Israel — the poster child for COVID-19 vaccination and the first country to reach herd immunity — has seen a recent rise in cases. Recently, most of the people testing positive are vaccinated, reported The Washington Post.

The trend has brought a slew of questions about the efficacy of COVID-19 vaccines and the implications of new strains for future outbreaks. While these trends initially seem like cause for vaccine skepticism, a closer look at Israel’s current outbreaks shows that vaccines are effective and working — even against the delta variant.

Let’s unpack the situation.

What’s happening in Israel’s coronavirus outbreak?

About a month ago, Israel celebrated what seemed like the end of its domestic pandemic. The country dropped all coronavirus restrictions, including mask mandates and social distancing requirements, reported Reuters. Unfortunately, the celebration was premature.

COVID-19 cases have begun to rise in Israel over the last few weeks, reported Reuters. The outbreaks started in schools among unvaccinated children then began spreading to vaccinated adults.

  • Last week, Israel recorded an average of 775 new daily cases last week, according to data from Reuters.
  • This is Israel’s highest number of daily new infections since March, Reuters reported.
  • The average number of weekly hospital admissions is currently 120 people, according to The Washington Post.
  • The country has reimposed mask mandates, social distancing requirements and quarantines for everyone arriving in Israel.

Just like in many other countries, the recent outbreak has been driven by the more contagious and “more vaccine-resistant” delta variant, reported The Washington Post.

Who is testing positive for COVID-19 in Israel?

Unlike in many other countries, most of the people testing positive in Israel are vaccinated, reported The Washington Post.

  • But this should not be surprising, according to epidemiologist Katelyn Jetelina, per The Washington Post.
  • “The more vaccinated a population, the more we’ll hear of the vaccinated getting infected,” she said.

And Israel has one of the most vaccinated populations in the world. About 60% of the nation’s entire population of 9.3 million has received at least one vaccine dose, reported Reuters. Among adults, about 85% have been vaccinated which means that Israel’s vaccinated community is five times larger than its unvaccinated community.

“Countries with high vaccination will see mostly vaccinated people getting ill from COVID,” wrote Arieh Kovler, a political analyst, on Hat Tip.

The people who are not testing positive in the current outbreak are those who have had COVID-19 previously and recovered. These people account for 9% of Israel’s population but less than 1% of recent infections, according to Kovler’s analysis. This has brought new questions about whether natural infections are more protective against the delta variant than vaccinations — but the answer is not yet certain.

What does Israel’s experience show about vaccines?

The Israel Health Ministry’s data analysis has produced some new estimates about the effectiveness of Pfizer vaccines, according to The Washington Post:

  • In protecting against infection, Pfizer vaccines are 95% effective for the alpha variant but only 64% effective for the delta variant.
  • In preventing symptomatic COVID-19 cases, Pfizer vaccines are 97% effective for the alpha variant but only 64% effective for the delta variant.
  • In preventing hospitalization and serious disease, Pfizer vaccines are 97.5% effective for the alpha variant and still 93% effective for the delta variant.

While the Pfizer vaccine is less effective against the delta variant, the vaccine’s effectiveness still far exceeds the 50% vaccine efficacy threshold required for WHO approval, according to the organization’s website.

“Just because a variant emerges that renders the vaccines less effective doesn’t mean those vaccines weren’t effective in the first place,” according to The Washington Post.

What is Israel’s post-vaccination outbreak like compared to pre-vaccination?

While vaccinated people are testing positive and being hospitalized in Israel’s delta outbreak, the current post-vaccination outbreak is only a fraction of the country’s worst pre-vaccination outbreak in January, reported The Washington Post.

  • Currently, cases are less than one-tenth as many as during January’s peak.
  • Hospitalizations during the current outbreaks are less than one-sixteenth of January’s peak, per The Washington Post. Put differently, Israel is currently averaging 120 weekly hospital admissions. In January, the country averaged 2,000 weekly hospital admissions.
  • Most importantly, admission to intensive care units for severe COVID-19 cases is less than one-twentieth the number of admissions in January.

“We estimate that we won’t reach high waves of severe cases like in previous waves,” said Israel’s health ministry’s director-general, Nachman Ash, per Reuters.

What does Israel’s experience mean for other countries?

“Israel is as good an example of vaccine efficacy as just about anywhere in the world,” according to The Washington Post. “The delta variant means the virus will probably continue to spread, even among vaccinated people and even in a strongly vaccinated country, such as Israel.”