How Has Israel Vaccinated So Many People So Quickly? https://mosaicmagazine.com/observation/israel-zionism/2021/02/how-has-israel-vaccinated-so-many-people-so-quickly/

It’s a question I’ve been asked by friends all over the world: how has Israel vaccinated so many people so quickly?

As of this week, over 2.5 million people there have now received both doses of the Pfizer or Moderna COVID-19 vaccines—a quarter of the population—and over 42 percent of the population have received their first shot. In the UK, meanwhile, which is technically ranked as the third leading nation in the vaccine rollout, 15 million people have received a single dose (about 20 percent of the population) while just roughly 530,000 have received their second one. In the United States, just 4.2 percent of the population have received both doses of the vaccine.

So suddenly Israel finds itself to be the envy of the world and the object of puzzled praise from mainstream media and social media alike. Even petty attacks highlighting Palestinians’ lack of access to the vaccine access—not Israel’s fault—have not taken off.

Everyone, it seems, has an explanation for this success. Many of them contradict, overlap, and circle around each other. Are any of them right?

Some credit Israel’s hard-won crisis preparedness and infrastructure. As a nation vulnerable to the whims of volatile neighbors, Israel faces its fair share of military crises, which translates to an unusual propensity for reacting and managing mortal threats. And the IDF has a proportionally huge number of active personnel and reservists, some of whom have been recruited to administer the shots alongside nurses and doctors. But a country like Singapore proudly boasts many of these same characteristics—it too is a small, wealthy, organized nation that drafts almost all of its citizens—and is nonetheless currently struggling to convince its population to get vaccinated. Besides, if Israel is so great at dealing with crises, how did the virus spread there to begin with?

American reporters and researchers, meanwhile, tend to be fond of praising “the secret sauce behind Israel’s successful COVID-19 vaccination program.” According to them, the answer is “Israel’s vast public-health infrastructure.”

Yes, it is true that Israel’s health system is publicly funded and that it requires (and ensures) that each citizen has access to healthcare. A solid health system surely helps the vaccination campaign, but it’s hardly the source of its strength. Most European countries, however, have similar public healthcare systems guaranteeing access to all, yet they’re still falling behind on vaccinations. In the UK, where I grew up, and where the virus death toll is climbing above 115,000, the National Health Service—a public institution often seen as the pride of the country—is logistically, financially, and medically struggling to keep up. Reports from family and friends indicate that scenes inside British vaccine facilities look far more like a crude and inaccurate caricature of chaotic, bureaucratized Israel than Israel itself ever could. Elderly ladies and gentlemen line up outside in the cold for hours on end and crowd waiting rooms for even longer alongside dozens of other vulnerable individuals as shot schedules are fumbled. Doctors turn away those who have allergies to things as unassuming as tomatoes, on the spot, despite having already invited and scheduled them for vaccination. (In Israel, you’re in and out within minutes, and if you have a food allergy, you simply take a Benadryl and move on.)

So the answer is not simply public healthcare. Besides, Israel’s healthcare system doesn’t fall squarely under the “public” category, allowing as it does for a large degree of competition between four rival health “funds.” And as of 2016, according to a leading study of international private health insurance, almost 60 percent of Israelis paid into a commercial insurance program. (Perhaps one could argue that it is this spirit of friendly competition—among Israeli health funds and hospitals alike—that has propelled Israel into the world-class health destination it is known as today.)

 

Where else to look, then? Some analysts have argued that Israel’s vaccine success reflects the fact that the prime minister is now up for a last-ditch election. Without Netanyahu’s fear of prison time (he’s under several long-running indictments and investigations), or national embarrassment if he loses that election, the argument goes, he would not have had the motivation to argue his way into receiving so many shipments of vaccines before many other countries, or to have called up Pfizer’s CEO dozens of times to arrange the deal. (The premium price Israel is paying might have helped, though—reportedly, Israel is paying $47 per person for the Pfizer and Moderna vaccines.) Josef Federman of the Associated Press argues that Netanyahu “appears to be betting that a successful vaccination effort can persuade voters to forget about his corruption trial and the economic damage caused by the coronavirus crisis.”

It’s true that Netanyahu is under a lot of pressure to perform right now, but what world leader isn’t? In the United States, as an election loomed, the outgoing president nonetheless chose to sideline pandemic response. In Canada, Prime Minister Justin Trudeau declined to buy 16 million more doses of the Moderna vaccine offered to the country, despite his teetering minority government and scandal-filled tenure. So maybe the answer is: threaten your leader with jail time unless he shapes up, though then again that doesn’t seem to have helped in America.

Whatever you do, don’t threaten the doctors, a signal mistake that America seems to love to make. A doctor in Houston is now famous for being fired and charged with theft for giving expiring vaccine doses to elderly patients and acquaintances so that it wouldn’t go to waste, while in New York City, a Harlem clinic tossed vaccines under similar legal fears.

Israel has thankfully avoided shooting its doctors in their feet. Starting last month, even as it was only officially vaccinating the general population over the age of sixty, its health providers tacitly approved of nurses offering spare doses not only to random, fortuitous passersby, but even to organized loiterers (a phrase that could describe many people in that country) outside of vaccine facilities. I know a few of them. In January I was sitting in the Tel Aviv apartment of one of my closest friends, a healthy twenty-three-year-old woman, who suddenly announced: “I’m going to line up to get the vaccine on Wednesday.” She meant she was going to wait outside a vaccine center all day in the hope of receiving a spare dose from an opened Pfizer vial.

 

In a recent conversation, a prominent Israeli journalist pointed out to me that my portrayal of the country in previous dispatches had made it look rather strange. Perhaps I had even made the Israeli people seem a little . . . crazy. What can I say? He’s right. Amid the vaccine success rate, infections have nonetheless skyrocketed. Israel has hardly been a positive model for managing the spread of the virus.  Coming out of its latest nationwide lockdown, Israel has seen huge per-capita rates of COVID-19 death and transmission, some of the worst in the world. Ḥaredi riots, general noncompliance among Orthodox and Arab citizens in certain cities, mass protests against Netanyahu, and government deadlock hardly make it a picture of stability—and that’s before you consider it’s going into another election soon.

That’s the nub of the issue, isn’t it: Israel has dealt spectacularly well and spectacularly poorly with the virus. So rather than ask how Israel has succeeded with vaccines, a better question might be: how, despite everything, has Israel succeeded?

Perhaps the answer lies somewhere beyond infrastructure and politics.

Even before the pandemic, Israel was never plagued by the atomization and anomie that characterize most Western and economically advanced countries. And during the pandemic, social isolation, despite strict lockdowns, has not taken effect in a small country where neighbors, family, and friends are ubiquitous, and the rituals of life and death are prioritized even amid moments of crisis. (Israel is one of the only countries that has always allowed family members to pay their respects to dying loved ones in coronavirus wards.)

A few weeks ago, I staked out a busy vaccination center (from a respectable distance, don’t worry) in Herzliya in central Israel. It did indeed look crazy. Unlike what one might expect from a pop-up medical facility, the vaccination center looked more like a festival tent than anything else. Bright colors from purple to blue to green lined the façade, upbeat pop music blasted from speakers, and a line of well-dressed Israelis hugged the perimeter. In other countries one hears stories of patients with appointments walking away from long waiting lines for the vaccine because they got cold, or bored. In Israel, people without appointments (and of demographics outside of the key risk brackets) were voluntarily lining up for their vaccines.

Israel’s connectedness means that it has effectively immunized itself against one of the more disturbing social diseases to emerge stronger from the pandemic: anti-vax sentiment. In Germany, where vaccination skepticism has long been an issue, only about half of the population is prepared to be vaccinated, according to one survey. (Perhaps this is related to the rise of the conspiratorial QAnon movement there.) In the UK, a reported 40 percent of people of Pakistani and Bangladeshi origin have expressed refusal to take the vaccine. The BBC cites worries that this apprehension is a result of fake news on social media. (The former Labor party leader Jeremy Corbyn’s brother Piers, who was recently arrested, sought to capitalize off of these fears by disseminating fliers comparing the vaccine to Auschwitz in parts of London with large South Asian populations.)

There is some anti-vax sentiment in Israel, but not much, and what there is gets stamped out. Israeli society is simply too interconnected to allow conspiracy theorists to fester underground. Instead, they are wrung out in broad daylight to their own shame. When Avigdor Lieberman, the head of the political party Yisrael Beytenu, recently defended the decision of one of his politicians not to get vaccinated, he was fiercely criticized by Israelis for his words. (And even in his foolish statement, Lieberman said that it is nonetheless “better for people to go and get vaccinated.”) Meanwhile, the fringe rabbis abusing positions of authority to badmouth the vaccine in online videos are drowned out by the voices of mainstream rabbis who argue that it is a religious imperative to get vaccinated. A relative of my husband’s works in a deli in Bnei Brak, the site of some recent ḥaredi riots. In January, a local and influential rabbi called the owner of the shop, also ḥaredi, to warn against the “forbidden” and “anti-religious” vaccine. In response, the deli owner berated him and told him never to call again. It even comes down to the way Israelis learn about the vaccine and book their appointments: every Israeli is required to have a primary care physician. These doctors personally call their patients to say, “as a doctor, I think this vaccine is the best thing for you, and I’m booking you for one.” The secret weapon here is not public healthcare, but personal healthcare—interconnected healthcare.

In most Western democracies, social isolation, and therefore conspiracy theories, abound. Maybe it’s that Israel never had the first and so was never afflicted by the second.

 

It seems that Israel has reached a point most other countries are still daydreaming about. There is some talk lately about a slowdown in vaccination rates. This concern is, in my opinion, overblown. Slow compared to what? Even in the month of February, Israel has still been vaccinating an average of 106,000 people per day. The United States has 36 times Israel’s population but is only vaccinating fifteen times more people.

The issue at hand today is not a slowdown suggesting a fatal flaw in Israel’s vaccine rollout, but a question all countries must grapple with at some point: how to make sure that people who are not eager to get vaccinated—the careless young, the conspiracy-minded, others outside the system—get vaccinated? Israel is merely facing this challenge earlier; it will come—hopefully soon—for America and elsewhere too.

Rabbi Meir Soloveichik argued recently that it is the Israeli thirst for life that has fueled its vaccine triumph. Israelis do love living, but plenty of other nationalities love it as well. Maybe the difference is not that Israelis love to live, but what life looks like in the Jewish state.

After all of the voluntary recipients of the vaccine have received it, it then remains to be seen how Israel, and other countries, will go about herding its remaining citizens towards vaccination appointments. (Officials are looking into denying admission for the unvaccinated to gyms, hotels, cafes, and sporting events.) I bet that convincing the stragglers to get vaccinated will not be an insurmountable challenge. My close friend in Tel Aviv was forced into quarantine on the same day she had intended to be vaccinated, due to potential COVID-19 exposure. Two weeks later, she was out, having tested negative, and proceeded straight to her local vaccination facility. She is now among the first twenty-three-year-olds in the world to be vaccinated. Great failure and great success, indeed.