What data is Israel actually giving Pfizer?

Vaccination center in Rabin Square Eyal Izhar

Experts are alarmed about possible breaches of confidentiality and the lack of transparency in Israel's vaccine deal with Pfizer.

Prime Minister Benjamin Netanyahu revealed over the weekend the main reason why Israel is receiving so many vaccine doses so quickly, mainly from Pfizer but also from Moderna. He said that Israel would lead the world out of the pandemic by the end of March and would serve as a large global testing laboratory for the efficacy of the vaccine. Netanyahu explained that Israel would share with Pfizer and Moderna data that would help them continue their R&D on Covid-19 vaccine and other treatments.

Netanyahu's words alarmed some of the public, mainly because of its lack of full transparency. Which data exactly will be passed on to Pfizer? In what way will the data be transferred? Could the information fall into the wrong hands? The Ministry of Health has been trying to soothe these concerns by insisting that the information to be handed over does not include specific medical histories of anybody in Israel.

"Globes" has sought to unravel some of the aspects of the deal and its future consequences for Israel and Israelis and asks some of the questions that many are demanding answers for.

Is receiving data the only reason that Pfizer has brought forward the provision of vaccine doses to Israel?

The 10 million doses that Israel will receive are a drop in the ocean in terms of the 1.3 billion vaccine doses that Pfizer expects to manufacture in 2021. While the EU was still hesitating over approving the product, Israel was waiting with its needles primed, providing an incentive for Pfizer to deliver to Israel many of the first batches of vaccine off the production line, where they would be used quickly. This was one of the reasons why Israel received so many of the early vaccine consignments.

The way Israel's HMOs (health funds) conducted their vaccination drives continued to justify this approach. Huge vaccination centers were quickly set up and vaccinations were given in straightforward priority according to age. Other countries received first consignments for a much smaller proportion of their population (because the countries are larger) and were more precise about priority populations, and made greater efforts to research exactly the place where they were needed. But all this took much longer. Add to that the large geographical distances in countries like the US where there are an enormous number of health insurers, and the inoculation drive becomes a logistical nightmare.

So Pfizer also estimated that nobody would feel the lack of the 10 million doses that were being allocated early to Israel, where they would be used by March. In North America and Europe they were finding it challenging enough to use the doses they already had.

Even so what does Israel's data give Pfizer?

Ziv Ofek, founder and CEO of MDClone, which operates big data systems that democratize medical information and specializes in data privacy, explained, "You must separate between certain types of data: statistical data compared with specific information about specific people."

The world is waiting anxiously to see Israel's statistical information. Does the vaccination really succeed in preventing infection among most of the people being inoculated? What is the scale of side effects? Does the vaccination reduce morbidity among those who have not yet been vaccinated? Israel is likely to provide the first evidence as to whether vaccinated people are not only immune but also whether they can infect others. Pfizer can already see that nearly two million people have been vaccinated in Israel and there are hardly any side effects. The data is open for all to see but even that alone makes Israel an attractive trial for Pfizer.

Pfizer is certainly interested in more specific data but still statistical information such as the correlation between preexisting conditions and efficacy of the vaccination and side effects. For example, the specific profile of those who contract Covid-19 despite having had the vaccination. Ofek said, "In Israel there are four computerized health funds that gather all this information. So it is very easy to find all these answers. One of the surest ways to do this is for Pfizer to submit a list of questions and somebody within Israel's system to look for the answer for them in the databanks. In that way the information itself is not transferred outside."

Ofek points out that there are malicious hackers who know how to pose apparently innocent looking questions and produce damaging data from it. Therefore it is not worth transferring even statistical data to everybody who asks although the risk of providing access to these questions only to Pfizer is very small and it is already given today to companies that collaborate with the health funds and hospitals.

"An additional type of information," Ofek adds, "is a databank with medical lists in which the personal details have been encrypted. I very much hope that this is not the information that has been passed on to Pfizer because it's very convenient for pharmaceutical companies to work with such a databank. Information like this allows cross referencing of data in order to locate identities even if they have been encrypted or omitted."

What is in fact the problem with the idea of personal medical information leaving the health system?

The concern that Ofek describes is probably the scariest but also the most banal. Exposure of embarrassing personal information to people that know you. Another worry is that data will serve for discrimination by employers, insurance companies or even potential dates. Any transfer of data to another location can raise the risk of a breach of confidentiality and consequently medical organizations are reluctant to allow full computerized lists out of their systems.

Why don't we know exactly what Pfizer is being given?

According to the experts that we spoke to this is the $64,000 question. Adv. Jonathan Klinger, legal advisor to the Israel Digital Rights Movement said, "The Ministry of Health claims that it is giving Pfizer only crude statistical data, which is also being given to all Israelis. But if that is the situation, how come there is an agreement with Pfizer? After all this is information that everybody can easily access. Without knowing what data is being sent, we cannot know what is really happening, and that is problematic."

Klinger added, "Unfortunately there is not a lot that we can do until we receive a copy of the agreement between Israel and Pfizer. We have to hope that the Privacy Protection Authority and the Ministry of Health have built in protections that will function to enforce the law and if there has been a violation."

Has the data been sold too cheaply?

Even if the data being given to Pfizer is only statistical, the question in such an instance is only whether the state is getting a fair price for a national resource. Prof. Nadav Davidovitch head of Ben Gurion University's School of Public Health said, "These figures are a gold mine. Providing these data in a transparent way to the WHO and Pfizer is in my opinion the right thing in terms of public health and the opportunity to help the world. But you have to be fully transparent with the public about what is being given. I think that they should have asked Pfizer for money for this information, and we have to see how the public can get back some profits from this."

Do the hospitals and health fund already sell our data?

Yes but as we have said they do not sell the data with your names. In terms of the law, anonymous information and all the insights that can be produced from it belong to the medical organization that collected it and not to the patients. Most of the health organizations in Israel already have agreements with academic and commercial bodies to provide access knowhow stemming from these data sources in exchange for different types of remuneration, whether money or cooperation.

How is the WHO connected to all this?

The WHO is one of the organizations that Pfizer consulted with about whether it should use Israel as a trial country, in other words what data could it receive after a large part of the country's population has been vaccinated, and how to gather it. This is because Pfizer is less used to undertake epidemiological trials on a national scale. The WHO will also receive Israel's information, although not all the information that Pfizer will receive. Most of the data that interests the WHO is accessible to all anyway.

Published by Globes, Israel business news - en.globes.co.il - on January 11, 2021

© Copyright of Globes Publisher Itonut (1983) Ltd. 2021

Vaccination center in Rabin Square Eyal Izhar
Vaccination center in Rabin Square Eyal Izhar
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