ALS - Unambiguous rise in cases, beginning 2021

26%-48% yearly additional cases, 2021-2024 vs. expected

Hebrew version גירסה בעברית

Amyotrophic Lateral Sclerosis (ALS) is a rare, terminal illness. It is a progressive neurodegenerative disease that leads to the loss of motor neurons, which control voluntary muscle movements. Over time, ALS causes severe muscle weakness, loss of mobility, difficulty speaking, swallowing, and eventually breathing. The average life expectancy after diagnosis is typically 2-5 years. There is currently no cure for ALS.

Following a complaint from an Israeli patient diagnosed with ALS after vaccination we send a FOIA request to the two largest HMOs, Clalit and Maccabi. Together the data covers approx. 78% of Israel’s population. The data included the monthly number of new ALS cases, 2017-2024. Both HMOs added that there may be underreporting of cases in the data. See the HMOs’ remarks and data below.

Monthly case numbers of the two HMOs were grouped into yearly cases (top graph). Next, the data was adjusted by calculating the Rate per 1 Million members. The first four years (2017-2020) formed a decreasing logarithmic regression line which is considered the baseline and represented the trend well (R²=0.9998). The following years (2021-2024) exhibited extreme peaks in case numbers above expected (the Covid-19 Pfizer vaccine campaign began just before 2021, On December 20th, 2020 ).

Finally, we extrapolated the data to the total population of Israel in each year separately, and estimated excess cases. According to the calculation, a total of 201 people were diagnosed with ALS in Israel 2021-2024, beyond expected.

Discussion

Could the rise in cases be caused by Covid-19 disease? Probably not. Despite almost half a million Covid-19 cases detected in 2020, this year was very much in line with the baseline. In addition, there is no clear evidence in literature of Covid-19 causing ALS. In fact, one study concluded that the Covid-19 infection phenotype was inversely associated with the risk of ALS (1) .

Could the rise be caused by mRNA vaccines? There is no clear evidence to support this either, but mRNA vaccines are linked to other neurological adverse events (2) , such as Bell’s Palsy, Hemorrhagic Stroke, GBS etc. There is a documented case of ALS following the J&J Covid-19 vaccine (adenovirus vector, non-mRNA) (3) .

Maccabi HMO explained the rise in case numbers by ageing of the population, based on a research which predicts a worldwide increase in cases. Our analysis is based on a larger dataset (also Clalit HMO’s data) and does not seem to agree with this theory.

News reporter diagnosed with ALS

On July 2022 Moshe Nussbaum, a famous Israeli journalist, was diagnosed with ALS (4) (5) . In an interview he claims the disease could have emerged due to a water cannon hitting him while participating in a political protest (6) .

Nussbaum had also participated in a Covid-19 vaccine trial and advertised it publicly (7) . The person on the right is Prof. Gili Regev-Yochay (head of the Infection Prevention and Control Unit in Sheba hospital) who advocated for the Pfizer vaccine during the pandemic, conducted the trial, and also received unrelated research grants from Pfizer, as she stated under the Competing Interest Statement in an article (8) .

Conclusion

While there is no evidence to indicate a causal link between mRNA vaccines and ALS, the rise in ALS cases in Israel has not been addressed nor investigated yet. Further research is necessary to validate or disprove this hypothesis.

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Remarks

Attached are remarks provided together with the data. Maccabi’s note on population ageing as the primary explanation for the rise in ALS cases was tested: Indeed there was an ageing effect of Maccabi members, approx. 6% more along 6 years, but the growth of the cohort was linear (R²=0.992) and therefore does not affect the reliability of regression analysis based on early years, since the rate of ageing was constant.

Maccabi HMO’s original data and remarks:

Along with the data, we note that this is a rare disease, and worldwide there is an increase in disease rates, including in Israel. There are several medical reasons for this, with the most prominent likely being the aging of the population, as this disease is typically diagnosed in older patients. We should also mention that when dealing with rare diseases with very small numbers of diagnosed cases, the possibility of bias should be taken into account, as some patients are treated in hospitals or nursing facilities, rather than through health maintenance organizations.

Clalit HMO’s original data and remarks:

1. The ALS category includes cases where there is a clear diagnosis of ALS in the record, and it is likely an underestimate of the true number of cases.

2. The ALS+MND category also includes cases of other MNDs along with ALS cases for which an MND diagnosis was written in the record, and therefore, in our assessment, represents an overestimate.