendelblit warned that the failure to do may seriously harm the Justice Ministry's work;.
Israel has so far administered 10 million doses in its vaccination drive and requires only a little over 2 more million doses to fully vaccinate its eligible population (namely, citizens over the age of 16), making the new acquisition five times larger than the total number of doses administered thus far in Israel.
As published in TheMarker, the deals and the details behind them are surrounded by much secrecy. Dozens of officials at the Finance and Health Ministries had to sign strict non-disclosure documents. Last week, the public broadcaster Kan reported that cabinet ministers also had to sign a document prohibiting them from discussing the deal in public.
It’s unclear whether these strict restrictions are business related or whether they are meant to preclude any public discussion of what seems to be the purchase of huge amounts of vaccines which could serve an unlikely worst case scenario.
The Israeli Association of Public Health Physicians argued that there is "no justification for concealing a discussion on health issues from the public, and in particular on the issue of vaccines" and called for a "transparent, professional and public discussion about the scope of vaccine procurement required."
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Tensions between the Finance and Health Ministries over this issue has been growing in recent weeks. The Finance Ministry is substantially opposed to the Health Ministry’s demand that the state purchase a large number of doses, which have a limited shelf life, and views the request and its associated costs as too high — far above any reasonable safety margin the state should establish.
So far, 10 million Pfizer doses have been administered in Israel, in addition to several hundred thousand Moderna doses, which were given mainly to Palestinian workers in Israel.
As part of earlier deals signed with Pfizer and Moderna, Israel is already guaranteed to receive extra doses in these amounts, which should be arriving in the next few months; this leaves an excess of millions of doses, which Israel could use to vaccinate children, if and when this is required. Despite this, the state is about to spend billions of shekels on tens of millions of extra doses, which will expire within a few months after arrival.
Sources at the Health Ministry say that they are aware this acquisition far exceeds the known requirements, but believe these are necessary due to the unforeseeable nature of the epidemic or future needs.
A further dispute relates to two questions: whether Israel would be able to sell any excess doses to a third party, and whether Israel would be able to receive vaccines suited to fight future strains.
Apparently, the answer to both questions is negative. Up until now, Israel’s efforts to distribute excess doses to other countries were halted by order of its attorney general.
The Health Ministry explains that the purchase of extra doses “insure” Israel in the event that a new strain spreads. So far, however, it has been unclear whether the new deal accounts for upgraded vaccines and how.
What about the AstraZeneca vaccine?
According to various reports, millions of doses have already been purchased from AstraZeneca and are expected to start arriving in March, with shipments lasting till September. The company is now in serious trouble in Europe due to reports of safety issues and reduced effectiveness, compared to the mRNA vaccines made by Pfizer and Moderna.
Even though countries that suspended use of the AstraZeneca vaccine resumed using it, the public's willingness to get this vaccine in those countries is relatively low, something which may also happen in Israel.
However, sources at the Health Ministry say that it’s important to acquire vaccines using more familiar technology such as the one used by AstraZeneca in addition to the mRNA ones, since we don’t yet know what, if any, implications there are of three or more doses of the latter. They add that Israel is expected to face stiff competition from all other countries in the future, and that it important to close deals now before the completion of pediatric trials.