More than 4,750 Israeli lives were saved between March 15 and June 26, 2021 due to the country’s mass vaccination campaign, according to a new study.
“The most effective and definitely most cost-effective way to reduce disease and mortality is vaccination,” said Dr. Ronen Arbel, assistant professor in the Technological Marketing Department and Maximizing Health Outcomes Research Lab at Sapir College, who led the study that was recently published on MedRxiv.
In December 2020, Israel managed one of the fastest rollouts of COVID-19 vaccines of any country. However, despite its stunning campaign, the level of total vaccination was not enough to induce herd immunity, partly because different age groups and sectors of the population vaccinated more or less and at different times.
On the one hand, “this uneven uptake created a theoretical possibility of a repository for evermore lethal disease to spread,” the report said. But on the other hand, there was a theory that “easing the burden on hospitals might reduce deaths as increased numbers of hospitalized patients had been shown to have led to higher excess mortality.”
The real question became: With 90% of the population over the age of 70 vaccinated for less than seven months, would Israel achieve dramatic reductions in transmission and mortality? Or, would this statistic simply push transmissions and deaths into lower-age populations?
Using real-world observational data, Arbel and his team set out to examine the effect of mass vaccination on COVID-19 mortality, comparing projected to actual deaths from the virus during a period when the country went from being largely closed in lockdowns to being open again.
The team included Dr. Candace Makeda Moore of Arbel's lab, as well as Ruslan Sergienko and Prof. Joseph Pliskin – both of Ben-Gurion University.
What they found was that there were 370 confirmed deaths from COVID-19 recorded in the over-70 population after mass vaccination versus 5,120 estimated without vaccinations.
“Vaccines against COVID-19 saved more lives than expected by simply applying individual vaccine efficacy to the vaccinated population in Israel, despite a loosening of government stringency,” the report said.
Arbel explained that about a year ago, he and his team received a grant from the Israel National Institute for Health Policy and Health Services Research to examine the impact of the country's efforts to stop the spread of the virus.
ISRAEL LARGELY used two methods: lockdowns and vaccination.
Arbel said that the lockdowns were effective in reducing mortality but these closures came with a very high price on the economy, education and other aspects of health beyond the virus.
“Before the vaccines, the reproduction rate would only go down when we locked down,” Arbel said, referring to how many people one sick person could infect. “You would lock down and about a month later you would get a reduction in mortality, open up and then after another two months you’d go into the cycle again.”
The race was between how quickly the country could get the infection rate down by locking down and be able to maintain it before the next lockdown needed to be rolled out.
“It was a vicious cycle,” Arbel said.
Three rounds of lockdowns cost the country as much as NIS 200 billion, he said. The vaccines, however, “were a game-changer.”
“What we saw in our analysis is that the R went down and stayed down without a lockdown,” once the vaccines were rolled out.
He said that even when the country was only 30% to 50% locked down, compared to 90% – the most closed that Israel had been – the disease remained under control, and both cases and mortality declined.
Arbel said it was also likely that without the vaccines, Israel would have shut down again in April or May.
“Our research demonstrates that there are empirically additional lives saved over that expected by vaccine efficacy with a strategy of targeting the adult population, even when confounders of government stringency and case distribution in age groups are accounted for,” the report said.
“We have demonstrated that the real-world effects of a vaccination campaign are not necessarily simply the sum of expected efficacy multiplied over a population, but instead, there is some synergistic effect similar to herd immunity.”