WITH the “first hard evidence” that Scotland’s Covid vaccinations are beginning to translate into a reduction deaths, the positive data emerging from Israel is increasingly seen as a forecast what lies ahead.
The latest data from National Records of Scotland shows that mortality from the disease is now falling fastest among elderly care home residents and the over-85s, who were prioritised for the inoculation.
Covid deaths falling fastest among care home residents and over-85s
First Minister Nicola Sturgeon said yesterday that the country is seeing the “first hard evidence of the positive impact of vaccination”, adding: “I think it is reasonable to take some heart from this because it strongly suggests that the vaccine programme is having the hoped for effect of reducing the death toll from the virus.”
Deaths are falling much more sharply in the over 85 age group – which includes those in care homes and the community – than in any other age group (Source: NRS)
The death toll among older care home residents has fallen by 62 per cent over the past three weeks, from 111 in the week beginning January 18 to 42 last week, compared to 28.5% for the population as a whole.
Nearly all eligible care home residents have received a first dose of the Pfizer/BioNTech vaccine since the rollout began in Scotland on December 14, but protective immunity – in the form of antibodies and T cells – take around 15 to 21 days to develop.
Covid deaths are also falling faster among the over-85s – who have accounted for 40% of Covid deaths in Scotland during the pandemic – than in younger age groups.
Over the past three weeks, Covid deaths for the over-85s are down 45% from 191 to 105, while in the 74-84 age group they are down by just 7.5%.
The NRS data for over-85s includes both care home residents in the age group and those living in the community, who are more likely to have received the AstraZeneca/Oxford vaccine since January 4.
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Uptake has exceeded expectations, reaching more than 98% of over-80s in the community, and second Pfizer doses for care home residents are getting underway.
It comes amid excitement over results emerging from Israel, which has had the world’s fastest vaccination programme.
Around three quarters the population has had at least one dose of the Pfizer vaccine, with one in three – and the vast majority of all over-60s – being fully vaccinated with both Pfizer doses.
Professor Eyal Leshem, who studied tropical medicine and hygiene at Glasgow University and is now the director of geographic medicine at Sheba Medical Centre in Tel Aviv, said Israel began seeing a drop in both infections and severe disease once around 80-85% of the older population were vaccinated.
So far 76% of Israel’s population have had at least one dose of Covid vaccine, compared to just under 25% in the UK
He said: “What we’ve seen is a reduction in infections among the vaccinated, compared to the unvaccinated, both in the proportion infected and the number infected.
“The second effect is that when we look at the several hundred people who are infected despite being fully vaccinated, even though many of them belong to a risk group – older age – only a few of them develop severe disease and get hospitalised.
“The majority of those who were infected despite being fully vaccinated remained well and stayed in the community. They didn’t have to be hospitalised.”
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The evidence that the vaccine is reducing infections as well as symptomatic disease is particularly important as this suggests that vaccines are also curbing transmission, meaning that herd immunity can be reached more quickly.
Israel’s largest health fund Clalit reported this week that there were 94% fewer Covid infections among vaccinated than non-vaccinated people matched by age and health status, and that the vaccine prevented almost all cases of serious illness including in the over-70s.
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While Scotland is vaccinating at 12 week intervals, instead of three, an analysis of Israeli data by the University of East Anglia also found that a single dose was “highly protective” from 21 days.
Israel is incentivising uptake in younger, more vaccine-hesitant age groups with ‘green passports’ that will allow fully vaccinated individuals to access gyms and mass gatherings as lockdown is eased. In some cases, they have been offered free meals or tickets to shows.
Bars and restaurants remain closed, but Israelis can meet indoors in groups of up to 10.
“In jurisdictions with low infection rates and high vaccination rates, education is partly or fully open,” said Prof Leshem, who is also an associate professor of infectious diseases at Tel Aviv University and briefed a cross-party group of MSPs on Tuesday night about the real-world evidence of the Pfizer vaccine’s safety and efficacy in the Israeli population.
“Previously we were restricted to staying within one kilometre of home, now we can move about freely.
“You are asked to exercise caution within your immediate family and not to gather more than 10 persons in closed spaces and 20 in the open.
“That’s going to slightly ease in the next few weeks with larger numbers allowed.”
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Prof Leshem, who has co-authored a paper set for publication in the Lancet journal tomorrow setting out the evidence from Israel’s vaccination experience, says he believes the UK has “a good chance of seeing substantial improvement” in deaths and infection rates before summer, if vaccination continues at its current pace.
He added: “I absolutely think that such high coverage, even if it is on a first dose in the at-risk population, will provide some protection and will allow the Government to ease some restriction.
“It’s a constant risk-benefit balancing act and when your risk to the older and frail population is reduced then the cost of remaining in lockdown doesn’t outweigh that risk.”