Three countries have pulled far ahead of the rest of the world in distributing Covid-19 vaccines

By Annabelle Timsit
Geopolitics reporter

It’s a miracle of modern medicine that scientists were able to develop multiple successful vaccines against Covid-19, a disease that wasn’t even on their radar a year ago. But so far, the global effort to roll out these vaccines and distribute them to vulnerable people is off to a slow start.

According to a tracker developed by OurWorldInData—a research partnership between the University of Oxford and the British non-profit Global Change Data Lab—three countries have vaccinated a higher proportion of their populations than the rest of the world: Israel, the United Arab Emirates (UAE), and Bahrain.

These Middle Eastern states have administered the jabs to 20.93%, 10.99%, and 5.25% of their populations, respectively, while the US, Denmark, and UK trail further behind at 2.02%, 1.98%, and 1.94%. The rest of the world hovers around 0.5%. (These are based on population estimates from the United Nations World Population Prospects, so other trackers, such as Bloomberg’s, may show slightly different proportions.)

What’s their secret?

Structural factors

First, Israel, the UAE, and Bahrain are small countries with populations of between 1.5 and 9.3 million people. For Israel and parts of the UAE, which are using the vaccine developed by Pfizer and BioNTech, that’s a logistical boon: Since the vaccine doses need to be stored at -70 to -80 degrees Celsius, short distances are key to preventing spoilage during transit. (Abu Dhabi and Bahrain are using the vaccine developed by China’s Sinopharm.)

The countries’ universal healthcare systems are also helping get people vaccinated quickly, says Tinglong Dai, an associate professor of operations management at Johns Hopkins University Carey Business School, because it “makes it easier to match [vaccine] supply and the demand.” Healthcare data are centralized and digitized effectively, so citizens can either access an app or call a hotline and receive an immediate appointment for a jab if they are eligible.

In Israel, every citizen has to be part of one of four major health insurance funds, called HMOs. These funds are incentivized to compete with one another for patients in order to obtain more funding from the government. And Israelis can switch their HMO memberships every six months if they’re not satisfied, so the funds “have every incentive to have their members get vaccines as soon as possible,” Dai explains.

Medical authorities in the three countries approved the jabs early. Bahrain was the second country in the world to approve the Pfizer/BioNTech jab, and it approved the Sinopharm vaccine in November. Israel was the third to approve Moderna’s jab on Jan. 5 and it has secured 6 million doses of it already. It certainly helps that the three countries can afford it.

Israel began to trial the transportation and delivery of the vaccine on Dec. 9 and launched its vaccine rollout on Dec. 19, more than a week before the European Union. It hasn’t said how much it paid for doses of the Pfizer/BioNTech, Moderna, and Oxford-AstraZeneca vaccines, but health minister Yuli Edelstein told The New York Times that even if his country overpaid, it will have been worth it to reopen the Israeli economy early.

Population attitude

A key factor of the success of any vaccination rollout is the population’s attitude towards it. In France, for example, vaccine skepticism, fueled by disinformation, is seriously impeding the country’s efforts to vaccinate people. In a survey conducted by the Kaiser Family Foundation in the US, 29% of respondents who work in a healthcare delivery setting said they probably or definitely wouldn’t get the vaccine.

Israel, the UAE, and Bahrain have invested resources in reassuring the public that the vaccine is safe and effective. That starts at the top: Israeli prime minister Benjamin Netanyahu was the first Israeli to receive the shot, and he did so on live television, while the king of Bahrain also received the jab early on.Health authorities in the countries liaised with religious leaders to make sure their communities turned up to get their jabs. For example, the UAE’s Fatwa Council issued an Islamic ruling in favor of the vaccine and its chairman, Abdullah bin Bayyah, was vaccinated in public. Israeli health officials consulted with ultra-Orthodox media and community leaders, although there is still a lack of trust among Muslim Arab and Christian minorities there.

Yoel Hareven is international and resource development director at Sheba Medical Center, the largest healthcare center in Israel and a major vaccination hub. He argues that the mood in Israel right now is evocative of wartime. “Everyone in Israel understands that this is a crisis,” he told Quartz. “And because we know how to act in crisis time, everyone is gathering, and unifying to fight Covid-19.”

What can the rest of the world learn?

At Sheba, Hareven is part of a team that collects lessons learned from Israel’s vaccination drive. He highlights a few:

  1. First, reach out to the leaders of minority communities who are more skeptical of the vaccine, wherever they may be. Get them on board and “earn their confidence.”
  2. Second, recruit volunteers to alleviate the strain on overworked healthcare staff. For example, Sheba called on retired staff to vaccinate the elderly in retirement homes so that frontline healthcare workers could stay in hospitals and clinics. “You will find out that in crisis times, people want to volunteer. You just need to ask them.”
  3. Third, invest in good digital infrastructure to process and centralize large volumes of health data—like shares of immunized people in a given area—in real time. But “don’t do heroic IT efforts,” he warns. “Play with what you have and adjust it for Covid.”

But Dai argues that while there’s lessons to be learned from the early successes of Israel, the UAE, and Bahrain, countries who are frontrunners now shouldn’t rest on their laurels. “Two months from now, the focus will shift to [vaccinating] the general population, and that’s where we’re going to see even more challenges,” he explains. “So it’s not clear who is a leader yet.”

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