Israel's Vaccination Success Due, In Part, To Innovations In Distribution

Rather than take the manufacturers' guidance on distribution, Israel's logistics experts found ways to make the initiative more efficient, which saved time, reduced waste and even enhanced the number of doses they could get from the shipments they had bought. 

Israel also bought data from the manufacturers. But despite its many successes, the refusal by some segments of the country's ultra-religous minority to take precautions has caused infection rates to continue to climb. JL

Jennifer Huizen reports in Medical News Today:

Those responsible for logistics have stored the vaccine doses underground near Israel’s main airport. They are in 30 large freezers, which are capable of holding 5 million doses. (They) also developed a way to repack doses from large, ultra-frozen pallets into insulated boxes roughly the size of a pizza box. Doing this has made it easier to distribute vaccine doses in smaller numbers and to remote sites. Healthcare professionals also managed to obtain more vaccine doses out of each vial than Pfizer advertised. Israel’s government agreed to pay top dollar for vaccines and purchase millions of doses. The price was about $30 per vaccine — double the average price abroad.

While the United States has struggled to meet COVID-19 vaccine rollout goals, within just 2 weeks, Israel vaccinated almost 15% of the country’s population of more than 9 million.

As of January 19, 2021, 25.6% of the Israeli population have received their first vaccine dose, and 550,000 people have received both doses.

To give some perspective, Israel is vaccinating residents at a rate of 32.4 people per 100, compared with 4.8 people per 100 in the U.S., and 7 per 100 in the United Kingdom.

But why exactly has the rollout been so successful in Israel? And what can we learn from this early success? In this Special Feature, we review what’s known about Israel’s COVID-19 vaccine rollout.

Early rollout successes

Israel’s success in rolling out the COVID-19 vaccine seems to be due to several factors influencing the access to and distribution of the vaccine.

The Israeli government started searching early on for a way to secure vaccine doses.

In June 2020, Israel became one of the first countries to sign a purchase agreement for a vaccine supply from Moderna. In November, the country announced additional vaccine deals with AstraZeneca and Pfizer.

The first Pfizer vaccine doses arrived in Israel on December 9, 2020, and vaccinations began on December 19, 2020. The country is still waiting for the other two vaccines.

Israel’s government also allegedly agreed to pay top dollar for vaccines and purchase millions of doses. Although the exact price is unknown, one official said that the price was about $30 per vaccine — double the average price abroad.

The makers of the vaccine that Israel is currently using — U.S. company Pfizer and German partner BioNTech — would not comment on the cost of the vaccine.

In exchange for an early, steady vaccine supply, the Israeli government also assured Pfizer that the country’s rollout would offer quick, large-scale results, promising to give the company detailed patient information on those receiving the vaccine in Israel.

Israeli officials expected Israel’s vaccine rollout to be successful because the country is small but has a vast healthcare infrastructure. The country also has a well-developed, universal healthcare system that connects all residents to a national digital health network.

All residents also have insurance from semi-private healthcare maintenance organizations (HMOs) that run services throughout the country, even in rural, remote regions.

Israel’s centralized, digitized system makes it easier to track and access information and roll out national healthcare agendas, such as vaccination campaigns.

“In a sense, Israel has become like a very large clinical trial,” Hadassah Medical Center virologist Dr. Rivka Abulafia-Lapid told The Times of Israel.

“Because everyone in Israel belongs to an HMO, and their records are kept along with their background data, this means we’ll get a good picture of responsiveness to the vaccine, in context of age, gender, and existing medical conditions,” Dr. Abulafia-Lapid added.

Distribution successes

Israel’s vaccine rollout success is also due in part to the handling of the vaccine and its delivery to citizens.

Those responsible for logistics have stored the vaccine doses underground near Israel’s main airport. They are in 30 large freezers, which are capable of holding 5 million doses.

Teams in Israel have also developed a way to repack doses from large, ultra-frozen pallets into insulated boxes roughly the size of a pizza box. Doing this has made it easier to distribute vaccine doses in smaller numbers and to remote sites.

Teams repack large vaccine pallets into bundles containing as few as 100 doses, which they then deliver to 400 vaccination centers. Healthcare professionals have also managed to obtain more vaccine doses out of each vial than Pfizer had initially advertised.

Pfizer have approved both of these processes.

Some 335 drive-through vaccination clinics also exist throughout Israel, allowing healthcare professionals to vaccinate larger groups of people quickly. On January 19, 2021, the country announced a new daily record of more than 210,000 vaccinations in 1 day.

Israel began vaccinating healthcare workers, teachers, people with medical conditions, and those over the age of 60 years. Now, the country is racing to vaccinate the entire population over the age of 16 years — equating to about 5.2 million people — by the end of March. As of January 20, Israel has started vaccinating residents over the age of 40 years.

At the time of writing, Israel has given at least one dose of the vaccine to more than 76% of the country’s inhabitants who work as teachers, are over the age of 60 years, or have health risks.