In Israel Coronavirus disease In the ward, doctors are learning which vaccinated patients are most likely to get serious diseases, because people are increasingly worried that vaccines will have weaker protection against the most serious diseases.
Approximately half of the 600 patients in the country currently hospitalized for serious illness received two doses of Pfizer injections, which is rare among the 5.4 million fully vaccinated people.
Most of these patients received two doses of the vaccine at least five months ago, are over 60 years of age, and also have chronic diseases that are known to exacerbate coronavirus infections. According to Reuters interviews with 11 doctors, health experts and officials, they ranged from diabetes to heart and lung diseases, as well as cancer and inflammatory diseases treated with immune system suppressing drugs.
Such “breakthrough” cases have become the core of the global debate about whether countries with high vaccination rates should receive a booster dose of the COVID-19 vaccine, and to whom.
Israel began to provide booster doses to people 60 years and older in July, and the qualification has since been expanded.
The United States quoted Israeli data and other findings on Wednesday that it will provide a booster dose to all Americans starting in September.
So far, other countries, including France and Germany, have restricted their strengthening plans to the elderly and people with weakened immune systems.
Noa Eliakim-Raz, head of the Coronavirus Ward at Petach Tikva Rabin Medical Center, said: “The vaccinated patients are older and in poor health. They are often bedridden before being infected, unable to move and already need care.”
In contrast, “the unvaccinated COVID patients we see are young, healthy workers whose conditions are rapidly deteriorating,” she said. “Suddenly, they were put on oxygen or respirators.”
The Israeli Ministry of Health issued a new alert this week. A report showed that the effectiveness of the Pfizer vaccine developed by BioNTech in Germany against serious diseases appears to have dropped from more than 90% to more than 90% of people 65 years and older who received the second injection. 55% in January.
Disease experts said that the representativeness of these numbers is not yet clear, but agrees that this is worrying because there is evidence that overall vaccine protection against infections is waning.
They cannot say whether this is due to the elapsed time after vaccination, the ability of highly infectious Delta variants to evade protection, the age and underlying health of the person vaccinated, or a combination of all these factors.
Health officials in the United Kingdom and the United States, two countries with high vaccination rates and a surge in delta infection rates, also reported similar trends.
In the UK, approximately 35% of people hospitalized with Delta cases in recent weeks have received two doses of the COVID-19 vaccine. According to federal data, nearly three-quarters of breakthrough infections that lead to hospitalization or death in the United States occur in people 65 years of age or older.
U.S. officials said that their strengthening plan is based on concerns that, over time, the protective effect of vaccines against serious diseases, including young people, will diminish.
Rochelle Varensky, director of the U.S. Centers for Disease Control and Prevention, said at a press conference on Wednesday: “We are carefully watching other countries and (worry) we will also see what Israel is seeing, as Over time, the infection rate is getting worse.” .
The World Health Organization has repeatedly urged rich countries not to provide boosters, and most parts of the world have not yet received the first dose of COVID vaccine.
In some cases, the immune response may not be triggered at all
The Delta variant originally discovered in India has become the major version of the global SARS-CoV-2 virus, accelerating a pandemic that has killed more than 4.4 million people.
In Israel, since the arrival of Delta, daily new cases have increased from single digits in June to around 8,000. Approximately half of the cases—most of which are mild to moderate—occur in vaccinated people.
Those who were first vaccinated in Israel are at high risk, including those 60 years of age and older. When the Delta attacks Israel, the immune response of some people may have weakened. But for other people with underlying health problems, the vaccine may not work at all.
Dror Mevorach, head of the Coronavirus Ward of Hadassah Hospital, said: “For some of them, the vaccine did not trigger an immune response. They did not have antibodies because of the disease itself or because they received medications that suppress the immune system.” In Jerusalem. He cited examples of chronic lymphocytic leukemia and lymphoma.
Of the 3 million vaccinated Israelis covered by Clalit, the country’s largest healthcare provider, 600 have suffered severe breakthrough cases since June. According to Ran Balcer, Clalit’s chief innovation officer, approximately 75% of them are over 70 years old and have been at least 5 months after the second injection. Almost everyone suffers from chronic diseases.
“We hardly see young vaccinated people in serious conditions,” Ballise said.
In the UK, doctors described similar characteristics among seriously ill patients who were vaccinated.
“Among those who come in because of age and comorbidities, they may be those who you think the vaccine is not as effective as other age groups,” said Tom Winfield, MD. Liverpool School of Tropical Medicine.
Delta Air Lines has contributed to a new surge in the number of coronavirus cases and deaths in the United States, especially in states where vaccination rates are still low. Among infected vaccinated patients, there is evidence that older people are hit harder.
According to a spokesperson for the Department of Public Health, in Texas, 92% of fatal vaccine breakthrough cases occurred in people over 60, and 75% of people had a known underlying disease that exposed them to COVID -19 high risk.
Preliminary data from Israel indicate that the booster injections in the past few weeks have reduced the risk of infection in the elderly compared to the elderly who received only two injections.
Israeli doctors say that even without a booster, vaccinated patients tend to recover faster.
“The vaccinated patients I have treated usually leave the ICU in about three days. It takes a week or two for unvaccinated patients to stabilize,” said Yael Haviv-Yadid, director of the intensive care unit at Sheba Medical Center near Tel Aviv.
Alex Rozov, director of the Coronavirus Ward at Barzilai Medical Center in Ashkelon, said that even if the vaccine did not prevent them from getting sick, it might have reduced their condition.
“Our impression of caution is that vaccinated patients are more likely to be ill-treatment is more effective for those who have antibodies.”
(Additional reporting by Alistair Smout and Josephine Mason in London, Carl O’Donnell in New York; editing by Michele Gershberg and Dan Grebler)
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