https://www.npr.org/sections/goatsandsoda/2021/08/20/1029628471/highly-vaccinated-israel-is-seeing-a-dramatic-surge-in-new-covid-cases-heres-why

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Highly Vaccinated Israel Is Seeing A Dramatic Surge In New Cases :
Goats and Soda What happened? Here are six lessons learned from
Israel's experience -- and one looming question for the future of the
pandemic.
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Highly Vaccinated Israel Is Seeing A Dramatic Surge In New COVID
Cases. Here's Why

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August 20, 202111:01 AM ET
Heard on All Things Considered
Daniel Estrin

Daniel Estrin

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Highly Vaccinated Israel Is Seeing A Dramatic Surge In New COVID
Cases. Here's Why

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[gettyimage]
Enlarge this image

Medics in Jerusalem transfer a COVID-19 patient to Hadassah Hospital
Ein Kerem. Many hospitals in Israel are at full capacity following a
sharp increase in coronavirus infections. Menahem Kahana/AFP via
Getty Images hide caption

toggle caption
Menahem Kahana/AFP via Getty Images

Medics in Jerusalem transfer a COVID-19 patient to Hadassah Hospital
Ein Kerem. Many hospitals in Israel are at full capacity following a
sharp increase in coronavirus infections.

Menahem Kahana/AFP via Getty Images

Israel was the first country on Earth to fully vaccinate a majority
of its citizens against COVID-19. Now it has one of the world's
highest daily infection rates -- an average of nearly 7,500 confirmed
cases a day, double what it was two weeks ago. Nearly one in every
150 people in Israel today has the virus.

What happened, and what can be learned about the vaccine's impact on
a highly vaccinated country? Here are six lessons learned -- and one
looming question for the future of the pandemic.

1. Immunity from the vaccine dips over time.

Israel had fully vaccinated slightly over half its population by
March 25. Infections waned, venues reopened to the vaccinated and the
prime minister told Israelis to go out and have fun. By June, all
restrictions, including indoor masking, were abolished.

But Israel paid a price for the early rollout. Health officials, and
then Pfizer, said their data showed a dip in the vaccine's protection
around six months after receiving the second shot.

2. The delta variant broke through the vaccine's waning protection.

It was a perfect storm: The vaccine's waning protection came around
the same time the more infectious delta variant arrived in Israel
this summer. Delta accounts for nearly all infections in Israel
today.

"The most influential event was so many people who went abroad in the
summer -- vacations -- and brought the delta variant very, very quickly
to Israel," said Siegal Sadetzki, a former public health director in
Israel's Health Ministry.

3. If you get infected, being vaccinated helps.

The good news is that among Israel's serious infections on Thursday
of this week, according to Health Ministry data, the rate of serious
cases among unvaccinated people over age 60 (178.7 per 100,000) was
nine times more than the rate among fully vaccinated people of the
same age category, and the rate of serious cases among unvaccinated
people in the under-60 crowd (3.2 per 100,000) was a little more than
double the rate among vaccinated people in that age bracket.

The bad news, doctors say, is that half of Israel's seriously ill
patients who are currently hospitalized were fully vaccinated at
least five months ago. Most of them are over 60 years old and have
comorbidities. The seriously ill patients who are unvaccinated are
mostly young, healthy people whose condition deteriorated quickly.

Israel's daily average number of infections has nearly doubled in the
past two weeks and has increased around tenfold since mid-July,
approaching the numbers during Israel's peak in the winter. Deaths
increased from five in June to at least 248 so far this month. Health
officials say that currently 600 seriously ill patients are
hospitalized, and they warn they cannot handle more than 1,000
serious infections at the same time.

4. Israel's high vaccination rate isn't high enough.

The country jumped out ahead of all other countries on vaccines, and
78% of eligible Israelis over 12 years old are vaccinated.

But Israel has a young population, with many under the eligible age
for vaccination, and about 1.1 million eligible Israelis, largely
between the ages of 12 and 20, have declined to take even one dose of
the vaccine.

That means only 58% of Israel's total citizenry is fully vaccinated.
Experts say that's not nearly high enough.

"We have a very large fraction of our population who are paying the
price for a small fraction of the population who did not go to get
the vaccine," said Eran Segal of the Weizmann Institute of Science,
who advises the Israeli government on COVID-19.

Unvaccinated people helped fuel the rapid spread of the virus while
the country remained open for business in recent months with few
serious restrictions.

"That will lead to mass infection, which is exactly what we are
seeing now," said Segal.

5. Vaccinations are key, but they are not enough.

Israel is trying to slow the wave without resorting to a new
lockdown, which Prime Minister Naftali Bennett says would take an
economic toll and "destroy the future of the country." The country is
placing caps on gatherings, increasing hospital staff and pleading
for unvaccinated people to get immunized.

On Israel's doorstep, the vaccination rate is much lower in the
Israeli-occupied West Bank and the Gaza Strip. Only around 8% of
Palestinians have been fully vaccinated. Palestinians are wary of
certain brands of vaccine in ample supply, like AstraZeneca's, while
Pfizer-BioNTech's vaccine is in shorter supply for Palestinians. But
the Palestinian population is not a source of transmission in Israel.
Only vaccinated Palestinians are given permits to enter Israel and
Israeli settlements.

As for the low rate of vaccination in the West Bank and the Gaza
Strip, "we don't have a shortage of vaccine. It is the hesitancy,"
said Randa Abu Rabe, a local World Health Organization official
working in the Palestinian territories.

[gettyimage]
Enlarge this image

An Israeli health worker administers a third dose of the
Pfizer-BioNTech vaccine at a vaccination center in Jerusalem. Israel
is the first country to launch a national booster campaign for the
Pfizer vaccine. Menahem Kahana/AFP via Getty Images hide caption

toggle caption
Menahem Kahana/AFP via Getty Images

An Israeli health worker administers a third dose of the
Pfizer-BioNTech vaccine at a vaccination center in Jerusalem. Israel
is the first country to launch a national booster campaign for the
Pfizer vaccine.

Menahem Kahana/AFP via Getty Images

6. Booster shots offer more protection -- if you are one of the
world's lucky few to get them.

Israel is the first country to offer a third shot of the Pfizer
vaccine in a nationwide booster campaign. Preliminary research in
Israel suggests booster shots significantly increase protection
against the coronavirus a week after a person receives the third
dose.

COVID Booster Shots Are Coming. Here's What You Need To Know

Shots - Health News

COVID Booster Shots Are Coming. Here's What You Need To Know

Israeli national HMO Maccabi Healthcare Services, which conducted the
preliminary study of 149,144 Israelis who received three Pfizer
shots, said for Israelis above age 60, a Pfizer booster shot reduced
the chances of infection by 86% and reduced the chances of severe
infection by 92%.

The early data reflects studies by vaccine-makers Pfizer and Moderna
and provides a glimpse at boosters' effects in a real-world setting.

After reviewing data on breakthrough infections in Israel, the U.S.
announced a booster shot campaign beginning in late September for
anyone eight months after their second shot. The U.K. has promised
boosters soon, and Turkey is offering Pfizer shots to those immunized
with the Sinovac vaccine to help citizens planning to travel, since
some countries will not recognize the Chinese vaccine.

Israel has lowered the minimum age for boosters to 40. "The triple
dose is the solution to curbing the current infection outbreak," Anat
Ekka Zohar of Maccabi said in a statement.

Boosters are not being offered in the Palestinian territories yet,
and the World Health Organization has called on countries to stop
giving COVID-19 booster shots in order to help poorer countries get
vaccinated.

Why A Push For Boosters Could Make The Pandemic Even Worse

Goats and Soda

Why A Push For Boosters Could Make The Pandemic Even Worse

"Israel very much respects the World Health Organization but acts
according to local considerations and the interests of Israeli
citizens. We help the world a lot," an Israeli health official told
NPR, speaking on condition of anonymity because he was not authorized
to speak publicly about the issue. "If the U.N. didn't secure enough
vaccines for Chad, Mali, Myanmar and Guatemala, that doesn't mean
that Israel shouldn't seek to prevent a pandemic from happening
here."

Experts warn if countries do not vaccinate their populations, more
variants will develop, threatening even vaccinated nations.

Looming question: Will we need COVID-19 vaccines every several
months? We don't know.

The Cinema City movie theater complex in Jerusalem teems with young
children and parents, but steps from the box office is a makeshift
vaccination station where dozens of mostly older residents wait their
turn to get booster shots.

More than a million Israelis have received a Pfizer booster shot in
the last several weeks. They are being watched around the world, as
Israel is the first nation to give a third dose of Pfizer on a mass
scale, just as it was ahead of the curve on the first round of shots.

"They make the test of us," said Etti Ben Yaakov, sitting in a
vaccination booth with her brother as he got a booster shot. "But in
the first [round], it was the same. So I don't feel it's something
wrong. I think it's good."

She predicts the coronavirus, like the flu, will mean shots every
year. "We will have to live with the corona," she said.

Ido Hadari, of HMO Maccabi, which led the preliminary booster shot
study, questioned whether regular shots will become the norm.

"I don't know of any disease where we are vaccinated every six
months, and to be honest, I don't think the public will come to get
vaccinated every six months," Hadari said. "But you cannot predict
anything with this disease."

Correction Aug. 20, 2021

An earlier version of this story misspelled the Weizmann Institute of
Science as the Weitzmann Institute of Science.

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