A year ago we were wondering whether an effective vaccine for coronaviruses might ever be developed for human beings. Six months ago we were wondering whether any of the vaccines in the pipeline would truly work or if 50 percent efficacy was the best we could hope for.

Today, looking at these numbers, I’m wondering whether the mRNA vaccines from Pfizer and Moderna are the most momentous medical breakthrough since the polio vaccine.

Bear in mind that the segment of the population in Israel that’s been fully vaccinated skews heavily older. According to the latest data, 80 percent of Israelis aged 60 or older have gotten both their shots whereas just 20 percent of the 16-59 demographic have. The vaccine has eliminated COVID deaths and almost completely eliminated severe cases of COVID among the demographic that’s *most susceptible* to those outcomes.

Salvation:

An Israeli healthcare provider that has vaccinated half a million people with both doses of the Pfizer vaccine says that only 544 people — or 0.1% — have been subsequently diagnosed with the coronavirus, there have been four severe cases, and no people have died.

That means the effectiveness rate stands at 93 percent, Maccabi Healthcare Services announced on Thursday, after comparing its immunized members to a “diverse” control group of unvaccinated members…

Out of the 523,000 fully vaccinated people, 544 were infected with COVID-19, of whom 15 needed hospitalization: Eight are in mild condition, three in moderate condition, and four in severe condition.

So if you’ve had both shots, you have a roughly one-in-1,000 chance of being infected, a one-in-35,000 chance of being sent to the hospital, and a one-in-130,000 chance of having a truly worrisome case. And again, that’s a sample that includes a huge percentage of older, previously vulnerable people. The vaccine has lifted the cloud of COVID from over the heads of Israeli senior citizens.

So much so, in fact, that Israeli hospitals are now seeing more new patients under 60 being hospitalized from the disease than over 60:

Israel: For the first time in the pandemic, there were fewer COVID-19 hospitalizations this week in the 60 y/o and older age group than in the 60 y/o and younger age group

The 60 y/o and older were first to vaccinate and 91% of them have been infected or vaccinated to date pic.twitter.com/adbHlQE8hx

— Eran Segal (@segal_eran) February 11, 2021

An immunized older person in Israel has a stronger immune response to the coronavirus than an unimmunized under-60 person does, it seems. The graphic on the right here also shows the curve of hospitalizations by age beginning to shift as vaccinations increase:

Israel vaccination campaign – ~ 80% of aged 60+ population vaccinated with a second dose

Noticeable changes in severe hospitalizations age distributions

Patients coming in are younger today

A challenge ahead to vaccinate remaining adult population pic.twitter.com/2V5mP9CGGs

— Hagai Rossman (@H_Rossman) February 12, 2021

The obvious wrinkle is that this data only tells us how effective the mRNA vaccines are. The vaccines that are still in the pipeline, like Johnson & Johnson’s and Novavax’s, use different means to trigger an immune response and haven’t reached levels of 95 percent efficacy in clinical trials as Pfizer and Moderna have. Biden’s pandemic advisors published a group op-ed yesterday, though, warning people not to get hung up on efficacy rates. It’d be great if every vaccine were as effective as Pfizer’s at preventing infection, but when push comes to shove no one cares about infection. We care about severe cases and deaths. A vaccine that didn’t prevent you from getting sick but *did* prevent you from having any symptoms worse than a cough and a low fever for a few days would be a great triumph with the death toll rising towards 500,000. And the good news, say Biden’s advisors, is that every major vaccine tested so far — every one — has been 100 percent effective at preventing bad outcomes in trials.

All seven COVID-19 vaccines that have completed large efficacy trials — Pfizer, Moderna, Johnson & Johnson, Novavax, AstraZeneca, Sputnik V and Sinovac — appear to be 100% effective for serious complications. Not one vaccinated person has gotten sick enough to require hospitalization. Not a single vaccinated person has died of COVID-19.

Not all infections are equal. People who are vaccinated against viruses still occasionally get infected. But thanks to a vaccine-primed immune system, the infections never progress to make them seriously ill. The vaccine efficacy rates vary only with respect to mild forms of COVID-19 illness. When it comes to the measures that really matter — hospitalizations and death — they are all functionally the same.

The reason that op-ed was published was to encourage Americans not to hold out for an mRNA vaccine if one isn’t available locally once you’re eligible to get vaccinated. People who follow the news on COVID know by now that Pfizer and Moderna are extremely effective at preventing infection whereas Johnson & Johnson’s product, at least according to the trial data, is a bit less so. Some will be tempted to pass on J&J for that reason, to wait it out until the mRNA products are back in stock. But that’s a bad idea, like choosing to go into battle without a bulletproof vest because the model of vest you prefer happens to be sold out at the moment. When push comes to shove, any vest that stops the bullet is fine. And in the case of COVID, from what scientists can tell so far, every “vest” that’s either on the market or will be soon accomplishes that task.

By the way, although Israel’s vaccination effort continues to roll onward, they’ve begun to slack off lately:

To some extent that drop-off is a simple matter of there being fewer unvaccinated people walking around at this point. But it also suggests that Israel has bumped into the outer bounds of the vaccine-skeptical part of the population. It’s easy to get people immunized quickly at the beginning if you have an efficient delivery system since everyone who’s gung ho will queue up without needing encouragement. But they’re through that group now. It’s time to start working on the fencesitters to push further towards herd immunity.

In lieu of an exit question, read this story about the FDA greenlighting Moderna to include 14 doses of its vaccine in its vials instead of 10, a boost that will quickly increase supply by 20 percent. That’s the good news. The bad news is that more doses in each vial means more of a risk of doses going to waste if the entire supply hasn’t been used in six hours after it’s opened. Good luck to the next Dr. Gokal who ends up being fired and prosecuted for trying to do the right thing in that situation.