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 That is how Israel came to be a leader of the world's COVID-19
vaccination drive, reaching nearly 15% of the country’s 9.3 million
population in about two weeks.
The first big decision was paying a premium to get early vaccines.
Israeli authorities have not said publicly what they paid for the
vaccine developed by U.S. company Pfizer and German partner BioNTech.
But one official said on condition of anonymity that Prime Minister
Benjamin Netanyahu's government was "paying around $30 per vaccine
dose, or around twice the price abroad."
Pfizer said in a statement that it uses "a tiered pricing formula
based on volume and delivery dates" but declined to disclose further
details.
Israel also offered the pharmaceutical companies the promise of a
quick rollout that could serve as a template for other places: swift
results from a small country with a universal healthcare system,
patient data stored centrally and the technological savvy to ensure
a digitised distribution network.
Health Minister Yuli Edelstein said freeing Israel's economy from a
series of lockdowns justified any higher purchase cost or buying an
excess of vaccines.
"What we basically said to Pfizer and Moderna and to the others was
that if we will be one of the first countries to start vaccinating,
very soon these companies will be able to see the results,"
Edelstein told Reuters.
"It's a kind of win-win situation," he said. "We are a small
country. And I knew for a fact that we better be one of the first on
the ground because after the vaccine is developed, the companies,
commercially speaking, wouldn't even look in the direction of
countries Israel's size."
The vaccination campaign has faced some criticism and hurdles.
Rights groups are outraged that Palestinians in the Israeli-occupied
West Bank and Gaza Strip face a long wait for vaccines.
Israel's 21% Arab minority has shown an initial wariness towards
vaccination.
Netanyahu's opponents accuse his right-wing Likud Party of using the
vaccination campaign for political gain before a March 23 election,
and lacking a clear long-term strategy for dealing with the impact
of COVID-19 -- charges the government denies.
But, while Israel is in its third lockdown and faces a recession and
high unemployment, it has avoided the shortages and bottlenecks
faced by other countries.
Graphic: COVID-19 vaccine doses administered -
https://graphics.reuters.com/HEALTH-CORONAVIRUS/xegpbbernpq/chart.png
DISTRIBUTION TECHNIQUES
Israel, which has reported more than 450,000 COVID-19 cases and
3,445 deaths, cast a wide net for securing vaccines early on, and
last June became one of the first countries to reach a purchase
agreement with Moderna.
Moderna has said it will begin delivery of 6 million doses this
month, though Edelstein said the shipment was probably two months
away.
In November, Israel announced similar deals with AstraZeneca and
Pfizer, and the first Pfizer shipment arrived on Dec. 9.
Israeli teams repacked the large ultra-frozen pallets into insulated
boxes the size of small pizzas, allowing for distribution in smaller
numbers and at more remote sites.
The technique, Israel says, got the green light from Pfizer. Other
refinements included squeezing more doses out of each vial than
advertised.
The vaccines are handled by SLE, the logistics unit of Teva
Pharmaceutical Industries, in an underground facility near Israel's
main airport. Thirty large freezers set to minus 70 degrees Celsius
(-94 Fahrenheit) can hold 5 million doses.
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 SLE repackages them into
bundles as small as 100 doses to be delivered to
about 400 vaccine centres, said Adam Segal,
SLE's logistics and operations manager.
That, officials say, means wider parallel
vaccination drives nationwide, allowing easier
access to small clinics as well as larger
centralised centres. UNIVERSAL
HEALTHCARE
A universal public healthcare system, which requires every resident
to be covered by a healthcare maintenance organisation (HMO) and
connected to a nationwide digital network, then kicks in.
Ran Balicer, chief innovation officer for HMO Clalit, said Israel
has integrated infrastructures of digital data with "full coverage
of the entire population, cradle to grave."
"So it is easy both to identify the right target population and to
create data-driven 'outreach' because this is something that is done
as our everyday care routine," said Balicer, who also chairs the
government's expert advisory coronavirus panel.
Administering about 150,000 shots a day at clinics and special
facilities, Israel has prioritised over-60s, health workers and
people with medical conditions. The city of Haifa offers
drive-through vaccinations.
"I have been waiting to be liberated from this pressure, from the
anxiety that's there in the background all the time, to be free, to
finally stop worrying," said 76-year-old psychologist Tamar Shachnai.
A week into the campaign she had already received a text message
with instructions from her HMO, scheduled an appointment and got her
first shot.
Shachnai was vaccinated at a centre in a Jerusalem sports arena
where about 500 people had passed through by lunchtime. Towards the
end of the day, about 20 younger people gathered outside the arena,
hoping to receive the vaccine.
Israel has also added vaccination centres in Arab towns, said Aiman
Saif, the health ministry's coronavirus coordinator for the Arab
community, following concerns about the low rate of vaccination
among Israeli Arabs. He said some Israeli Arabs
initially appeared reluctant to be vaccinated and may have been put
off by misinformation on social media, prompting Israel to
accelerate a public campaign to combat "fake news" about alleged
side effects.
Palestinian health official Yasser Bozyeh estimated that
Palestinians would begin receiving doses in February through the
World Health Organization's vaccine scheme for poor and
middle-income countries.
The Palestinian Authority, which exercises limited self-rule in the
West Bank and has its own health system, has also contacted private
drugmakers.
Edelstein said it was in Israel's interest to make sure the
Palestinian population was also vaccinated and that he was open to
discussing passing on any extra vaccines once Israel meets its own
demand. Netanyahu's office declined to comment.
(Additional reporting by Dan Williams, Rami Ayyub, Rami Amichay, Eli
Berlzon and Douglas Busvine in Berlin, Editing by Stephen Farrell,
Jeffrey Heller and Timothy Heritage)
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