How Israel Became a World Leader in Vaccination Against Covid-19
Is it because of the small population, or rather the clever strategy?
More than a third of Israel’s population has been fully vaccinated and is eligible for “green pass”, an entry permit that allows Covid-vaccinated inhabitants to visit gyms, bars, restaurants, and hotels. As vaccination rates are skyrocketing, Israelis are thrilled to go back to normal. How did the nation manage to get ahead in this global race?
Benjamin Netanyahu, Israel’s prime minister, and Yuli Edelstein, the health minister, made a secret agreement with Pfizer in early 2020. The deal consists of exchanging citizens’ data for 10 million doses of the coronavirus vaccine, including a promise of shipments of 400,000–700,000 doses weekly. The data includes the age, gender, and medical history of those receiving the jab as well as its side effects and efficacy. Netanyahu allows these details to be shared with the WHO too.
It is a win-win for both parties. According to a Pfizer spokesperson, Israel's small population allows for an epidemiological analysis to assess whether a certain vaccination rate will trigger herd protection on top of direct protection. This agreement helped the nation receive its first shipment of COVID-19 vaccines already by mid-December last year, making Israel ahead of any other country, even the EU and the U.S.
“We are vaccinating at 10 times the pace of the United States, no country has done what we are able to do.”- Mr. Netanyahu
However, several scholars argue that the deal with Pfizer is not the only secret to the rapid vaccine rollout. This study suggests that other specific national characteristics such as Israel’s small size (in terms of both geography and population density), a relatively young population, relatively warm weather in December 2020, a centralized national system of government (which is highly prepared for possible emergencies). And most importantly, Israel's universal health care system helped the nation triumph over Coronavirus.
Since 1995, Israel has had universal national health insurance coverage, financed primarily by the government. There are four large, competing, non-profit, health plans; the participation in one of which is compulsory for Israeli residents. All four health plans have well-developed electronic health records, not to mention the long experience in nation-wide initiatives and emergency responses. The advanced, digitized health system of the nation made communication very easy.
“We have become used to working in a state of emergency, our four health funds are used to moving quickly, instantaneously gearing up for emergencies and providing complex reassignments of a lot of personnel.” — Balicer, Director of Calit Health Services
Effective communication is an essential tool in this pandemic. An instrument that many other countries such as Belgium, and the EU in general, have failed to provide so far.
Belgium is Europe's vaccine production epicenter, yet it is the slowest in the race to vaccinate. Belgian political scientist Dave Sinardet suggests that one of the main problems impeding vaccination is communication. For example, when invitations to inoculation in Brussels were sent to 11,000 workers, only 3,000 replied to make an appointment. Why? Some of the invitations, sent out by e-mail and SMS, went into people’s spam folder. Others may have not arrived at all. He adds an extra difficulty is that the purchase of the vaccines is on the federal level and administration is on a regional level. Sinardet comments: "It is a typical Belgian situation". But is it?
Actually, bureaucratic difficulties are associated with almost any EU member state. In fact, the European Union was slower to approve the first Covid-19 vaccines than her close neighbor, the UK. Part of the delay is due to security routines. Also, approval must be given by every single member state. This process takes time. And the delay in securing contracts did not really help the situation.
Similar challenges were faced by the U.S. federal administration. According to this article, different views on vaccination rather than any of the many weaknesses of the U.S. healthcare system made the response to a nation-threatening emergency very slow. The Israeli government, although fractioned on many issues, managed to put differences aside and unify its strategy to defeat the virus. While authorities in the U.S. lagged behind fussing over ethical implications of the vaccine prioritization list and a series of other issues that only made implementation more complicated and time-consuming; Israel decided to make COVID vaccination a number one priority without worrying too much about the pricing or data-sharing arrangements in the deal.
“The importance of a unified strategy in recognizing and responding to a national emergency. Let’s hope that the incoming Biden administration sees Israel’s experience as an exemplar of that lesson.”- Sherry Glied
Consistent with Israel’s view of COVID vaccination as mission-critical, infractions of vaccine prioritization criteria were treated as understandable and forgivable. In the U.S., similar breaches, mainly associated with the need to use up open vials of vaccine (both the Pfizer-BioNTech and Moderna vaccines need to be stored at cold temperatures and used within hours of thawing), generated disproportionate recriminations.
Although Israel has some advantages, not available to many other countries, such as the very well-developed information system. It was the flexible and comprehensive vaccination strategy that made the difference. National advantages would have been useless without the clever strategy implementation.
Crisis calls for coordination and understanding, not division and red tape.
