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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day three hundred

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Speaker 1: and sixty two since coronavirus was declared a global pandemic.

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Speaker 1: Today's main story Israel has been a model for how

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Speaker 1: to quickly vaccinate millions of people. Now the country has

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Speaker 1: come out with one of the best studies yet on

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Speaker 1: the effectiveness of the vaccine, and the news is very good.

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Speaker 1: But first, here's what happened in virus news today. The

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Speaker 1: US Centers for Disease Control and Prevention is finally letting

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Speaker 1: people know what they can and can't do after they've

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Speaker 1: been vaccinated. According to new CDC guidelines, innoculated people can

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Speaker 1: visit indoors without masks, but must still wear them in

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Speaker 1: public and avoid large gatherings around unvaccinated or vulnerable people.

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Speaker 1: Germany will drastically speed up its vaccination campaign to as

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Speaker 1: many as ten million weekly inoculations by late March. The

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Speaker 1: country's finance ministers set on German television that in April,

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Speaker 1: May and June, vaccination centers and doctors will have to

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Speaker 1: handle millions of doses every week. Germany has administered a

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Speaker 1: total of seven point three three million doses since inoculation

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Speaker 1: started ten weeks ago, according to Bloomberg's Vaccine Tracker. Finally,

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Speaker 1: India's COVID nineteen vaccination drive has jumped nearly fourfold. After

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Speaker 1: a sluggish start, The country's program, one of the world's biggest,

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Speaker 1: sped up after it expanded eligibility and got a crucial

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Speaker 1: public endorsed it from the inoculation of Prime Minister Norrendra Moody.

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Speaker 1: Almost twenty one million shots have been administered in India

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Speaker 1: so far, up from five point eight million a month ago,

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Speaker 1: according to data compiled as of Monday by Bloomberg and

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Speaker 1: Johns Hopkins University and Now for today's main story. Israel

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Speaker 1: has had one of the world's most successful vaccination efforts

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Speaker 1: yet now a new study from the country shows the

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Speaker 1: Fiser vaccine was overwhelmingly effective against the virus. Public health

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Speaker 1: experts say the Israeli studies shows that immunizations could end

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Speaker 1: the pandemic. Naomi Krasy reports on what makes the Israeli

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Speaker 1: study so significant and why at might point to an

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Speaker 1: eventual way out of the pandemic. Art These are the

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Speaker 1: sounds of a busy vaccination center in Israel. Early this month,

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Speaker 1: the country's inoculation campaign started on December. By now more

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Speaker 1: than half its nine million residents have had at least

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Speaker 1: a first dose, largely of the Messenger RNA vaccine developed

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Speaker 1: by Fiser and its German partner by On Tech. That's

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Speaker 1: the highest COVID vaccination rate in the world. And as

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Speaker 1: part of a deal for quick vaccine shipments that Israeli

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Speaker 1: Prime Minister Benjamin Netanyah, who made with Fiser, he agreed

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Speaker 1: to share the data on the real world results. Netanyah

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Speaker 1: who explained the project at a World Economic Forum meeting

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Speaker 1: in January, and we offered to share that with Fiser

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Speaker 1: and with all humanity to understand what the effects of

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Speaker 1: mass inoculations are. The most important thing, I think the

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Speaker 1: most pressing thing is the question of what real degree

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Speaker 1: not only of personal protection you get from vaccines, but

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Speaker 1: what is the level of preventing infections when you receive

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Speaker 1: the inoculation. That's critical question obviously, as you want to

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Speaker 1: open the economy and restore life to normal. Netania Who's

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Speaker 1: deal vaccines for data, did raise some questions within Israel

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Speaker 1: about safeguarding patient information, but the country is uniquely positioned

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Speaker 1: for this type of experiment. Four large HMOs manage its

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Speaker 1: universal health care system, and about of citizens have digital

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Speaker 1: health records that go back as many as twenty years.

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Speaker 1: Ben Rice, who directs the Predictive Medicine Group at the

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Speaker 1: Boston Children's Hospital Computational Health Informatics Program and Harvard Medical School,

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Speaker 1: told me Israel's system enables radical integration of health data

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Speaker 1: into one place. Since d H and MOS in Israel

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Speaker 1: provide the healthcare, provide the vaccination services, and the coronavirus

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Speaker 1: testing services, all this data could be integrated into one

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Speaker 1: anonymized record to track the real effects of vaccines. Researchers

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Speaker 1: needed to use this extremely detailed data on a massive scale.

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Speaker 1: Rice and a team of other researchers from Harvard and Klalite,

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Speaker 1: the policy arm of Israel's biggest HMO, set out to

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Speaker 1: solve the problem. Fiser wasn't involved with their project. So

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Speaker 1: in order to conduct such a study, you need a

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Speaker 1: very specific set of circumstances that will happen. It's Noah Taken,

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Speaker 1: director of Data and AI driven Medicine at Kluit and

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Speaker 1: one of the lead researchers on the study. First, you

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Speaker 1: have to have information about a community based cohort of

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Speaker 1: individuals for which you know all background medical information, and

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Speaker 1: for the same cohort of individuals, you need to know

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Speaker 1: several things. You need to know which of these are

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Speaker 1: being tested for COVID nineteen, the PCR results. You'll have

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Speaker 1: to know the results of those tests. You have to

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Speaker 1: know who got vaccinated at at what date, and you

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Speaker 1: have to know what happened to them. And that means

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Speaker 1: that you have to have an integrated data source that

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Speaker 1: takes all of these different resources together, because usually hospital

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Speaker 1: data is collected in one electronical medical record, and laboratory

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Speaker 1: results are collected in another setting, and the community electronical

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Speaker 1: medical record is the third setting, and all these together

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Speaker 1: are needed in order to do that. In Israel, the

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Speaker 1: Ministry of Health created a reporting system that asks everyone

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Speaker 1: to record COVID nineteen test results, hospitalizations, and degrees of

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Speaker 1: severity of hospitalization. That gave Noah and the team two

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Speaker 1: data sets to work with, the h m MOS decades

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Speaker 1: of health data and the government's detailed pandemic data. And

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Speaker 1: when we cross these two resources together, we can actually

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Speaker 1: know where each patient is and what happened to them

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Speaker 1: in order to tell how well the vaccine was working.

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Speaker 1: The team needed as unbiased a comparison between the vaccinated

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Speaker 1: and unvaccinated as possible. They needed to match up each

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Speaker 1: inoculated person with someone as similar as possible who hadn't

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Speaker 1: yet gotten a shot. So as an example, for you,

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Speaker 1: to be matched in the study, you have to find

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Speaker 1: someone was very similar to you. So a seventies six

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Speaker 1: year old ultra Orthodox Jewish male from specific neighborhoods from

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Speaker 1: Tel Aviv who received four influenza vaccines in the last

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Speaker 1: five years and has two common abilities that are known

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Speaker 1: risk factors for severe corby nineteen will only be matched

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Speaker 1: in the study if we can find a similar ultra

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Speaker 1: Orthodox Jewish mail from the same neighborhood who's aged seventy

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Speaker 1: six to seventy seven years and received three to four

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Speaker 1: influenza vaccine and has two common abilities. It was a

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Speaker 1: computing challenge. Every day from December twentie to February one,

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Speaker 1: the team matched each newly vaccinated person with an unvaccinated control.

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Speaker 1: So I can tell you that the first iteration of

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Speaker 1: code that we've written took four or five days just

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Speaker 1: to run to run it, not to write it. And

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Speaker 1: we wrote that piece of code in different languages and

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Speaker 1: with different algorithms again and again until if we reduced

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Speaker 1: the running times from five days to one day, and

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Speaker 1: from one day to four or five hours, and in

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Speaker 1: the final version to ten or fifteen minutes, and that

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Speaker 1: that's the current version that we're using now, and we

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Speaker 1: are rerunning every few days to see what what's the

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Speaker 1: status with the information that is gradually building. Ultimately, the

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Speaker 1: team was able to compare five hundred and ninety six thousand,

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Speaker 1: six hundred and eighteen people vaccinated between December and February

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Speaker 1: one with their unvaccinated counterparts added together almost one point

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Speaker 1: two million people in all. Published on February in the

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Speaker 1: New England Journal of Medicine, their results were overwhelmingly positive.

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Speaker 1: Two doses of the vaccine prevented of symptomatic COVID nineteen cases.

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Speaker 1: Once the team counted people who hadn't had symptoms but

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Speaker 1: tested positive for the virus anyway, they found two doses

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Speaker 1: prevented of the documented infections, and importantly, it showed the

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Speaker 1: vaccine was also extremely effective for people who are older

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Speaker 1: or who have other diseases. Here's Ron Ballaser, director of

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Speaker 1: health policy planning for Klalite, and we've been able to

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Speaker 1: demonstrate that the vaccine is exceedingly effective as it was

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Speaker 1: in the clinical trial. This study that was performed in

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Speaker 1: Israel at Kalite, would be able to demonstrate for decision

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Speaker 1: makers and the public worldwide that mass vaccination campaigns have

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Speaker 1: a huge potential in controlling the illness globally, as well

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Speaker 1: as curbing the detrimental impact of disease dissemination on human lives.

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Speaker 1: Ron told me that he hopes at some point the

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Speaker 1: study won't be able to continue because they'll run out

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Speaker 1: of unvaccinated people to use as control comparisons, But for now,

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Speaker 1: the team is continuing as their study population grows. They

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Speaker 1: hope to answer questions about how specific groups of people

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Speaker 1: respond to the vaccine and help CLAD and other health

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Speaker 1: providers know how to handle COVID nineteen immunizations for those groups.

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Speaker 1: Here's no one part of clear It's head of epidemiology

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Speaker 1: and research, so we constantly gather data so we have

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Speaker 1: the biggest possible result pool with which to to inform

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Speaker 1: decisions within the organization. Also for subgroups. So for example,

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Speaker 1: what we do have a huge sympathize for the overall population,

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Speaker 1: maybe we specifically want to know what is happening with

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Speaker 1: people who are immuno compromise with people who have certain

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Speaker 1: remote with conditions. So we do continue to gather these

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Speaker 1: data daily to have better and better hands. But for now,

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Speaker 1: at the end of this long dark winter of seemingly

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Speaker 1: unending pandemic anxiety, we were finally given something really solid

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Speaker 1: to cheer about, real world evidence that the vaccine is

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Speaker 1: working and perhaps even better than people thought, because it

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Speaker 1: seems to prevent not just infection with COVID, but also

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Speaker 1: transmission of the virus. That was Naomi Kraski. And that's

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Speaker 1: it for our show. To day for coverage of the

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Speaker 1: outbreak from one and twenty bureaus across the world, visit

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Speaker 1: Bloomberg dot com slash coronavirus and if you like the show,

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Speaker 1: please leave us a review and a rating on Apple

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Speaker 1: Podcasts or Spotify. It's the best way to help more

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Speaker 1: listeners find our global reporting. The Prognosis Daily edition is

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Speaker 1: produced by Tophor foreheads Magnus Henrickson and me Laura Carlson.

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Speaker 1: Today's main story was reported by Naomi Kresky. Original music

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Speaker 1: by Leo Cedrin. Our editors are Rick Shine and Francesca Levi.

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Speaker 1: Francesco Levi is Bloomberg's head of punk casts. Thanks for listening.