With Israel so far ahead of the West in vaccinating its population, it can be seen as a very large
phase 4 trial for the Pfizer/BioNtech vaccine. And even just a fortnight into this trial, the
initial results are very promising, adding to positive signals out of the US. Data from the
Israeli Health Ministry suggests that the first shot of the vaccine has been about 50% effective in
curbing infections after fourteen days. This is backed out by asking people testing positive for the
virus whether and when they received a shot. The data provided by other health officials are
somewhat discrepant, with some sources stating 33% protection after fourteen days, others as much as
60%. So the data is noisy, but 50% efficacy seems robust enough. If this 50% number sounds
disappointing against the 95% efficacy from clinical trials, it is far from disappointing if put
into the right context. For one, the trial data suggested that the first shot of the vaccine would
provide 'only' 52% protection on average until the second shot after 21 days. At face value,
therefore, the Israeli data so far seem in line with trial results. But they may be even better. Importantly, the trial data showed not only a 52% average efficacy between the two doses; they
also showed that protection against infection rose non-linearly over this period and only really
kicked in after about 10-12 days. In the initial 10 days or so, participants on the vaccine were
almost as likely to be infected as those on the placebo. It is was only after day 15 that protection
rose to as much as 89%. Hence, if the vaccine provides Israelis with 50% efficacy in the first 14
days of being vaccinated, this would be marginally better than expected. For most Israelis that have been vaccinated, peak protection is yet to kick in over the next week or two. That's why we
see these initial data out of Israel as very positive.
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