Israel’s rapid rollout of vaccinations for COVID-19

Abstract

As of the end of 2020, the State of Israel, with a population of 9.3 million, had administered more COVID-19 vaccine doses than all countries aside from China, the US, and the UK. Moreover, Israel had administered almost 11.0 doses per 100 population, while the next highest rates were 3.5 (in Bahrain) and 1.4 (in the United Kingdom). All other countries had administered less than 1 dose per 100 population.While Israel’s rollout of COVID-19 vaccinations was not problem-free, its initial phase had clearly been rapid and effective. A large number of factors contributed to this early success, and they can be divided into three major groups.The first group of factors consists of long-standing characteristics of Israel which are extrinsic to health care. They include: Israel’s small size (in terms of both area and population), a relatively young population, relatively warm weather in December 2020, a centralized national system of government, and well-developed infrastructure for implementing prompt responses to large-scale national emergencies.The second group of factors are also long-standing, but they are health-system specific. They include: the organizational, IT and logistical capacities of Israel’s community-based health care providers, the availability of a cadre of well-trained, salaried, community-based nurses who are directly employed by those providers, a tradition of effective cooperation between government, health plans, hospitals, and emergency care providers – particularly during national emergencies; and support tools and decisionmaking frameworks to support vaccination campaigns.The third group consists of factors that are more recent and are specific to the COVID-19 vaccination effort. They include: the mobilization of special government funding for vaccine purchase and distribution, timely contracting for a large amount of vaccines relative to Israel’s population, the use of simple, clear and easily implementable criteria for determining who had priority for receiving vaccines in the early phases of the distribution process, a creative technical response that addressed the demanding cold storage requirements of the Pfizer-BioNTech COVID-19 vaccine, and well-tailored outreach efforts to encourage Israelis to sign up for vaccinations and then show up to get vaccinated.While many of these facilitating factors are not unique to Israel, part of what made the Israeli rollout successful was its combination of facilitating factors (as opposed to each factor being unique separately) and the synergies it created among them. Moreover, some high-income countries (including the US, the UK, and Canada) are lacking several of these facilitating factors, apparently contributing to the slower pace of the rollout in those countries.

The Implementation of Mass-Vaccination against SARS-CoV-2: A Systematic Review of Existing Strategies and Guidelines

“…One of the most important aspects of vaccine delivery is the equitable access of vaccines to the entire population and vaccinating vulnerable populations to reduce morbidity and mortality [56]. Although Israel has been successful in delivering vaccines to the vast majority of its population, the country is wealthy, well-resourced, and has a small population [9]. The ability to extend this to the Palestinian population remains a challenge [9].…”

“…By the end of February 2021, Israel had vaccinated over 80% of its population, presenting a model for rapid implementation [8]. Israel's success has been attributed to high-level political commitment together with coordinated and well-resourced collaboration between the government and health care providers [9]. Despite this early progress, more than 100 countries are yet to commence vaccination [8].…”

BNT162b2 COVID-19 mRNA vaccine elicits a rapid and synchronized antibody response in blood and milk of breastfeeding women

“…The accelerated COVID-19 vaccination campaign in Israel was initiated in December 2020 and currently nearly 50% of the adult population have received the Pfizer-BioNTech BNT162b2 COVID-19 mRNA vaccine (mRNA vaccine) 1 . The vaccine campaign initially targeted high-risk populations (≥60 years old and healthcare providers) 2 and was soon expanded to lactating women 3 .…”

An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times

“…The United Kingdom and Israel are the leading countries in COVID-19 vaccination. Different factors have contributed to this accomplishment, particularly, robust and coordinated efforts within healthcare systems and governmental institutions [84,85]. Some examples of these factors are the stratification of fewer groups with a reduced age threshold to be prioritized, their rapidness in starting with massive vaccination programs, and the creation of multiple vaccination sites [86][87][88].…”