Canada Urges Halt in Use of AstraZeneca Covid-19 Vaccine in People Under 55

OTTAWA—Canadian authorities recommended Monday a halt on administering the AstraZeneca PLC Covid-19 vaccine on people under the age of 55 in light of evidence from Europe on potentially serious side effects targeting younger women.

The change in guidance marked a sharp shift from Canadian health officials, who up until now have said the AstraZeneca vaccine was safe for people of all ages—a point they emphasized earlier this month when governments in Europe paused the vaccine’s use amid worries over blood clotting. This also marks the latest setback for the British-Swedish drugmaker, which has faced pushback from governments, regulators and the public about the rollout of its vaccine.

Health Canada, the country’s drug regulator, has ordered AstraZeneca to conduct a detailed risk-benefit analysis on the vaccine by age and gender. The information, officials said, would help determine whether specific demographic groups might be at higher risk.

Canadian officials said the change in guidance on AstraZeneca stems from the emergence of additional reports of blood clotting in people who received the vaccine in Europe. Some European cases were reviewed in a recent preprint research paper that focused on nine patients in Germany and Austria. The findings from the preprint were first reported by researchers earlier this month.

The preprint research looked at nine patients whose ages ranged from 22 to 49 and who had developed thrombosis, which occurs when a blood clot forms inside a blood vessel, beginning four to 16 days after getting the AstraZeneca vaccine. Eight of the patients were female. Four of the nine patients died.

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Clashes in Europe spread as protesters question lockdowns and policing.

A year after European leaders ordered people into their homes to curb a deadly pandemic, thousands are pouring into streets and squares. Often, they are met by batons and shields, raising questions about the tactics and role of the police in societies where personal liberties have already given way to public health concerns.

From Spain and Denmark to Austria and Romania, frustrated people are lashing out at the restrictions on their daily lives. With much of Europe facing a third wave of infections that could keep these stifling lockdowns in place weeks or even months longer, analysts warn that tensions on the streets are likely to escalate.

In Britain, where the rapid pace of vaccinations has raised hopes for a faster opening of the economy than the government is willing to countenance, frustration over recent police conduct has swelled into a national debate over the legitimacy of the police — one that carries distant echoes of the Black Lives Matter movement in the United States.

“What we’re seeing is a growing level of discontent among members of our society who see a fundamental illegitimacy in law enforcement under the pandemic,” said Clifford Stott, a professor of social psychology at Keele University in England and an expert in crowd behavior. “And it has created strange bedfellows.”

The potential for more such confrontations is high, Professor Stott said, citing “the warmer weather, duration of the lockdown and increasing dissatisfaction among sections of the community about the imposition of control measures.”

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As Europe’s Lockdowns Drag on, Police and Protesters Clash More

LONDON — In Bristol, an English college town where the pubs are usually packed with students, there were fiery clashes between police and protesters. In Kassel, a German city known for its ambitious contemporary art festival, the police unleashed pepper spray and water cannons on anti-lockdown marchers.

A year after European leaders ordered people into their homes to curb a deadly pandemic, thousands are pouring into streets and squares. Often, they are met by batons and shields, raising questions about the tactics and role of police in societies where personal liberties have already given way to public health concerns.

From Spain and Denmark to Austria and Romania, frustrated people are lashing out at the restrictions on their daily lives. With much of Europe facing a third wave of infections that could keep these stifling lockdowns in place weeks or even months longer, analysts warn that tensions on the streets are likely to escalate.

In Britain, where the rapid pace of vaccinations has raised hopes for a faster opening of the economy than the government is willing to countenance, frustration over recent police conduct has swelled into a national debate over the legitimacy of the police — one that carries distant echoes of the Black Lives Matter movement in the United States.

sense of outrage is the case of Sarah Everard, a 33-year-old woman who was abducted and killed, allegedly by a police officer, while walking home in London. The Metropolitan Police then roughly broke up a vigil for Ms. Everard on the grounds that the participants were violating coronavirus rules on social distancing.

The potential for more such confrontations is high, Mr. Stott said, citing “the warmer weather, duration of the lockdown and increasing dissatisfaction among sections of the community about the imposition of control measures.”

a crowd pulled down the statue of a 17th century slave trader, Edward Colston, and dumped it into Bristol Harbor.

This time, however, he fears that the images of shattered windows and burned police vehicles will help Prime Minister Boris Johnson pass the police law, which has already cleared two key hurdles in Parliament.

“The consequences of what they’ve done is to increase the likelihood of that bill winning support,” Mr. Rees said.

For many in Britain, that would be a bitter irony, given that the pandemic has already led to the greatest restriction of civil liberties in recent memory. Coronavirus regulations that were expected to last no more than a few months have now been in place for a year, causing tensions between police and the public not just at protests, but also at house parties and even with those meeting outside for coffee.

Early in the pandemic, one local police force used drones to shame a couple walking a dog on a lonely path. The owners of gyms and sports clubs were raided by police when they opened against the regulations.

An earlier version of the government’s coronavirus regulations contained a provision that allowed nonviolent protests. But that was removed from a later version, leaving the right to peaceful assembly in a kind of legal limbo. Under the latest draft of the rules, issued on Monday, protests would be allowed under limited circumstances, starting next Monday.

These emergency laws were rushed through Parliament without the scrutiny normally applied to legislation. Lacking a written constitution, Britons who want to take to the streets have to rely on the less clear-cut protection of a human rights act.

By contrast, Germany’s Federal Constitutional Court last year upheld the right of its citizens to protest, provided that they adhered to social distancing rules.

“This pandemic has exposed the weaknesses of our unwritten constitution when it comes to certain rights,” said Adam Wagner, a human rights lawyer and expert on the coronavirus rules. “If you take representative democracy from the process of lawmaking, you miss out on key voices.”

The government makes other arguments for the policing bill. Cabinet ministers note, for example, that the security costs of protecting a new high-speed rail link from environmental protesters has been 50 million pounds, or $69 million.

Priti Patel, the home secretary, condemned the clashes in Bristol has “thuggery and disorder” and said protecting the police was the government’s top priority — though not, she added, of some members of the opposition.

“We have been clear that to save lives and fight this pandemic, people must not currently hold large gatherings,” she said in a statement to Parliament. “Too many this weekend selfishly decided that this did not apply to them.”

Further raising the political temperature, the policing bill is moving through Parliament at the same moment as the government’s renewal of its coronavirus regulations, which also drew fire from the libertarian right.

“The Coronavirus Act contains some of the most draconian detention powers in modern British legal history,” said Mark Harper, who chairs the Covid Recovery Group, a caucus of Conservative lawmakers critical of the lockdown rules.

While many say the debate on the role of the police in Britain is overdue, some sympathize with the plight of the officers. They are caught between politicians and the public, with a nebulous constitutional status and a shifting set of rules to enforce, particularly during a public health emergency.

“It’s not the fault of the police that the coronavirus regulations are in part necessarily draconian and in parts unnecessarily draconian,” said Shami Chakrabarti, an expert in civil liberties and a Labour Party politician.

The bigger problem, she said, is that Britain tends to conduct debates about the role of the police after wrenching episodes like a police shooting, the killing of Ms. Everard or the violent clashes in Bristol. This inflames public opinion in one direction or the other, she says, but can get in the way of a thoughtful debate.

“We almost only ever have this discussion in moments of crisis,” Ms. Chakrabarti said, “not in peacetime.”

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Pope Struggles to Contain Conservative-Liberal Tensions in Catholic Church

Pope Francis is struggling to manage powerful bishops in the U.S. and Germany, two groups at opposite ends of the ideological spectrum, as he tries to advance his progressive agenda without jeopardizing the unity of the Catholic Church.

The election of President Biden, a progressive Catholic whom some U.S. bishops want to censure for his support of abortion rights, has exacerbated longstanding tensions between the pope and the largely conservative American episcopate. U.S. church leaders have resisted promoting the pope’s priorities of social and economic justice and care for the environment over opposition to abortion and defense of religious freedom.

On the left, the pope is trying to rein in German bishops who—encouraged by the pope’s liberalizing gestures on topics including sexuality, ecumenism and the role of women—are pressing for changes that go further than Pope Francis is comfortable with, and that conservatives warn could cause a schism.

Pope Francis’ most recent attempt to restrain the Germans came in this week’s Vatican document forbidding clergy to bless same-sex unions, a practice supported by some leading German bishops.

Each country presents “a different set of issues, a different set of struggles but I think some of the underlying dynamics are the same,” said Adam DeVille, a professor of theology at Indiana’s University of Saint Francis. “In both cases, the pope I think is really trying to say, ‘come on guys, let’s rein it in here, let’s get back into the same lane all together.’”

For years, a minority of U.S. bishops closely associated with Pope Francis have pressed for greater adherence to his social agenda. In November 2019, the last time the U.S. Conference of Catholic Bishops met in person, liberals protested a statement in the conference’s voter guide describing opposing abortion as its “pre-eminent priority.”

In response to a request for comment from The Wall Street Journal, the USCCB said, “Advocacy for the poor and marginalized, migrants, people on death row, the unborn, and everyone in need of God’s mercy is central to the mission of the USCCB, and in this, there is an unbreakable unity with the Holy Father.”

Following Mr. Biden’s election, Pope Francis broke protocol by phoning to congratulate the president-elect. But on inauguration day, Archbishop José Gómez of Los Angeles, president of the USCCB, said, “Our new president has pledged to pursue certain policies that would advance moral evils and threaten human life and dignity, most seriously in the areas of abortion, contraception, marriage and gender.”

Meanwhile, some bishops say Mr. Biden’s abortion stance makes him ineligible to receive the Eucharist.

“I do not think he should be presenting himself for Communion,” said Archbishop Salvatore Cordileone of San Francisco. “If I knew he were coming and planning to attend Mass, I’d engage in a conversation with him ahead of time to clarify that.”

Asked about the archbishop’s statement, a White House official said on Friday that it was a private matter.

Cardinal Wilton Gregory, a progressive who as archbishop of Washington, D.C., is Mr. Biden’s pastor, has said that the president may continue to receive Communion there.

For Mr. DeVille, the disagreement over how to handle Mr. Biden exemplifies a larger trend: “The U.S. bishops are hardening in some ways into, not totally divergent paths, but clearly different paths…with differently ranked priorities from the pope,” he said, noting that Pope Francis is 84 years of age and perhaps approaching the end of his pontificate. “A lot of the American bishops, especially those on the younger side, are just going to wait him out.”

For his first international trip during the pandemic, Pope Francis visited Iraq.

Meanwhile in Germany, bishops and leading lay Catholics are engaged in a national synod considering major changes to church life, including the possibility of women clergy, married priests and changes to church teaching on sexuality.

This week’s Vatican statement that clergy may not bless same-sex relationships because God “cannot bless sin,” which contrasted with the pope’s conciliatory approach to homosexuality, was meant specifically as a message to Germany, said Sandro Magister, a Vatican expert who writes for Italy’s L’Espresso magazine. Conservative bishops in both the U.S. and Germany have warned that the German synod could lead the church into a split with the rest of the Catholic world.

The statement drew defiant reactions from clergy in Germany and beyond, including Austria and Belgium, with some priests vowing to bless gay couples despite the prohibition.

“The danger is that the German church, if permitted, will become an autonomous church deviating on important points of doctrine,” Mr. Magister said. “This explains why the pope is putting on the brakes.”

Mr. Magister also saw a warning to Germany in the pope’s decision in February 2020 not to loosen requirements for priestly celibacy or allow the ordination of women deacons in Latin America’s Amazon region, despite his earlier indications of openness to those possibilities to address a serious shortage of clergy there.

Vatican offices have also recently issued statements that rule out giving Communion to Protestants or allowing laypeople to administer parishes on an equal basis with priests, both ideas popular with German bishops.

According to Massimo Faggioli, a professor of theology at Villanova University, Pope Francis prefers to delegate the delivering of messages that his progressive supporters will find disagreeable.

“When there are gestures of welcoming and so on, it is Francis that does them. When there is some bad news, he lets the CDF,” Mr. Faggioli said, referring to the Vatican’s doctrinal office.

Despite disappointment in Germany with the statement on gay couples, liberals there retain an overwhelmingly positive view of the pope, said Ludwig Ring-Eifel, head of the German bishops’ news agency KNA.

“The perception goes somewhat like this: Francis has opened all the doors which [Popes John Paul and Benedict] had previously declared closed on gays, on celibacy, on intercommunion. But the conservatives in the Vatican still stand in his way, and he alone is too weak to complete the revolution,” Mr. Ring-Eifel said.

Write to Francis X. Rocca at francis.rocca@wsj.com and Ian Lovett at ian.lovett@wsj.com

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Scientists Say They Found Cause of Rare Blood Clotting Linked to AstraZeneca Vaccine

BERLIN—Scientists in Europe said they had identified a mechanism that could lead the AstraZeneca PLC vaccine to cause potentially deadly blood clots in rare instances as well as a possible treatment for it.

Two teams of medical researchers in Norway and Germany have independently found that the vaccine could trigger an autoimmune reaction causing blood to clot in the brain, which would offer an explanation for isolated incidents across Europe in recent weeks.

Several European countries briefly halted their rollouts of the vaccine this week after more than 30 recipients were diagnosed with the condition known as cerebral venous sinus thrombosis or CVST. Most of the people affected were women under the age of 55.

The issue affected a tiny portion of those who had received the shot however, and after investigating, the European drugs regulator ruled that the benefits outweighed the potential risks of the vaccine, and recommended vaccinations resume.

Latest Vaccine Developments

Some countries, such as Germany, France and Italy, resumed vaccination with AstraZeneca’s shot on Friday, with an added warning that it could be linked to blood clotting. The French healthcare authority, which recorded three cases of CVST connected to the vaccine, advised the government on Friday to only administer the shot to people older than 55.

Others, including Norway, Sweden and Denmark, said they needed more research before restarting their rollouts. Norway registered three cases of CVST, one of them fatal. The country vaccinated around 120,000 people with the shot. Finland suspended the use of AstraZeneca on Friday, after recording two cases of what the authorities called unusual blood clotting.

Pål André Holme, a professor of hematology and chief physician of the Oslo University Hospital who headed an investigation into the Norwegian cases, said his team had identified an antibody created by the vaccine that was triggering the adverse reaction.

​Europe’s top drug regulator endorsed AstraZeneca’s vaccine after it was suspended in several countries over blood-clot concerns. WSJ explains what’s at stake for a shot that’s been widely used around the world and may soon be considered for emergency use in the U.S. Photo: Mykola Tys/SOPA Images

“Nothing but the vaccine can explain why these individuals had this immune response,” Prof. Holme said.

Norway’s health authority cited the findings when announcing that it would not resume the vaccination.

A team of German researchers around Andreas Greinacher, professor of transfusion medicine at the Greifswald University Clinic, said they had independently come to the same conclusion as Prof. Holme in a statement and a press conference on Friday.

In Germany, 13 cases of CVST were detected among around 1.6 million people who received the AstraZeneca vaccine. Twelve patients were women and three died.

The German researchers, who coordinated with colleagues in Austria, Ireland and Britain, said in a statement that patients who show symptoms four days after vaccination, such as headaches, dizziness or impaired vision, could be quickly diagnosed with a blood test. Prof. Greinacher said the news meant that people should not fear the vaccine.

“Very, very few people will develop this complication,” Prof. Greinacher said in a press conference Friday. “But if it happens we now know how to treat the patients.”

Pål André Holme’s team at Oslo University Hospital identified an antibody created by the AstraZeneca vaccine that was triggering the adverse reaction.

Photo: Terje Pedersen/Associated Press

He said that, after a swift diagnosis, the condition could be treated in any mid-sized hospital.

The German government said it was examining the findings, but stuck to its decision to resume use of the AstraZeneca vaccine.

AstraZeneca didn’t immediately react to a request for comment. Neither did the medicines regulators in Britain, Germany, Austria and The Netherlands, where vaccinations using the AstraZeneca vaccine have either resumed or weren’t suspended this week.

The European Medicines Agency, or EMA, which regulates medicines for most European countries, said that it had assessed the cases from Germany and Norway and discussed them with the relevant national authorities.

A spokeswoman for EMA said that the vaccine may be associated with very rare cases of blood clots, including CVST, but that the benefits of the vaccine outweigh that risk.

“A causal link with the vaccine is not proven, but is possible and deserves further analysis,” the spokeswoman said in a statement.

Neither the German nor the Norwegian findings were published or peer reviewed. Prof. Greinacher said he had submitted his findings for publication to the British medical journal The Lancet.

The German Society for Thrombosis and Hemostasis Research reviewed Prof. Greinacher’s work and issued a statement Friday advising physicians how to diagnose and treat the condition should it arise in vaccine recipients.

Dr. Robert Klamroth, deputy-chairman of the Society for Thrombosis and Hemostasis Research, said the rare autoimmune reaction occurred more frequently in Germany because the country initially only authorized the vaccine for people younger than 64. Britain, which had fewer incidents but vaccinated many more people, was predominantly giving the shot to older recipients.

Once diagnosed, the condition should be treated with blood thinning medication and immunoglobulin, which targets the antibody that causes the problem.

“We believe the most likely hypothesis is that this particular vaccine is causing a rare autoimmune reaction that triggers antibodies, which then interact with the platelets, but we don’t know why this is happening,” Dr. Klamroth said.

Covid-19 Vaccines

Write to Bojan Pancevski at bojan.pancevski@wsj.com

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How Israel Delivered the World’s Fastest Vaccine Rollout

TEL AVIV—In the world’s fastest coronavirus vaccine rollout to date, Israel has given at least one shot to nearly 60% of its residents, a feat propelled by an ample supply of doses and an uncommon healthcare system that combines competition with tax-funded universal coverage.

Israel, a small, wealthy nation with a young population, was uniquely qualified to confront the pandemic: Prime Minister Benjamin Netanyahu had secured enough vaccine stocks by paying more, as well as by offering access to Israelis’ personal health data to gauge the vaccine’s effectiveness. Its healthcare system had the means to quickly deliver the shots into the arms of Israelis.

The country’s four health-management organizations used centralized data-keeping, technology and the cradle-to-grave ties between Israelis and their doctors to speed up the vaccination drive, targeting residents nationwide with text messages, emails and phone calls. The efficiencies of Israel’s HMOs have been honed by years of competing for patients—and for the tax revenue gained by adding each new member—as they try to outdo each other in quality and availability of care.

“It’s really a unique structure,” said economist Moshe Bar Siman Tov, who oversaw Israel’s coronavirus response last year. “I’m not sure it’s possible to duplicate it. It’s a mixture of socialist fundamentals and entrepreneurial spirit.”

Israel’s bars and restaurants reopened last week to vaccinated people, prompting street parties in Tel Aviv, and the country is now looking ahead to a broader economic rebound.

Crowds of masked people passing through Carmel Market in Tel Aviv.

Photo: Kobi Wolf/Bloomberg News

The tiered “green passport” system has drawn protests by some who don’t want to get inoculated. But, in a country where anyone can get a jab on the spot, this strategy has been broadly accepted. Mr. Netanyahu, who is up for re-election Tuesday, is campaigning largely on the vaccination drive’s success.

Agam Rafaeli-Farhadian, 33 years old, received his first shot of the Pfizer-BioNTech vaccine in January. “I got the text and was like, ‘Whoa, this is cool,’ ” he said, adding that it took 30 seconds to sign up and five minutes to get each of his two shots.

While Israel’s vaccination rate is the world’s highest, its HMOs are still struggling to overcome reluctance in some population groups. Health officials say full herd immunity will require inoculating 80% of the population, a number that includes children under 16, for whom no approved vaccine exists so far.

Meanwhile, vaccinating as many remaining adults as possible will be key to avoiding more lockdowns and not overloading health systems. Trying to reach that goal, the HMOs are working with Magen David Adom, Israel’s emergency response services, to set up pop-up vaccination points on busy streets, at workplaces and in night-life districts.

Unlike Israel’s healthcare providers, many of Europe’s national health services buckled under the wave of coronavirus infections last year, and European Union nations are still struggling with the vaccine rollout. The U.S., after initial difficulties, is rapidly gaining speed. The U.K., which has the fastest vaccination rollout among large countries, has an inoculation rate that is a third of Israel’s.

Since the start of the pandemic, 6,057 people or 700 per million have died from Covid-19 in Israel. In the U.S., the latest number is 536,914 people or 1,625 per million. In the U.K., the death rate was 1,857 per million.

Many in Israel credit its hybrid healthcare model with providing high-level care that kept the death toll low. Israel’s relative youth—the average age is 30—has also blunted the pandemic’s severity. Most of the coronavirus deaths world-wide have been among older people.

Another advantage: Israelis agree to share personal information with government-supervised systems, part of a cohesive social compact forged in a country where men and women must serve in the army and where military conflicts break out every few years. Patient data allowed Israel’s four HMOs to monitor individuals who contracted the virus and to intervene early as the disease progressed.

Amanda Lounsbury, a 33-year-old environmental researcher in Tel Aviv, tested positive in January. Right away, she started receiving daily calls from her HMO’s family doctors and nurses. The provider sent her a pulse oximeter to check her blood oxygen level and report the reading during their calls, a standard practice.

“I felt very much not alone,” said Ms. Lounsbury, who is originally from Connecticut. She has since made a full recovery.

Supply side

Pfizer Inc. and BioNTech agreed to supply their vaccine to Israel ahead of other nations, in part, because the country’s assent to share medical data would provide them insights for future research. Privacy experts say the agreement shows how far Israel lags behind European nations in protecting confidential personal data.

An Israeli woman gets a coronavirus vaccine shot at the Kupat Holim Meuhedet clinic in Jerusalem.

Photo: menahem kahana/Agence France-Presse/Getty Images

“We’re all very, very happy about the results of the vaccine efficiency research, but you need to take a very, very careful look at the process,” said Tehilla Shwartz Altshuler, a senior fellow at the Israel Democracy Institute, a Jerusalem-based, nonpartisan think tank. “Israel is a kind of lab for the world. It’s frightening. We need to have stricter rules in terms of asking for consent.”

Israel’s healthcare system is mandatory. All residents pay up to 4.8% of their income in health taxes, part of their overall tax bill. Residents can switch their HMO provider, though only 1% to 2% actually do each year.

“There is no competition over money, because everybody pays the same.” said Ehud Davidson, chief executive of Clalit, the largest Israeli HMO. Many medical services are free with the occasional copay.

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Clalit and the three other HMOs, all of them not-for-profit entities, are reimbursed by the state according to a formula based partly on the number of members, their ages and where they live. Providers that lose patients to rivals also lose revenue. To retain members, the HMOs have an incentive to provide better levels of service and easier access to doctors, clinics and diagnostic facilities.

“We based our conversations with Pfizer on the very existence of Israel’s HMOs,” Israel Health Minister Yuli Edelstein said. “We were able to say to Pfizer, ‘If we get the vaccine quickly, we will run such a massive operation and such a quick one, the whole world will be talking about the Pfizer vaccine.’ ” Israel has almost exclusively relied on the Pfizer-BioNTech vaccine.

During the peak of the pandemic, hospitals in Italy, the U.K. and parts of the U.S. were overrun and had to ration access to lifesaving treatments. Israel escaped those shortages, even though it had similar or higher infection rates and significantly fewer hospital beds per 1,000 people. Some of this can be explained by the relative youth of Israel’s population. But with one of the world’s highest life expectancies, there are many Israeli’s in their 80s and 90s.

“There was enough equipment, ventilators, monitors and drugs,” said Mr. Davidson of Clalit. “There was never a situation of collapse in any Israeli hospital, and every patient received maximum treatment.”

Cradle to grave

Israel’s healthcare reform of 1995 required the country’s four HMOs to accept everyone and to provide similar medical services, regardless of either pre-existing conditions or affiliation with labor unions or political parties. Clalit accounted for 63% of the market at the time and has since seen its share dented by rivals, particularly Maccabi, now the second-largest.

A medic of Israel’s Maccabi health-management organization collects a swab sample at a mobile-testing station for Covid-19.

Photo: ahmad gharabli/Agence France-Presse/Getty Images

In Israel’s system, family doctors affiliated with an HMOs each supervise between 1,000 and 1,500 residents, developing lifelong connections.

“In healthcare, Israeli citizens are very traditional. When they have a relationship with a doctor, they have it from birth to death,” said Sigal Regev Rosenberg, chief executive of the Meuhedet HMO, with 1.2 million members.

All four HMOs operate their own networks, in addition to providing coverage for independent and state-owned hospitals and, if care is unavailable in Israel, for treatment in specialized facilities overseas.

While all of Israel’s 9 million Jewish and Arab citizens have the same basic healthcare coverage, the quality of service is higher in affluent secular Jewish communities, such as in Tel Aviv, compared with poorer ultra-Orthodox Jewish and Arab neighborhoods.

Dr. Osama Tanous, a pediatrician in Haifa who is currently at Emory University on a fellowship, said the system, with its roots in the Jewish settlement movement in the early 20th century under Ottoman and British rule, never adjusted to the needs of Israel’s 1.6 million Arab citizens. As a result, Israel’s Arabs have worse outcomes than Israel’s Jews in parameters that include heart disease, diabetes and neonatal health.

Unlike Israel’s Arab citizens, the 5.1 million Palestinians in the West Bank and the Gaza Strip aren’t covered by the Israeli healthcare system. The exception are some 340,000 Palestinians, who are not citizens of Israel, living in annexed East Jerusalem.

The 1993 Oslo agreements between Israel and the Palestine Liberation Organization that established the Palestinian Authority in the West Bank and Gaza transferred the Israeli-run health infrastructure there under the Palestinian ministry of health, which provides far more limited services. In Gaza, where the Islamist Hamas movement seized power in 2007, a United Nations agency has become the most important healthcare provider.

Palestinians who work in Israel stand in line for a Covid-19 vaccine shot at the Tarkumiya crossing between the West Bank and Israel.

Photo: Sebastian Scheiner/Associated Press

The cash-strapped Palestinian Authority has been much slower than Israel in organizing a vaccination campaign, which will mostly rely on the Covax program led by the World Health Organization. Criticized by human-rights groups for neglecting to share with the Palestinians, Israel recently donated about 5,000 vaccine doses to healthcare workers in the West Bank. Last week, it began vaccinating some 120,000 Palestinians who work in Israel and the Jewish settlements in Israeli-run sites at border crossings and industrial areas inside the settlements. Covax doses also began arriving this week.

The United Arab Emirates, meanwhile, shipped some 20,000 doses of the Russian Sputnik V vaccine to the Gaza Strip, as part of its world-wide vaccine diplomacy campaign.

Israel’s swift vaccine rollout figures prominently in Mr. Netanyahu’s re-election campaign. He showed up to receive the first shipment of vaccines at the Tel Aviv airport and got inoculated during a prime-time TV broadcast. In recent weeks, he has hosted the leaders of Austria, Denmark, the Czech Republic and Hungary to share Israel’s vaccination experience.

Mr. Netanyahu, who faces a trial on corruption charges that he denies, is running to retain power in Israel’s fourth national election in two years after a previous coalition collapsed. His final campaign poster, released ahead of the vote, shows him standing with two thumbs up, surrounded by flying confetti; above, a motto proclaims: “Back to Life.”

A woman getting a Covid-19 vaccination at a temporary Clalit clinic, set up on a basketball court in Petah Tikva, Israel.

Photo: ammar awad/Reuters

Write to Felicia Schwartz at felicia.schwartz@wsj.com Yaroslav Trofimov at yaroslav.trofimov@wsj.com

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Europe’s Vaccine Suspension May Be Driven as Much by Politics as Science

Those political considerations rippled across the continent in recent days after someone in Austria who had been given the AstraZeneca vaccine died after developing blood clots. An unremarkable event, it nevertheless prompted that country in early March to stop using a batch of that vaccine. Other countries soon followed suit, raising an alarm about any new reports of blood clotting, rare as they may have been.

In recent days, Spain’s health minister, Carolina Dorias, spoke to her counterparts around the continent, according to an official from the ministry, who asked not to be named because the discussions were private. There was a case of thrombosis detected in Spain last weekend, and some regions had stopped distributing a batch of AstraZeneca vaccines, amid safety concerns.

But the chief motivation was political.

France, too, appeared to bow to pressure to act in unison with its powerful neighbors. It had been relying on the AstraZeneca vaccine to catch up on vaccinations after its glacial start, and Olivier Véran, France’s health minister, had said only days ago said there was “no reason to suspend.”

But after Germany made its intentions clear — and public — Mr. Macron had a choice between following suit or being an outlier. And so on Tuesday, Mr. Véran changed his tune. France, he told Parliament, had to “listen to Europe, listen to all the European countries.”

That was the sort of thing Mr. Speranza, Italy’s health minister, expected might happen after he spoke with his counterpart in Germany, in a discussion recounted by an Italian official with knowledge of it.

When Mr. Speranza brought the issue to Prime Minister Draghi, he noted the unbearable public pressure Italy would face if it alone used a vaccine considered too dangerous for Europe.

Mr. Draghi, a champion of European unity, checked in with Chancellor Angela Merkel in Berlin, and with Mr. Speranza decided to suspend AstraZeneca until Europe’s medicines agency gave it the all clear.

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