What Israel's Vaccine Rollout Got Right
Updated: Jan 27, 2021
Patients at a COVID-19 vaccination center in Tel Aviv (Photo by Oded Balilty/AP)
Many countries with sluggish COVID-19 vaccine rollouts looked to learn from Israel’s success.
Israel expects to accomplish inoculation of its 8.9 million population by the end of April. The vaccination program began on December 19. By January 21, Israel had given at least one of the prescribed two jabs to 2.37 million, ranking third in the world for number of people. The country’s comparatively small population will help it toward its goal.
The United States (population 331 million) ranked first with number of people who received at least one jab at 14.27 million (January 20); the United Kingdom (population 68 million) was second at 4.61 million (January 19), and Portugal (population 10 million) ranked 11th at 106,000 (January 15), according to Our World in Data website, which is a collaboration between University of Oxford researchers and a nonprofit.
“It’s amazing. It is going well beyond my wildest dreams, and it’s not often I can say that,” Ronit Calderon-Margalit, professor of epidemiology at the Hadassah-Hebrew University Braun School of Public Health told CNBC (January 8).
What is Israel doing right?
To find out, hundreds of government officials and journalists from around the world attended an online briefing last week by the Israeli Ministry of Health.
Advance planning and effective collaboration among government and health agencies as well as flexibility have been key to Israel’s success, according to Dr. Asher Salmon, head of the International Relations Department of Israel’s Ministry of Health, in The Irish Times (January 21).
The priority group includes those older than 60, healthcare workers, carers and high-risk populations. However, the rollout’s flexibility is shown when the young and healthy can be vaccinated at the end of the day with surplus stock to avoid the waste of unused vials.
Along with advance planning, an informational campaign to gain the people’s trust also worked in Israel’s favor, Dr. Boaz Lev, who chairs the advisory committee for epidemic control and coronavirus vaccines at Israel’s Ministry of Health, told CNBC.
Anti-vaccine sentiment is low in Israel with mainstream media of all political leanings supporting the vaccination drive. The government also launched a campaign against misinformation. The Ministry of Justice successfully petitioned Facebook to remove four groups that published “content designed to mislead about coronavirus vaccines,” according to The Guardian (December 30).
“Create a good flow of vaccines, a good flow of people . . . with a good administrative background so that you can register them and they know when to come for their next jab,” said Lev.
Meetings on Zoom taught staff how to prepare and administer the inoculations. For example, the Pfizer vaccine, stored at -70 Celsius, may be thawed in the refrigerator (about 2 to 3 hours) or at room temperature (30 minutes to 2 hours). Once thawed, the vaccine should not be refrozen. Vials at room temperature must be mixed with 0.9 percent sodium chloride within two hours or returned to the refrigerator. After mixing, the vial should be gently inverted 10 times, not shaken. After six hours, any unused vaccine must be discarded, according to the U.S. Centers for Disease Control and Prevention.
Vaccines in Israel are administered at 350 locations, ranging in size from local health centers to large sports stadiums, reported The Irish Times.
Israel’s public health system requires everyone to belong to one of four healthcare maintenance organizations, according to CNBC. Vaccine supplies were distributed to the health groups, which allocated them to their members.
“They’re very good with the logistics of distribution of services, of the vaccines,” said Calderon-Margalit, professor of epidemiology.
Chief Medical Officer for the Israel Defence Forces (IDF), Colonel Dr. Tomer Koler, said that collaboration between the military and Israel’s strong public healthcare system contributes to the efficiency of the vaccine rollout.
“The IDF and the medical corps and the home-front command are intertwined with civilian life in Israel,” Koler told TIME (January 15). He said that the IDF called up and trained 700 reservists to support the healthcare providers.
In addition, Israel’s health system is highly digitized. Therefore, everyone’s inoculations are registered by the Ministry of Health.
Also, there seems to be an ample supply of vaccines, though Israeli officials have not revealed the quantity. However, vaccine-makers said that the country already has secured 8 million doses of the Pfizer/BioNTech vaccine and agreed to 6 million of the Moderna vaccine, both of which require two doses. The first shipment of 100,000 doses of the Moderna vaccine was scheduled to be delivered earlier this month, according to The Times of Israel (January 6).
“But in both cases, Israel ordered significantly larger quantities of the new vaccines than other countries, many of which waited for cheaper alternatives to come on stream,” reported The Irish Times.
Salmon, of Israel’s Ministry of Health, acknowledged that Israel paid “a bit more” than the European Union for its vaccine supplies:
“We paid the best price we could get. I don’t know what others did but yes, I think our terms were less favorable than yours.”
However, Salmon said that the price of COVID-19 vaccines is “ridiculously low” compared with the “terrible economic damage” caused by virus-related closures.
An Israeli Ministry of Health official said the country paid $62 a dose as compared with $19.50 by the United States, according to The Guardian (January 3).
Early on, administrators recognized the need to break up supplies of the Pfizer vaccine into smaller parcels, according to The Irish Times. The 950-vial units were too much for many vaccination locations, especially given the storage and transport requirements. So, the vaccines were repackaged into smaller cases.
Finally, call centers support the work of health professionals by registering people as well as answering questions.
Each weekend, the distribution plan is reset in preparation for the following week. Deliveries occur three times a week.
Israel has agreed to share weekly data with Pfizer “to determine whether herd immunity is achieved after reaching a certain percentage of vaccination coverage in Israel,” according to Reuters (January 18).
Israel transports and distributes COVID-19 vaccines in the West Bank. However, they are only given to Jewish settlers, not the 2.7 million Palestinians living around them who may have to wait weeks or months, according to The Guardian (January 3).
“I don’t know how, but there must be a way to make us a priority, too,” said Mahmoud Kilani, a 31-year-old sports coach from the Palestinian city of Nablus.
Israeli officials have suggested that they might provide surplus vaccines to Palestinians and claim that they are not responsible for Palestinians in the West Bank and Gaza, citing 1990s interim agreements.
Salmon, of the Ministry of Health, said that Israel has an interest in the vaccine becoming available in the Palestinian Authority as quickly as possible, according to The Irish Times. With 100,000 Palestinians passing in and out of the country each day, it would be impossible to eliminate the disease in one country without doing so in the other.
Government ministers voted to extend a national lockdown by an additional 10 days to January 31 as Israel experienced its highest yet COVID-19 infection rate, according to The Times of Israel (January 19).
The Ministry of Health said that a record of 10,051 infections was confirmed on January 18, bringing the country’s total caseload to 565,629, including 82,652 active cases. The rate of positive tests passed 10 percent for the first time in more than three months, with 10.3 percent of more than 100,000 tests coming back positive.