Raymond Richman - Jesse Richman - Howard Richman
Richmans' Trade and Taxes Blog
Which version of the Pfizer vaccine is Israel using now?
Israel was the first country in the world to inoculate the vast majority of its citizens with the Pfizer COVID-19 vaccine and the statistics were amazing. On May 6, I mistakenly reported in American Thinker:
But in early July, the number of COVID-19 cases in Israel started to rise exponentially. There were two theories about why this occurred:
At the beginning of August, Israel started testing the second theory by massively administering a third dose of the same alpha-targeted Pfizer vaccine which had earlier failed. For the next month the number of COVID-19 cases continued to rise rapidly. By September 1, Israel had more confirmed cases of COVID than any other country in the world according to statistics calculated by the Daily Mail.
Fortunately, during the first two weeks of September, the rate that COVID-19 cases were rising in Israel started to slow. In mid-September the number of cases per day peaked according to statistics published by Worldometer.com. By early November, the number of COVID-19 cases in Israel had fallen back to a low level. Other countries have experienced seasonal waves of COVID-19 cases. This wave surged when Israelis were using air conditioning and receded when they would have stopped doing so.
We don't know why the Pfizer vaccine appeared to work in September after it had seemed to stop working in July. Perhaps the booster renewed the effectiveness of the alpha-targeted Pfizer vaccine. Perhaps the tailing off of air conditioning use was responsible. It is also possible that Israel switched in September to a version of the vaccine which targets the delta variant. On August 24, Israel's coronovirus czar Zarka had told Times of Israel that Israel would eventually switch to Pfizer's delta-targeted vaccine. Specifically:
We also know that the Pfizer's delta-targeted vaccine exists and is being tested. According to Advisory Board:
Pfizer would be reluctant to make public any news that its delta-targeted vaccine was being used in Israel. That version has not yet been approved by the slow-moving public health bureaucracies in the United States and Europe, and Pfizer would not want to get stuck with old alpha-targeted vaccines that nobody wanted. An epidemiologist interviewed by Advisory Board suggests that this would be their motivation:
Adding fuel to speculation that Israel had switched to the delta-targeted vaccine, on September 23 Pfizer Vice President Dormitzer privately told selected scientists in a Zoom call that Pfizer was using Israel as a "laboratory" to test its experimental vaccines:
Did Israel start giving the delta-targeted booster to Israelis in September? If so, we probably wouldn't know. Pfizer would not want any announcement that would diminish demand for its alpha-targeted vaccine.
Comment by Maya, 11/24/2021:
The Delta-specific vaccines aren't being tested in Israel, certainly not in a widespread way. You have to be told if you participate in a vaccine trial, and I asked in a large coronavirus discussion group for Israel and everyone confirmed that they had received the regular Pfizer vaccine. Furthermore, the last election in Israel was extremely close, so any politician who could take credit for bringing a new and more effective vaccine to Israel would be doing so from the rooftop. Israel serves as a laboratory for Pfizer in that they have only administered Pfizer vaccines and are carefully studying the results and releasing them in a very transparent way. Ironically, Israeli days will probably prevent a Delta-specific vaccine from being widely distributed, because it shows that a booster makes the original vaccine highly effective against Delta as well. The one thing that changed in September was that middle-aged Israelis received their boosters; all my friends in Israel received their second shots then.
Response to this comment by Maya, 11/24/2021, 11/24/2021:
Response to this comment by Howard Richman, 11/24/2021:
Response to this comment by Maya, 11/24/2021, 11/25/2021:
Comment by Jesse Richman, 11/24/2021:
I think Maya's comment makes some very good points. It's important to distinguish between two quite different things: the possibility of testing being done on alternative vaccine candidates (quite likely and I hope it is happening) and the possibility that most people in Israel are getting a reformulated vaccine without anyone knowing it (almost impossible).
Is Pfizer testing reformulations of its vaccine aimed at improving performance against variants? There is some evidence that it is. And I certainly hope it is -- continued progress in vaccine design can only help improve the ability of the world to combat Covid-19 and other viruses. So it is likely that such tests are under way on a limitted scale. And once such tests are completed, I believe Pfizer would have EVERY incentive to trumpet them if they demonstrated success. A substantially more effective vaccine would give Pfizer a huge competitive advantage in the global competition to sell vaccines. That advantage would outweigh by-far any costs the company might bear in the short term from the transition. Put simply, the non-anti-vax portion of 7 billion people would be beating on their door if they had a vaccine substantially better at fighting Delta.
However, it is exceedingly unlikely to the point of complete implausibility that most people in Israel are getting a reformulated vaccine. This would be completely at contradiction with the way vaccine development works.
First, one ALWAYS tests the vaccine on a smaller population before extending the tests to a larger population. Even if a very large test was being carried out in Israel right now, the number of people involved would be tiny compared to the overall population.
Second, as Maya noted, informed consent requirements would dictate that people getting the reformulated vaccine would have to be told in some way that they were part of a study. As Maya noted, this just hasn't happened on a nationwide scale.
All of this makes it exceedingly unlikely that any testing of vaccines had much to do with the decline in cases Israel experienced starting in mid September.
The tests to evaluate the Pfizer vaccine's efficacy in 2020 involved 42,000 volunteers. That's about how many people were testing positive for Covid-19 every three or four days in Israel during the peak of its most recent surge in cases. Vaccinating that many people with a third dose simply wouldn't have the scope or scale to account for the drop off in cases Israel has experienced since that peak. And furtheremore, it is extremely unlikely that testing of a new vaccine would be confined to a single country. The earlier tests were in multiple countries, and such an approach simply makes sense because virus waves come and go, and by spreading testing across multiple countries the odds of getting good data go up.
Like you I am a social scientist who is not an epidemiologist, but it looks to my uninformed eye like the decline in cases in Israel is probably due to a combination of two primary factors. (1) The seasonality of the virus. Israel had a peak in 2020 that began going down at almost exactly the same time as its peak in 2021. This suggests to me that the drop is probably partly seasonal. Perhaps when the summer weather cools and people turn off their air conditioning, cases drop. The same phenomenon can be seen in the Florida data for the last two years. (2) increased vaccination with the standard Pfizer vaccine as more people get their first doses, and more people get their booster doses.
Response to this comment by Howard Richman, 11/24/2021:
Comment by Howard Richman, 12/11/2021:
A British study regarding the sucess of boosters against the delta strain of COVID was ambiguous. In the test tube, the antibodies produced by the Pfizer vaccine booster were effective against the delta strain but much more effective against the original strain. The jury is still out on whether Israel quietly switched to a booster that was effective against delta or stayed with the original. I'm still of the opinion that they switched at the beginning of September and that is why their booster was so successful, but I may be wrong.
Response to this comment by Howard Richman, 12/11/2021, 12/17/2021:
Journal of Economic Literature:
Atlantic Economic Journal: