With Israel being the global leader in COVID-19 vaccine administration per capita, there are several factors that have ensured the success of the programme, two experts explain.
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Israel started its vaccination programme in December, led by its Prime Minister Benjamin Netanyahu. Six weeks after, roughly 64% of the general population (and about 90% of older people) in Israel had received at least one dose of Pfizer’s two-shot COVID-19 vaccine. Just over a half had got two doses. The plan is to have vaccinated 80% by May.
According to the Our World in Data, next in line are the U.K. where 18.4% of population has been vaccinated, and the U.S. with 12.3%. The gap is impressive, and there are several factors that have contributed to Israel’s success. Writing for in The BMJ Opinon, Ruth Waitzberg and Nadav Davidovitch (2021) focus on those having long-term implications, specifically availability, provision and compliance.
Availability. The authors highlight the importance of the vaccine delivery deal Israel made with Pfizer early on: the country gets enough vaccine, and the company, receiving “anonymised, aggregated epidemiological data” about Israel’s residents, tests the validity of the herd immunity approach in a real-life setting. As a result, Israel secured more vaccines per capita than any other country. At the same time, while having a robust national data management system, Israel’s laws on data protection come from the 1990s, so “questions remain about the levels of aggregated data that will be shared and how the data will be protected,” the authors note.
Provision. For inoculations Israel relied on its well-established primary care structure, in which the majority of nurses work for health plans and are authorised to administer vaccines. As such, nurses could be efficiently and timely deployed for the massive vaccination programme. In addition, health plans and local organisations combined their effort to organise distribution of the doses left over from the day to non-priority groups.
Compliance. The prevailing attitude to inoculations is positive in Israel, thanks in part to a massive information campaign led by the prominent figures, including Netanyahu. However, with Israel’s layered society, to some groups, such as ultra-orthodox Jews and Arab communities, a different approach might be needed to ensure compliance with the vaccination programme.
In an earlier piece, also co-authored by Waitzberg (Rosen et al. 2021), the researchers divided the factors that played their role in the early success of the country’s immunisation programme into three large groups.
The first one comprised basic characteristics such as Israel’s small size, young population, and robust emergency management system.
The second group contained health-system specific traits, namely well-developed organisation and infrastructure of Israel’s health system, availability of workforce, and strong ties of healthcare providers with the government, among others.
The third group included the COVID-19 specific factors like allocation of special funding for vaccination, the timely agreement with the supplier, clear prioritisation of population groups, an effective public communication campaign, etc.
The researchers noted, however, that only all those factors combined in a very Israel-specific way secured the success of the country’s programme. Indeed, there is evidence that the vaccination drives down new cases and hospitalisations among older people (Mallapaty 2021a, 2021b). However, the overall number of cases continues to rise. In an interview (Tarnopolsky 2021), Galia Rahav, the head of the infectious-disease unit at Tel Aviv’s Sheba Medical Center, attributed this to the overall weariness of general population from the lockdowns, and of the “politicisation” of the constantly changing rules.