Israel has a more scientific approach to COVID immunity and how to use it to drive health policy than we do — by far.
I initially had some hesitation about their Green Pass because it restricts those who don’t qualify from going to many public places, including indoor restaurants and shopping malls; as of next week, however, a Green Pass will no longer be necessary to gain access to swimming pools, outdoor restaurants, or open-air attractions, although it will be required at gyms.
I agree with these changes. This is fair and safe.
Israel’s Green Pass, along with the European Union’s Digital COVID Certificate, take the place of actual mandates, which often are too rigid and lead to even more vaccine hesitancy. Opponents of the vaccine mandates cite personal choice, and they are correct up to a point: It is your right to put your own health at risk from smoking or alcohol (which damage your lungs and liver, respectively) or even from COVID. But it is NOT your right to subject others to the impact of these risks, meaning you should not be able to drive drunk on the highway, smoke in a public place, or circulate freely among others in public places if you haven’t demonstrated some immunity to COVID.
The primary public health goal of vaccination is not just to protect you from hospitalization or death — it’s to decrease the amount of circulating virus in the community as well, protecting others. This is why the Green Pass and the Digital Certificate make sense.
Consider that the Green Pass is far more in keeping with principles of public health than our current U.S. system of “vaccine-or-bust,” which has turned off so many people. Itamar Grotto, professor at Israel’s Ben Gurion University and associate director general for the Public Health Services of Israel’s Ministry of Health until earlier this year, told me this past week in an interview on SiriusXM that Israel — like the European Union — includes recovery from COVID as a qualification for immunity.
But the requirements for the Green Pass are changing, in keeping with evolving science. If you have had COVID in Israel, your natural immunity will be accepted as covering you for six months per the new requirements, and then you will only need one shot of the Pfizer vaccine for your Green Pass to continue to be valid for another six months. If you never had COVID, two shots will qualify you for six months and a third shot for an additional six months.
This strategy is in keeping with the science showing a ten-fold increase in neutralizing antibodies with one shot after infection. The booster rules make sense, too, especially for those over age 60, because of the Israeli data demonstrating immunity against severe infection waning after six months for the second Pfizer dose. For those who have never had a positive PCR test, but develop antibodies against infection and have one vaccine dose, they qualify for a Green Pass for six months, as do children under age 12 who have antibodies from prior infection. Children under 12 without immunity (as well as adults) can get a Green Pass for a week if they have a negative PCR test, or for a day with a negative rapid antigen test.
All of this makes sense to me and is a detailed, responsible way to approach viral control, which includes natural immunity in the equation for public health protection in ways that have been demonstrated by current science yet have been completely ignored in America.
The European Union’s Digital COVID Certificate states that it “serves as proof that a person has been vaccinated against COVID-19, has recently received a negative COVID-19 test, or is protected against the disease after being infected (recovery valid for up to 6 months).” This is very similar to the new Green Pass requirements.
I am not as certain that everyone age 12 and up who hasn’t had COVID needs to have another shot after six months to continue to qualify for a Green Pass or an EU Digital COVID certificate. This seems to me to be overreach, and I would set the age much older.
Israel is not offering the vaccine to the 5-to-12-year-old group unless they are at high risk, another policy with which I agree. There is talk about this changing in Israel by the end of this month, as the new Pfizer data is rolled out, though I am hoping the Green Pass requirements for this group still won’t be as stringent and that parents and pediatricians will be involved in vaccine decisions.
When it comes to adults, a vaccine is a matter of personal choice — except where areas of potential viral spread are concerned. That’s where something like Israel’s Green Pass can come in.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, "COVID; the Politics of Fear and the Power of Science."