By Rebecca Roth
Israel is one of the most vaccinated countries in the world right now, and that’s all thanks to the country’s size, centralized healthcare system, and the deal it has struck with Pfizer: “vaccines for data.” While the ability to vaccinate their citizens and prove the effectiveness of the vaccine is an amazing opportunity, the question remains: at what cost? Is the promised “return to normalcy” worth it if citizens’ private information might be shared and publicized?
On Monday, March 8, the five millionth vaccination occurred in Israel. For a county with a population of 9.3 million, this is a significant number. As of March 9th, Israel has given at least one dose to 53.7 percent of the population and both shots to 41.5 percent of its population. The percentages for elderly people and those at high-risk, due to preexisting conditions, is even higher. Israel is vaccinating its citizens at the highest rate worldwide, with 101 doses having been administered per 100 people. This can be compared to the UK’s 35.8 and the US’s 28.2 per 100 people.
The data emerging from Israel is promising and shows that the light at the end of the tunnel is in sight. There has been a 93 percent decrease in serious COVID-19 cases and deaths, and 90 percent decrease in transmission. While the latter figure is controversial due to the potential that many asymptomatic cases went undetected, it still provides an optimistic outlook for the future. Other studies have shown that the vaccine prevents 98.9 percent of COVID-19 deaths, which is even higher than the trial data had suggested. This, too, is a welcome sign after over a year of lockdowns and fear about the coronavirus.
Israel was one of the first countries to acquire the Pfizer COVID-19 vaccine because they promised to inoculate their citizens at a fast pace and to share the data with Pfizer. While this may seem benign on the surface, it raises privacy concerns about the authority of the government to share medical information with a third party. Israel was in the perfect position to inoculate their citizens at a fast pace and gather data because it has a digitized, centralized healthcare system, and nearly every Israeli is a member of one of four health maintenance organizations (HMOs). This means that every Israeli’s medical information from the last thirty years can be found in a centralized health database. This has allowed the government to track trends across those testing positive for COVID-19 who become seriously ill by comparing it to any comorbidities which are already found in the system. The same can be done with the vaccine and its effectiveness on different age groups or any demographic that Pfizer desires.
There are doubts regarding the true anonymity of data and the authority of the government to share this without its citizens explicitly opting in. Israel has introduced a “green passport” whereby people who have received both vaccinations have expanded privileges such as the ability to enter gyms, concerts, movie theaters, and synagogues. This provides a significant incentive for people to get the vaccine. But in doing so, Israelis also unwittingly authorize the government to share their information
While the Israeli government claims that they are only sending Pfizer statistics that are available to the public, such as COVID-19 deaths and hospitalizations, their contract states that Israel will provide “subgroup analyses and vaccine effectiveness analyses, as agreed by the Parties.” If the subgroups are small enough, there is a potential for personal information to be uncovered. Additionally, if this personalized or private data is sent to Pfizer, it could be hacked and disseminated regardless of Israel or Pfizer’s intentions.
This is not the first time that Israel has had pushback about COVID-19 policies and privacy. In the beginning of the pandemic, Shin-Bet, one of Israel’s intelligence agencies, was given access to citizen’s location information for their cell phone’s GPS in order to track their location for quarantine and contact tracing purposes. They were granted this authorization due to the public health situation, but many felt that the government was invading its citizens’ privacy and overstepping their authority.
Israel is not the only country that has had a debate about the ability of the government to encroach upon privacy rights due to public health concerns. The EU, the UK, and the US have all had pushback against their contact tracing policies and COVID-19 contact tracing apps. Challengers of these countries’ policies raise a meaningful question: do citizens have a right to privacy even during a pandemic?
The answer must be yes. While testing and contact tracing are one of our best strategies to contain the spread of COVID-19, there is a difference between someone voluntarily getting tested and telling the government who they have been in close contact with, or choosing to download an app that would track their movement and notify their close contacts if necessary, and being almost forced, to receive a vaccine which automatically allows the government to send their personal information to a third party without the patient’s explicit consent.
To be sure, it is necessary for people to sacrifice some of their rights in order to help society emerge from this pandemic. The vaccine was only able to be developed because people volunteered to be a part of a clinical trial. The distribution of this vaccine and the analysis of the data is also a medical experiment. But the participants have not been given the ability to opt-out. And while everyone has the right to give up their privacy, that must be a choice — rights are not subject to arbitrary suspension by the government.
At this point in Israel, all that is left to do is to trust that the Israeli government is forthcoming and sharing the whole truth about the anonymity of the data shared and that no one will be hurt by the potential breach of privacy. But it does raise the question of which, if any, rights the government can take away during a public health crisis.