Israeli COVID-19 vaccination program: Safe. Simple. Flexible.

Israel is becoming the global leader in successful COVID-19 vaccination. What aspects of the country's program can be transferable and scalable to other countries planning their vaccine rollout?

Watching my 83-year-old vaccinated father-in-law, a holocaust survivor, hugging my 15 year-old daughter after one long year of social distance- made all of us very emotional. We cried and suddenly felt full of hope!

Thanks to the Israeli Vaccination Program, we have found new hope.

With universal healthcare, a world-renowned expertise in emergency preparedness, a highly digitally integrated health system, and good vaccine compliance, Israel is becoming the global leader in successful COVID-19 vaccination. How did we get here? What lessons can be learned? What aspects of Israel’s successful program can be transferable and scalable to other countries planning their vaccine rollout?

Procurement

Israel initially joined the World Health Organization and GAVI[1] – The Vaccine Alliance in the COVAX Facility, which facilitated access for at least 20% of the population. We also entered into talks with Pfizer, Moderna, and Astra-Zeneca at very early stages of their vaccine trials. The effort to procure vaccines was “all hands on deck”, led by the Prime Minister’s Office, the Ministry of Health, and the Ministry of Defense.

Logistics

Airport - storage facility - provider - patient. We have a clear and well-rehearsed strategy for getting the vaccines from plane to patient, which includes splitting up shipments into smaller batches in order to reach smaller vaccine centers and minimize waste. Forward planning on distribution and defrosting has been critical to avoid waste. The Ministry of Health works with the Health Maintenance Organizations (HMO), and hospitals, to ensure each provider receives the number of doses they require, an effort supported with digital tools.

Distribution

The vaccination operation is carried out primarily by the four HMOs. Our universal healthcare structure ensures that every Israeli is enrolled in one of the four HMOs, and each HMO coordinates their patients’ vaccinations. The strong relations between Israelis and their HMOs is integral in the vaccine rollout. Moreover, training members of the medical community from EMTs and paramedics to nurses and doctors has helped to surge our capacity for daily dosing.

Cross-sector cooperation is important to make vaccination accessible to populations living far away from vaccination centers. Israel Defense Forces (IDF) and Magen David Adom (MDA)[2] ambulances are helping distribute the vaccines in remote locations and bringing homebound patients to vaccination centers.

The IDF also provides additional personnel to vaccination centers in the form of hundreds of reserve medics who support and enhance the vaccination campaign.

Patient outreach

Israel is a world leader in digital health, and this has been integral to our vaccination strategy. The National Health Information Exchange makes electronic medical records (EMR) available at all points of care in a safe and secure manner. The integration between these records and the HMO’s communications capacities makes it easy to coordinate appointments for targeted populations based on health/age criteria. The vaccinations are then also recorded through the national health information exchange. In cases where there are leftover or defrosted doses, we use digital tools to identify and contact target groups so that no doses are wasted. The simplicity of using interfaces familiar to health providers to book appointments, where the HMO takes a proactive role has contributed to our success.

Prioritisation

An integral facet of our vaccine strategy is its simplicity. Everyone in Israel knows who has been prioritized (first priority went to medical staff, institutionalized persons, and 60+ population, and now 16+ population excluding recovered patients). The simplicity of this tiered approach took a tremendous decision-making burden off doctors, streamlining our rollout.

The prioritization has a crucial impact on the continuity of the economy and the emergency management efforts. We, at NEMA, had prioritized a small group of "essential workers" so that critical infrastructure (water, electricity), health and security sectors employees can provide their services.

Israel is also thinking about younger generations and hence prioritized the education sector early on, especially teachers and grades 11-12, so that the educational system was able to open safely.

Vaccine compliance

In general, Israel has a very high level of vaccine compliance. Thanks to our internationally recognized pediatric vaccination program, Israelis generally support vaccinations. Media campaigns using influencers and public figures from each sector of Israeli society, including leaders such as the Prime Minister and Minister of Health, have also encouraged people to line up to vaccinate. We have also tailored our media outreach to certain minority communities including those who do not use many modern means of communication.

Here is some data as of February 24, 2021:

We have administered over 4.5M first doses and over 3.1M second doses, which together with our recovered patients accounts for over 57% of our population.

Finally, we hope that Israel and the rest of the world will soon go back to normal and build back better the resilience for future threats and emergencies.

My thanks for the Israeli Ministry of Health, for providing the data and information presented in the article.

Mrs Grimberg is a Division Head at the Israeli National Emergency Management Authority in Ministry of Defense.

Over the past decade, Mrs Grimberg has been leading the long term strategic planning and thought leadership practice on topics of national emergency readiness relating to all emergency scenarios and the impact of the Geo-Political situation on the response for each emergency situation.

In 2018, Mrs Grimberg had been nominated as the Israeli focal point for the UNDRR and the Sendai Framework for Disaster Risk Reduction working group. In this capacity, Mrs Grimberg is spearheading the implementation of the DRR principles in both existing working processes and in long term national strategy in Israel.

In addition, Mrs Grimberg coordinates the practical research for emergency situations in NEMA and how it translates to all government ministries and first responders in Israel.

Mrs Grimberg holds a BA in Geography and International Relations and an MA in Business Administration from the Hebrew University in Jerusalem.