What Israel Can Teach Us

But first, here's what happened in virus news today. The US Centers for Disease Control and Prevention is finally letting people know what they can and can't do after they've been vaccinated. According to new CDC guidelines, innoculated people can visit indoors without masks, but must still wear them in public and avoid large gatherings around unvaccinated or vulnerable people. Germany will drastically speed up its vaccination campaign to as

many as ten million weekly inoculations by late March. The country's finance ministers set on German television that in April, May and June, vaccination centers and doctors will have to handle millions of doses every week. Germany has administered a total of seven point three three million doses since inoculation started ten weeks ago, according to Bloomberg's Vaccine Tracker. Finally,

India's COVID nineteen vaccination drive has jumped nearly fourfold. After a sluggish start, The country's program, one of the world's biggest, sped up after it expanded eligibility and got a crucial public endorsed it from the inoculation of Prime Minister Norrendra Moody. Almost twenty one million shots have been administered in India so far, up from five point eight million a month ago, according to data compiled as of Monday by Bloomberg and

Johns Hopkins University and Now for today's main story. Israel has had one of the world's most successful vaccination efforts yet now a new study from the country shows the Fiser vaccine was overwhelmingly effective against the virus. Public health experts say the Israeli studies shows that immunizations could end the pandemic. Naomi Krasy reports on what makes the Israeli study so significant and why at might point to an eventual way out of the pandemic. Art These are the

sounds of a busy vaccination center in Israel. Early this month, the country's inoculation campaign started on December. By now more than half its nine million residents have had at least a first dose, largely of the Messenger RNA vaccine developed by Fiser and its German partner by On Tech. That's the highest COVID vaccination rate in the world. And as part of a deal for quick vaccine shipments that Israeli Prime Minister Benjamin Netanyah, who made with Fiser, he agreed

to share the data on the real world results. Netanyah who explained the project at a World Economic Forum meeting in January, and we offered to share that with Fiser and with all humanity to understand what the effects of mass inoculations are. The most important thing, I think the most pressing thing is the question of what real degree not only of personal protection you get from vaccines, but what is the level of preventing infections when you receive

the inoculation. That's critical question obviously, as you want to open the economy and restore life to normal. Netania Who's deal vaccines for data, did raise some questions within Israel about safeguarding patient information, but the country is uniquely positioned for this type of experiment. Four large HMOs manage its universal health care system, and about of citizens have digital health records that go back as many as twenty years.

Ben Rice, who directs the Predictive Medicine Group at the Boston Children's Hospital Computational Health Informatics Program and Harvard Medical School, told me Israel's system enables radical integration of health data into one place. Since d H and MOS in Israel provide the healthcare, provide the vaccination services, and the coronavirus testing services, all this data could be integrated into one

anonymized record to track the real effects of vaccines. Researchers needed to use this extremely detailed data on a massive scale. Rice and a team of other researchers from Harvard and Klalite, the policy arm of Israel's biggest HMO, set out to solve the problem. Fiser wasn't involved with their project. So in order to conduct such a study, you need a very specific set of circumstances that will happen. It's Noah Taken, director of Data and AI driven Medicine at Kluit and

one of the lead researchers on the study. First, you have to have information about a community based cohort of individuals for which you know all background medical information, and for the same cohort of individuals, you need to know several things. You need to know which of these are being tested for COVID nineteen, the PCR results. You'll have to know the results of those tests. You have to know who got vaccinated at at what date, and you

have to know what happened to them. And that means that you have to have an integrated data source that takes all of these different resources together, because usually hospital data is collected in one electronical medical record, and laboratory results are collected in another setting, and the community electronical medical record is the third setting, and all these together

are needed in order to do that. In Israel, the Ministry of Health created a reporting system that asks everyone to record COVID nineteen test results, hospitalizations, and degrees of severity of hospitalization. That gave Noah and the team two data sets to work with, the h m MOS decades

of health data and the government's detailed pandemic data. And when we cross these two resources together, we can actually know where each patient is and what happened to them in order to tell how well the vaccine was working. The team needed as unbiased a comparison between the vaccinated and unvaccinated as possible. They needed to match up each inoculated person with someone as similar as possible who hadn't

yet gotten a shot. So as an example, for you, to be matched in the study, you have to find

someone was very similar to you. So a seventies six year old ultra Orthodox Jewish male from specific neighborhoods from Tel Aviv who received four influenza vaccines in the last five years and has two common abilities that are known risk factors for severe corby nineteen will only be matched in the study if we can find a similar ultra Orthodox Jewish mail from the same neighborhood who's aged seventy six to seventy seven years and received three to four

influenza vaccine and has two common abilities. It was a computing challenge. Every day from December twentie to February one, the team matched each newly vaccinated person with an unvaccinated control. So I can tell you that the first iteration of code that we've written took four or five days just

to run to run it, not to write it. And we wrote that piece of code in different languages and with different algorithms again and again until if we reduced the running times from five days to one day, and from one day to four or five hours, and in the final version to ten or fifteen minutes, and that that's the current version that we're using now, and we are rerunning every few days to see what what's the

status with the information that is gradually building. Ultimately, the team was able to compare five hundred and ninety six thousand, six hundred and eighteen people vaccinated between December and February one with their unvaccinated counterparts added together almost one point two million people in all. Published on February in the New England Journal of Medicine, their results were overwhelmingly positive. Two doses of the vaccine prevented of symptomatic COVID nineteen cases.

Once the team counted people who hadn't had symptoms but tested positive for the virus anyway, they found two doses prevented of the documented infections, and importantly, it showed the vaccine was also extremely effective for people who are older or who have other diseases. Here's Ron Ballaser, director of health policy planning for Klalite, and we've been able to demonstrate that the vaccine is exceedingly effective as it was

in the clinical trial. This study that was performed in Israel at Kalite, would be able to demonstrate for decision makers and the public worldwide that mass vaccination campaigns have a huge potential in controlling the illness globally, as well as curbing the detrimental impact of disease dissemination on human lives. Ron told me that he hopes at some point the study won't be able to continue because they'll run out of unvaccinated people to use as control comparisons, But for now,

the team is continuing as their study population grows. They hope to answer questions about how specific groups of people respond to the vaccine and help CLAD and other health providers know how to handle COVID nineteen immunizations for those groups. Here's no one part of clear It's head of epidemiology and research, so we constantly gather data so we have the biggest possible result pool with which to to inform

decisions within the organization. Also for subgroups. So for example, what we do have a huge sympathize for the overall population, maybe we specifically want to know what is happening with people who are immuno compromise with people who have certain remote with conditions. So we do continue to gather these

data daily to have better and better hands. But for now, at the end of this long dark winter of seemingly unending pandemic anxiety, we were finally given something really solid to cheer about, real world evidence that the vaccine is working and perhaps even better than people thought, because it seems to prevent not just infection with COVID, but also transmission of the virus. That was Naomi Kraski. And that's

it for our show. To day for coverage of the outbreak from one and twenty bureaus across the world, visit Bloomberg dot com slash coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Tophor foreheads Magnus Henrickson and me Laura Carlson. Today's main story was reported by Naomi Kresky. Original music

by Leo Cedrin. Our editors are Rick Shine and Francesca Levi. Francesco Levi is Bloomberg's head of punk casts. Thanks for listening.