Data from Israel and around the world attest to the effectiveness of the Pfizer vaccine in preventing serious illness and death [1, 2]. It seems that the vaccine not only reduces the risk of developing a serious illness requiring hospitalization among those whohave contracted the virus, but also improves the rate of recovery and reduces the risk of requiring ventilation [3, 4]. These data highlight the significant protection against COVID19 that the vaccine provides to at-risk populations.
Nevertheless, a question arises as to the impact of unvaccinated persons on vaccinated persons: whether, if at all, unvaccinated persons put vaccinated persons at risk, either directly (through contagion) or indirectly (by prolonging the pandemic or by being a burden on the healthcare system).
The scientific aspects
- The rate of vaccinated individuals among individuals with verified COVID19 cases is close to and even identical to their relative proportion in the population [5, 6], even when sorted by age group, and even thoughthe regulations of the Ministry of Health encourage a large number of tests among the unvaccinated [7].
- A number of studies and publications [8-10], as well as official documents from the S. Centers for Disease Control [11] and from Public Health England [12], show that the viral load in vaccinated and unvaccinated individuals is similar. Since viral load is the most significant factor in the ability to infect, it seems that there are no significantdifferences in the chances of infecting others between vaccinated and unvaccinated [13]. Beyond that, it seems that even vaccinated persons can be super-spreaders who infect many other people, among them other vaccinated persons [10, 14, 15].
- Studies show that the rate of transmission of asymptomatic persons is 20 times lower than that of symptomatic patients (who are tested and isolated anyway, regardless of their vaccination status), so that the likelihood of an asymptomatic healthy person who does not know that they carry the virus to infect another person is significantly lower than 1% [16]. Considering the rate of verified cases in the population, the chance of being infected from a randomencounter (as opposed to contact with household members) is about 1 in tens of thousands (the product of the percentage of contagious patients in the population [6] and the rate of asymptomatic contagion [16]).These findings show that despite the apparent effectiveness in protecting against severe illness, the effectiveness ofthe vaccination in preventing transmission and contagion is not significant and may even be negligible.From here it follows that an unvaccinated individual is not fundamentally different when it comes to the direct risk to transmit the virus compared to a vaccinated individual.
- Countries with the highest vaccination rates, up to 80-90% of the population, still experience significant epidemic Iceland, for example, where 81% of the total population have been vaccinated (compared to 67% in Israel), iscurrently experiencing the highest wave of morbidity it has experienced since the onset of the pandemic [17]. Toillustrate, in order to reach Iceland’s vaccination level, Israel would have to vaccinate another 1.4 million citizens, well over the million of currently unvaccinated citizens (and even then, as mentioned, a new wave of the pandemic could not be prevented.)These data show that the vaccination of the remaining population will not prevent the next wave, as it seems that thesewaves continue to occur despite high rates of vaccination. Therefore, unvaccinated persons are not what causes the pandemic to continue, nor do they endanger the vaccinated in that aspect. In fact, it seems that the hope oferadicating COVID19 by achieving “herd immunity” through vaccination of a high-enough percentage of the population has been proven to be unrealistic.
- At the time of writing this, COVID19 hospital beds make up about 3% of hospital beds in Israel [6], and about 30% ofpatients in critical condition are unvaccinated [6]. In addition, the lion’s share of those who have not been vaccinated are young persons [6], whose likelihood of creating excessive burdens on the system are extremely low. The number of unvaccinated individuals in Israel is significantly lower than one million, as this population includes many who cannot or should not get vaccinated: