Covid vaccination programme benefits may take longer than expected to be seen in UK, Israel experts warn

ISRAEL-HEALTH-VIRUS-VACCINES
An Israeli health worker administers a dose of the Pfizer-BioNtech Covid-19 vaccine in the central Israeli city of Hod Hasharon
AFP via Getty Images
Ross Lydall @RossLydall18 February 2021

The benefits of the vaccine programme may take longer than expected to be seen in the UK, experts in Israel have warned.

They said the impact of Israel’s vaccine roll-out – the fastest in the world – was only starting to become apparent and may have been delayed by the impact of the UK or “Kent” variant of Covid.

More than 2.5m Israelis – a third of the country’s population – have received two doses of the Pfizer jab, and theatres, sports events and fitness centres will reopen on Sunday to people who have been vaccinated.

Israeli health minister Yuli Edelstein said it was a situation “we wouldn’t be even dreaming about” were it not for the vaccination programme, which has reduced the average age of its hospital patients seriously ill with Covid from 69 to 63.

Mr Edelstein told ITV’s Peston on Wednesday: “There is no doubt that there is a gradually descending scale of severe disease and infection in general in people who got two doses of the vaccine.”

Dvir Aran, an assistant professor at Technion-Israel Institute of Technology, this week published a study on the “real-world effectiveness” of the Pfizer vaccine in Israel.

He said there was “little doubt” it was “highly effective in in reducing cases, hospitalisations and deaths”, with cases down 66 to 85 per cent and severe hospitalisations down more than 90 per cent.

This was despite early frustration at an apparent lack of progress last month as the roll-out coincided with a third wave of the pandemic.

Dr Aran found that, for people aged 60 and above, there was a 28 per cent reduction in infections 13 days after the first dose – rising to 83 per cent a week after the second dose.

He told the Standard: “We now have more evidence to support the notion that the vaccine reduces transmission and not just infection.

“Two recent studies showed that 12 days after the vaccine, those that were positive to [Covid] had much lower viral load than those not vaccinated, which probably means they will be less infectious.

“Therefore, vaccinated individuals help to break chains of infection, and in turn reduce the effective reproduction rate. In lay language - as more people are vaccinated, the harder for the virus can spread.”

He cast doubt on claims that younger, unvaccinated Israelis had changed their behaviour as a result of older people being vaccinated and had sparked an increase in hospitalisations.

But he said a combination of lockdown fatigue and the Kent variant meant it took longer than predicted to see the effect of the vaccines.

Dr Aran said: “Numbers of cases went up, and stayed high for weeks, and only a couple of weeks ago we started seeing cases and hospitalisations go down.

“In my analyses I don’t see any effect of the vaccine up to day 21. It seems that it takes longer than expected, and there might be several explanations for this - maybe it’s a result of changes in behaviour, where those vaccinated increase their encounters once they think they are protected, or it might be related to the B.1.1.7 [Kent] variant, which there is some evidence that the vaccine is less effective against it in the first three weeks.

“I do see the effect of the vaccines kick-off on the fourth week, and there are two options - it takes three weeks for the vaccine protection to kick-off, or we need the second dose for it to work. If the latter is true, it might be a problem for the UK.”

Academics at the University of East Anglia, who studied the Israel results, found that people’s risk of infection doubled in the first eight days after vaccination – possibly because they became less cautious.

But they said a single dose was “highly protective”, though this can take up to 21 days to achieve.

Professor Alastair Grant, of the University of East Anglia, who has been mathematically modelling the pandemic, said the vaccination programme in Israel had created an age divide in new cases.

He told the Standard: “For a period, case numbers were decreasing in those over 60 but increasing among those who were under 60 and hadn’t been vaccinated. The people who haven’t been vaccinated will continue to be vulnerable to the virus.

“[In the UK], the biggest number of people in intensive care are people in their 50s and 60s. Until everyone down to 50 has been vaccinated, there will be pressure on the NHS.”

He added: “People’s compliance with the rules does vary. Older people have a direct personal incentive to follow the rules because they are at a significant risk of serious illness.

“For younger people, complying with the rules is more for the benefit of others, though the risks are not trivial. There is a real tension there – that we are asking younger people to restrict their social interactions for a benefit that is primarily for older people.

“At the moment it’s hard to see a strong signal of a reduction in cases or mortality due to vaccination in the UK.

“Two-thirds of over 80s were vaccinated by January 24, and there are some reports that the mortality among the over 80s is decreasing slightly faster than in the population as a whole, and that has been taken as a positive sign of vaccination.

“As yet we haven’t seen a convincing sign that vaccination is leading to a reduction in cases and mortality. It ought to – we ought to see that fairly soon – but the dominant effect in reducing case numbers is the current lockdown.”

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