Israel’s COVID vaccine: Yes, we can!

Design a first-class fourth-generation multi-role jet fighter? We can, and did – the Lavi, in the 1980s. (The US nixed it).

Send a spacecraft to the moon? Launched on February 22, 2019, Beresheet was within a few yards of landing successfully on the Moon’s surface.

Create all-weather missile interceptors to shoot down short-range and long-range rockets, with 95% success? We did – Iron Dome and Arrow. The US Army now deploys two Iron Dome batteries. The US buys more arms from Israel than from any other country.

Develop an effective, even superior, COVID-19 vaccine? In no time? Piece of cake, And this, for a little country no more populous than the modest Chinese city of Wuhan.

Here is the story of Israel’s coronavirus vaccine. Warning: It may not have a happy end. I relied in part on excellent reporting by The Jerusalem Post’s Maayan Hoffman and The Times of Israel’s Ricky Ben-David.

What happened on Saturday night, February 1, 2020 – just three weeks after the novel coronavirus was identified by Chinese authorities and 20 days before the first case in Israel was confirmed, when a woman tested positive after returning from quarantine on the Diamond Princess ship in Japan?

Within a few months, a vaccine was being tested; IIBR announced in August 2020 that it was ready for a Phase I clinical trial. Netanyahu asked IIBR to start setting up a production plant.

In December 2020, IIBR researchers published their breakthrough idea in the leading scientific journal Nature Communications: “We show that a single-dose vaccination results in a rapid and potent induction of SARS-CoV-2 neutralizing antibodies. Taken together, we suggest the recombinant VSV-∆G-spike as a safe, efficacious and protective vaccine against SARS-CoV-2.”

More about what that medical jargon means, below.

WHAT IS the real story of IIBR in Ness Ziona? What role does IIBR play and why is it shrouded in so much secrecy?

The Israel Institute of Biological Research, Ness Ziona, was founded in 1952 as a government research institute. Mostly, its mission is to do R&D to protect Israel from chemical and biological threats – and that work is top secret.

The IIBR website states: IIBR leads national efforts to counter any and all biological threats from intentional attacks as well as naturally emerging diseases.

In 1991, a subsidiary, Life Sciences Israel Research, was established alongside IIBR, to research, develop, produce and market civilian products.

The “Bri” is the first part of the Hebrew word for health, briyut; the “iL” stands for Israel and Life, for life.

More than a year ago, the Post listed three scientists as the “most influential Jews” for 2020: Tal Zaks, an Israeli who led development of the Moderna vaccine; Alexander Leonidovich Gintsburg, who led development of Russia’s Sputnik V vaccine and Shmuel Shapira, who led development of BriLife, Israel’s vaccine.

The first two vaccines have been widely produced and injected. BriLife has suffered bureaucratic delays. What is going on? What lies beneath the medical jargon, and why is the Israeli BriLife vaccine is so ingenious? How does the Israeli vaccine work, compared to the mRNA vaccine of Pfizer – and what are its main advantages?

STANDARD VACCINES work by injecting small pieces of the weakened germ we want to prevent, like flu or measles. The body’s immune system gears up against it – and is ready to defend when the real germ attacks.

The mRNA vaccine is different; it tells our body to make the “puncture protein” that COVID-19 uses to invade our cells and reproduce inside them. And then, when COVID-19 invades, and tries to “spike” our cells to invade them and reproduce, our immune system recognizes it and kills it by making antibodies.

BriLife is different. And, as a non-expert, I believe it is brilliantly creative.

IIBR took a harmless virus, known as VSV, and genetically engineered it to produce the COVID-19 spike “puncture” protein on its outer surface. Through genetic engineering, proteins are attached to the VSV virus to form coronavirus “crowns” that are identified by the body as COVID-19. The body quickly produces antibodies against it.

When injected in humans, the Israeli vaccine does not cause illness. It can’t, because it is not COVID itself. But it does spur the body’s immune system to attack and kill COVID-19 if and when it invades. It is like providing photos of dangerous terrorists to border police, so they can recognize, intercept and imprison them when they show up.

What are the main advantages of the Israeli vaccine over the Pfizer version?

Senior Hadassah Medical Center physician Prof. Yossi Caraco notes that the incidence of side effects is much lower [for BriLife] and they are less severe than with Pfizer and Moderna. Moreover, he claims, the level of neutralizing antibodies the shots produce is promising and even encouraging.

According to the Times of Israel, while the Pfizer vaccine has waning effectiveness after six months – which caused Israel to launch a booster campaign – the IIBR data show that BriLife, given at a high dose, provides longer-term protection.

A study by Sheba Medical Center researchers, published in a top medical journal, shows that antibody levels in 4,800 subjects decreased rapidly after two doses of the Pfizer vaccine. In contrast, some 200 Israeli volunteers who received the highest dosage of the BriLife vaccine were told they did not need a third dose of the vaccine, as their protection remained high six months after getting a second dose.

Why did Israeli government officials purposely stall progress on the IIBR vaccine?

I don’t know. But I can guess. Netanyahu cozied up to Pfizer CEO Albert Bourla, calling him at 3 a.m. to get priority for buying millions of doses of Pfizer’s vaccine, at a time when many nations were all vying to do the same. The precise cost and many details of the deal are still secret.

Had Israel announced plans to produce its own BriLife vaccine, Bourla may have been far less amenable. Why help a competitor?

Shapira resigned as IIBR head in May. He has published a book in Hebrew, The Pandemic Circus; the title says it all about how he perceives the way the government managed the COVID-19 crisis and BriLife in particular. Reminder: Brilife was ready for clinical trials in August 2020, more than a year ago.

Who got the worldwide rights to develop, manufacture and market BriLife, and why?

In July, according to Hoffman, the Defense Ministry gave a US-Israeli company NRx Pharmaceuticals exclusive worldwide development, manufacturing and marketing rights for BriLife, after more than three months of negotiations and a year of bureaucratic delays. BriLife is now undergoing final Phase III clinical trials in Georgia and Ukraine.

NRx has a distinguished American CEO, Prof. Jonathan Javitt, and board members include former Mossad chief Tamir Pardo and former President of Teva International Chaim Hurvitz. But in my view, producing and distributing BriLife worldwide are shoes way too big for the NRx start-up, founded in 2014, which merged in May with a special purpose acquiring company, and is still mainly in “clinical stage” (i.e. without revenues).

Should Israel build a vaccine plant?

We’ve done it before. IIBR developed and manufactured smallpox vaccine to vaccinate 15,000 health workers, police officers and soldiers, during July through September 2002, after the 9/11 terrorist attack raised fears of germ warfare. It used a different vaccine strain than that used in the US, with fewer side effects.

Personally, I enjoy living in a country that acts as if it were Annie Oakley. But in reality, no, we cannot do everything better than anyone. We must place our bets with care. BriLife is a really good bet.

Given the fact that COVID-19 may become globally endemic, or at least, persistent, for years, and given the fact that other vaccines seem less effective when new variants pop up – perhaps national security does suggest Israel should manufacture its own BriLife vaccine. That may be a good place to invest our money. It could become a profitable export -- and like so many other Israeli innovations, it could create huge value for the world as well.

Were we too hasty in assigning all rights to BriLife to NRx? In general, why does Israel continue to sell its brains rather than use them to produce ingenious ideas at home and sell them abroad?

We have the ideal place for such a plant – Yeroham, the Negev development town, population 10,000. Yeroham Mayor Tal Ohana says there is a detailed plan for launching a vaccine factory in her town. She said she hopes IIBR can begin manufacturing BriLife, after FDA approval. But Shapira is skeptical.

The proposed 2022 Defense budget totals a whopping NIS 58 billion ($17.8b.). A single F-35 jet fighter plane costs $110 million, and Israel has decided to buy 14 more of them. Shapira told Hoffman that the government invested only NIS 176 million ($55m.) in BriLife, a tiny fraction of what Pfizer, Moderna and Astra-Zeneca invested in their vaccines.

Israel could build a BriLife vaccine factory for less than the defense budget’s rounding error, or the cost of one F-35. It would protect us strategically far more than that lone F-35.

The Israeli vaccine may well be a victim of sad grammar. For Brilife, “yes, we can” has morphed into “well, yes, maybe we could have, but…”

And that is a travesty.

Postscript: On August 30, the World Health Organization announced it was tracking a “[COVID-19] variant of interest, known as Mu, which carries “key mutations…linked with increased transmissibility and reduced immune protection.” Mu represents 39% of the total cases in Colombia, and 13% in Ecuador – places where its prevalence “has consistently increased.”