Breakthrough cases are also a matter of concern. Earlier this month, Science magazine reported that 514 Israelis were hospitalized with COVID as of August 15, that 59 percent of these had been fully vaccinated, and that the vast majority of these fully vaccinated people were aged 60 or older.
Newsweek was unable to get confirmation from Israel’s health ministry regarding current data on how vaccinated people have fared in terms of deaths or the seriousness of their condition compared to unvaccinated people—but the severity of the cases in hospitalised patients brings the purported mildness of breakthrough cases to the fore.
Uri Shalit, a bioinformatician at the Israel Institute of Technology, told Science that “most of the hospitalised patients are actually vaccinated.”
The figures come as breakthrough cases, particularly in regards to the delta variant, are a topic of concern.
Israel’s director of public health services, Dr Sharon Alroy-Preis, said at the start of this month there was evidence of waning immunity against COVID in people who got vaccinated early on in Israel.
COVID vaccines were never promised to be 100 percent effective, but they were found to be highly effective in initial studies. The data from Israel, therefore, raises concerns about the increased threat of delta over previous variants, as well as waning immunity.
Waning immunity?
Commenting on the situation in Israel, Rowland Kao, professor of veterinary epidemiology and data science at the University of Edinburgh, U.K., told Newsweek: “The key finding here is that there is evidence of waning immunity from the vaccinated population.
“Israel with its very early vaccination campaign has been looked to as being an advance indicator of what happens in other countries, and the evidence they present that immune protection in the face of the delta variant declines with time is an important indicator of what may happen in other countries.”
He said the critical question is whether or not COVID, along with other respiratory infections such as the flu, will result in hospitalisation rates that overrun hospital capacity this winter.
In that, there is uncertainty, and data from countries with high vaccination rates such as Israel and the U.K. will likely start to provide an answer.
Vaccines aren’t a silver bullet…
In light of the data from Israel, several experts have pointed out that vaccination is not a silver bullet for ending the pandemic and that breakthrough cases—potentially even more so with delta—were always going to be a factor.
“I think the public expected vaccines to work overnight and put a full stop to the pandemic,” William P. Hanage, associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, told Newsweek.
“Ultimately, while vaccines are the key to controlling the pandemic and transitioning to a more steady ‘normal’ post-pandemic state, they will not do it immediately both because of the residual non-immune unvaccinated population, and the potential for variants.”
Alexander Edwards, associate professor in biomedical technology at the University of Reading, U.K., echoed the point.
Vaccines are not 100 percent effective, and Edwards told Newsweek that they “are not a silver bullet” and “cannot be expected to eliminate public health problems caused by infections.”
“Instead,” he said, “they remain a vital tool—in fact a solid gold tool—but other tools are still essential.”
This is where non-pharmaceutical interventions (NPIs) come into play—methods to control the virus without using medicine such as vaccines or antibody treatments—according to Dr Edward Hutchinson, senior lecturer at the Centre for Virus Research at the University of Glasgow, U.K.
People around the world are well-acquainted with NPIs by now. Regular hand washing, social distancing, and mask-wearing are all ways to control the virus alongside the COVID vaccine arsenal.
“Something I can’t stress enough is that the variants emphasise the importance of NPIs, which were always important,” he said. “If vaccination isn’t slowing down the spread of the virus enough, even if it’s stopping you getting very ill, try to reduce how much virus it has to protect you against.”
…but they aren’t failing, either
While the data from Israel may appear alarming, there are factors to take into consideration.
Last week, Reuters reported that Israeli doctors found severe COVID breakthrough cases were mostly in older, sicker patients.
Israel has also embarked on its COVID vaccine booster campaign, which is reported to have been significantly improving levels of protection.
For Hutchinson, it’s important to look back to really put current vaccine effectiveness into perspective.
“Back in mid-2020 we would have been delighted with a vaccine that offered even partial protection against severe disease, and we ended up with multiple, safe vaccines that gave almost complete protection against severe disease,” he said.
“Given how hard it has previously been to make good vaccines against new viruses, it is hard to overstate how remarkable the SARS-CoV-2 vaccines are.
“They cannot completely stop the spread of the virus—that genie is out of the bottle. But they can be used to turn SARS-CoV-2 into a virus that does not disrupt our normal lives.”
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