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The Israeli immunization programme and population vaccination principles
An immunization programme protects both the individual and the community: once the share vaccinated passes the herd immunity threshold, the chain of transmission is broken – so high coverage, the cold chain, records and adverse-event surveillance matter as much as the vaccine itself.
Why it matters in the exam
The exam includes practical items from the Ministry of Health immunization guide: a child who missed doses and needs a catch-up plan, the interval between two live attenuated vaccines (on the same day or at least 28 days apart), vaccines in pregnancy (pertussis and influenza), influenza vaccination ages (from 6 months), HPV vaccination in eighth grade, and vaccination of health workers and health-profession students. Other items deal with computing vaccine efficacy from attack rates in vaccinated and unvaccinated people, the herd immunity threshold, and the difference between efficacy in a trial and effectiveness in the field. Also tested is vaccine refusal – in Israel vaccination is not compulsory, and the team's role is explanation and access – and the polio debate: Israel combines an inactivated injected vaccine with a live bivalent oral vaccine, because the inactivated vaccine protects the individual but does less to stop spread in the gut. Further items ask about true contraindications, such as anaphylaxis to a previous dose, versus false contraindications such as a mild fever.
Key points
- Herd immunity also protects those who cannot be vaccinated.
- The herd immunity threshold is one minus one divided by R0.
- Live attenuated vaccines are given on the same day or at least 28 days apart.
- In pregnancy, pertussis vaccination in every pregnancy and influenza vaccination are recommended.
- A mild illness is not a contraindication; anaphylaxis to a previous dose is.
Summary table
| Principle | Meaning | Exam example |
|---|---|---|
| Herd immunity threshold | One minus one divided by R0 | Measles, with a high R0, needs coverage of about 95% |
| Vaccine efficacy | (attack rate in unvaccinated minus vaccinated) divided by the attack rate in unvaccinated | 10% versus 2% – an efficacy of 80% |
| Live attenuated vaccines | On the same day or at least 28 days apart | MMRV and varicella; forbidden in pregnancy and severe immunosuppression |
| True versus false contraindications | Anaphylaxis to a previous dose, versus a mild fever or antibiotics | A mild illness is no reason to delay vaccination |
| Vaccination in pregnancy | Pertussis (Tdap) in every pregnancy and influenza in season | Protects the infant in the first months |
| Polio in Israel | Inactivated injected vaccine combined with a live bivalent oral vaccine | The live vaccine prevents spread in the gut |
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Sources
- Israel Ministry of Health, Division of Epidemiology – Immunization guide (תדריך חיסונים), current edition — General principles and routine schedule
- WHO, Immunization in Practice, 2015 — Planning and managing immunization sessions; Vaccine safety
- Plotkin's Vaccines, 8th ed., 2023 — Community protection
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.