What America Can Learn from Israel’s COVID-19 Vaccine Rollout

As the U.S. struggles to figure out how to vaccinate its population against the coronavirus amid soaring morbidity and death rates, Israel has made its vaccine rollout look easy. And while Israel is much smaller than the U.S. and different in key ways, there are lessons from the Israeli experience that can help Americans fight the virus. 

With a population of about 9.3 million, Israel managed to vaccinate 2.6 million citizens with a single dose and 1.2 million receiving both doses by January 25, after beginning its vaccination campaign on December 19—just shy of a week from the date of the first shot administered in America.

In Israel, the vast majority of the deaths from the virus were among the elderly, and the elderly were given priority for the vaccine. Less than a month into the campaign, more than 72% of Israeli senior citizens had been vaccinated. On December 20, medical personnel began to receive the vaccination. While each of these groups had priority in the U.S. as well, healthcare workers generally received shots first.

By December 21, Israelis over 60 and anyone with chronic illnesses were eligible to receive the vaccine. Only after the majority of those over 60 and medical personnel were vaccinated was the campaign opened for teaching staff and younger people. The age for eligibility to receive vaccines went down by about a decade a week. 

A Celebratory Public Health Campaign

The rollout was carried out so quickly for several reasons. One was the willingness of the population to be vaccinated. While surveys taken as recently as mid-December showed about 30% of the population was skeptical about the vaccine, the government allayed the public’s fears in a number of ways.

On the night of December 19, Prime Minster Benjamin Netanyahu and Health Minister Yoel “Yuli” Edelstein were vaccinated on live television, which was broadcast on all three Israeli television networks, as well as on social media.

The next morning, Professor Ronni Gamzu, a doctor well known to the public due to his stint as the coronavirus czar, which ended in November, was vaccinated in the lobby of the Tel Aviv Sourasky Medical Center, the hospital where he is the CEO. It was a festive event widely covered in the media. A popular singer serenaded him as doctors and nurses danced. Gamzu was joined by the finance minister, another well-known politician, and a famous rabbi. Stations were set up in the lobby and medical staff and over-60 celebrities were vaccinated all day. Vaccinations continued in the following weeks in hospitals, stadiums and pop-up stations in city squares.

“Soon, everyone had a relative who had been vaccinated and this helped build confidence and trust in the vaccine,” Professor Jonathan Halevy, the president and former director general of Shaare Zedek Medical Center in Jerusalem, tells Verywell. The public celebrity vaccinations also helped, he says.

Another factor in building public trust is that the anti-vax movement, while it exists, has never been strong in Israel, noted Professor Nadav Davidovitch, director of Ben-Gurion University of the Negev’s School of Public Health, in a webinar held by the Jerusalem Press Club in January. “Vaccinations are embedded in our culture, through a strong system of mother-child healthcare clinics,” he said. This community clinic system insures that children receive their vaccinations on schedule and that the public does not fear them.

Universal Health Care Simplifies Logistics

Winning public trust was only part of the vaccination battle. Israel had to acquire the vaccines from abroad, since the vaccine Israeli scientists had been developing, BriLife, was not ready yet. 

Early on in the pandemic, long before any vaccine was approved for use, the Israeli government made plans with various companies to acquire their vaccines as soon as they were ready. “Very early in the development stage of the [Pfizer] vaccine, the prime minister spoke 17 times to the CEO of Pfizer,” Halevy says. “I’m unaware of any other head of state who took time out to nudge the CEO.” The American president at the time, Donald Trump, “didn’t take the pandemic seriously,” he says.

Once the vaccines were flown into Israel, the government wasted no time in getting them to the people who needed them. “The main reason for this could happen so quickly is Israel’s national healthcare system,” Halevy says.

 “Every person has a primary healthcare physician he knows personally,” Halevy says. In addition, the system has computerized data on each patient, which makes it easy to contact them. As soon as the vaccine became available, Israelis eligible to be vaccinated received text messages, phone calls and, in some cases, emails from their health funds, asking them to make an appointment. While there were some glitches in the early days—people were put on hold and disconnected, etc.—soon, appointments were made.

A special effort was made to bring the vaccine to the most vulnerable population, the elderly living in nursing homes. The health funds also provided transportation and staff to help some of the homebound elderly receive vaccinations. And the moment a first dose was given, an appointment was made automatically for that person’s second dose. 

“When you have an integrated healthcare system, it does help,” Dr. Yoav Yehezkelli, a lecturer in the master of disaster management program at Tel Aviv University,, tells Verywell. He says in Israel, all the health funds keep up-to-date contact information on file for all members. By contrast, according to the University of Michigan's National Poll on Healthy Aging, 45% of US senior citizens lack online medical accounts that they could use to sign up for COVID-19 vaccinations.

Crisis Management as Culture

Another factor that has helped Israel mobilize to vaccinate so quickly is its long experience in being prepared for disasters. “Israel is in a constant state of emergency,” Davidovitch said, due to war and terror threats. During both Gulf Wars, for example, the government feared Iraq would target Israel with chemical weapons, as it had threatened to do, so kits containing gas masks and syringes filled with atropine were distributed to all Israelis, along with instructions on how to use them. A mass vaccine campaign was not daunting for a population used to coming together in times of trouble, Davidovitch said. 

Israelis have found creative ways not to waste doses of the vaccine, which must be used quickly or discarded once they are removed from cold storage. Waste is anathema in Israeli culture, where people tend to live frugally. Even wealthy Israelis do not have hot water 24 hours a day, but heat water before they shower. When there are unused doses of vaccines left at the end of the day, they are given to anyone in the vicinity, as The Jerusalem Post reporter Gil Hoffman can attest. On January 7, he tweeted that he was passing a nursing home and a volunteer from Magen David Adom, Israel’s Red Cross equivalent, stopped him in the street and offered to give him a vaccine dose that was left over after all the residents and staff had been vaccinated. The Israeli press has been full of dozens of such stories.

Takeaways for the U.S.

As President Biden works to put together a workable plan for vaccinating America, he can learn from what Israel has done, Halevy says, suggesting the federal government leave more of the decisions to each state. “On a state by state basis, each state can develop its own plan for how its vaccine program can work,” he says.

Yehezkelli agrees. “Even if you have a fragmented system, like in the States, you can deal with the situation on the state and county levels,” he says.

They also both recommend a major media push on the part of trusted authority figures and celebrities to convince the public that the vaccine is safe. 

While the U.S. faces an uphill battle because of the nature of the American medical system, this could be a wake-up call that it is time for a more centralized approach to medicine—one that would make it easier to cope with a public-health emergency. “The issue of preparedness is very important And it shows that access to good healthcare for everybody is important and not only during emergencies,” Yehezkelli says.

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