How Israel Became a World Leader in Vaccinating Against Covid-19

JERUSALEM — More than 10 percent of Israel’s population has received a first dose of a coronavirus vaccine, a rate that has far outstripped the rest of the world and buoyed the battered domestic image of the country’s leader, Benjamin Netanyahu, at a critical juncture.

Israel’s campaign, which began Dec. 20, has distributed the vaccine to three times as much of its population as the second-fastest nation, the tiny Persian Gulf kingdom of Bahrain, according to figures compiled mostly from local government sources by Our World in Data.

By contrast, less than 1 percent of the population of the United States and only small fractions of the population in many European countries received a vaccine dose by the end of 2020, according to Our World in Data, though China, the United States and Britain have each distributed more doses overall.

“It’s quite an astonishing story,” said Prof. Ran Balicer, the chairman of the national advisory team of experts that is counseling the Israeli government on its Covid-19 response.

Israel’s heavily digitized, community-based health system — all citizens, by law, must register with one of the country’s four H.M.O.s — and its centralized government have proved adept at orchestrating a national inoculation campaign, according to Israeli health experts.

With a population of nine million, Israel’s relatively small size has played a role as well, said Professor Balicer, who is also the chief innovation officer for Clalit, the largest of the country’s four H.M.O.s.

An aggressive procurement effort helped set the stage.

The health minister, Yuli Edelstein, said in an interview on Friday that Israel had entered into negotiations with drugmakers as an “early bird,” and that the companies were interested in supplying Israel because of its H.M.O.s’ reputation for efficiency and gathering reliable data.

“We are leading the world race thanks to our early preparations,” he said.

Internal political conflicts, confusing instructions and a lack of public trust in the government left Israel seemingly fractured in October as the country struggled to cope with a surge in coronavirus cases and deaths that, relative to the size of the population, were among the worst in the world.

While restrictions imposed in the fall reduced the number of new coronavirus cases, in recent weeks, Israel has seen them rise to more than 5,000 a day, sending the country back into a third, if partial, lockdown. More than 420,000 Israelis have been infected and 3,325 have died.

Israeli officials have not publicized the exact number of vaccine doses that it has received so far, or how much it paid for them, saying the agreements are confidential. But if it turns out that Israel overpaid compared to other countries, Mr. Edelstein said, the cost would still be worth it even to reopen the Israeli economy one week earlier than it otherwise could have done.

Prof. Jonathan Halevy, the president of Shaare Zedek Medical Center in Jerusalem, said getting in early had been a “correct strategy.”

With Israel having prioritized health workers and citizens 60 and older, Mr. Edelstein said that a majority of its high-risk population should receive the second of two doses of the Pfizer-BioNTech vaccine by late January. About 150,000 Israelis are being vaccinated per day.

Mr. Netanyahu — who is on trial on charges of bribery, fraud and breach of trust — has made the vaccination campaign something of a personal mission, taking credit for signing agreements and securing millions of doses from Pfizer, along with Moderna and other companies.

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Answers to Your Vaccine Questions

With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:

    • If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
    • When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
    • If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
    • Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
    • Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

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