Israel’s vaccine rollout holds lessons for us,
Ontario vaccine task force studying other rollouts as province ramps up delivery
It was 1 a.m. in Israel, but officials in that country were on the phone with members of Ontario’s science advisory table to discuss the strategies they were using to vaccinate residents with the COVID-19 vaccines at a pace that has now made them one of the fastest in the world.
“They just said ‘we’re just going to get the vaccine out. We’re going to put it in arms. We’re going to use all of the available technology that we have to facilitate that,’ ” said Dr. Gerald Evans, chair of the division of infectious diseases at Queen’s University and a professor of medicine, who was on the call this year.
“And bingo, look at how much they’ve done already,” Evans added.
On Sunday, the country reached a milestone — half of Israel’s residents have been vaccinated. And nearly 90 per cent of people over the age of 50 have received the shot, according to media reports.
What’s more, the Pfizer-BioNTech vaccine has been shown to be effective in populations that wouldn’t have necessarily been included in clinical trials such as elderly and frail seniors living in retirement homes or people who have compromised immune systems.
“What you’re seeing in real-world settings is the tremendous effectiveness of the vaccine,” said Dr. Isaac Bogoch, a member of the Ministry of Health’s COVID-19 Vaccine Distribution Task Force. “It’s preventing infection. It’s preventing hospitalization. It’s preventing ICU stays. It’s preventing deaths. And quite frankly, it works.”
A recent peer reviewed study in the New England Journal of Medicine of vaccine data from Dec. 20 to Feb. 1, showed that the Pfizer-BioNTech vaccine could reduce symptomatic cases by 94 per cent, hospitalizations by 87 per cent and severe COVID-19 cases by 92 per cent, seven or more days after the second dose.
Israel has used the Pfizer vaccine exclusively for its citizens, striking a deal with the company that gave the country unprecedented access to doses in return for vaccine data and allowing them to ramp up vaccine delivery more quickly than other countries.
“They really mastered speed and precision simultaneously. And they were very well organized,” Bogoch said. But “the key ingredient is vaccines. If you have more vaccines, you can scale up quickly and broadly.”
Ontario expects to ramp up vaccine delivery near the end of March into April and when that happens, public health units will use many of the same strategies that helped put Israel ahead, said Bogoch.
“And that involves mass vaccine sites, drive through sites, community centres as sites, pharmacies administering the vaccine, sending teams into people’s homes to administer vaccines for people that can’t mobilize,” he said.
The country was able to overcome a key challenge of distributing the PfizerBioNTech vaccine, which the manufacturer stipulated it had to be stored in deep freezers and then transported in large trays containing 195 vials, enough for 975 doses.
Evans said the vaccine contains “little lipid nanoparticles” that could potentially fall apart due to “shock instability.”
But with permission from Pfizer, Israel was able to repackage the vaccine in insulated pizza-sized boxes that allowed it to be distributed in smaller amounts and to more remote sites.
Pfizer-BioNTech has also provided Canada with updated guidelines for redistribution of its vaccine, said Health Canada spokesperson Andre Gagnon.
In an email, Gagnon said that “certain provinces have advised that they have redistributed the vaccines in smaller quantities in some instances to accommodate their own requirements.”
Like Ontario, Israel set up call centres and a website where residents could book vaccine appointments, but a mobile application was also employed.
Evans said Israel found it was not only useful to send people a text message to remind them to keep their appointments and when to schedule a second dose, but also to keep track of adverse reactions.
A report on Israel’s vaccine distribution by Ontario’s COVID-19 Science Advisory Table said use of the technology created a sense of trust and transparency in the system while allowing for “rapid data collection for a national registry of adverse vaccine events.”
Call centres were also created for health professionals who had clinical questions or wanted shipment information.
And in Israel, if there were doses of the vaccine left over, they were administered “to local individuals irrespective of their age eligibility,” according to the report. That country is now employing more technology to make it easier for residents to navigate the pandemic.
Residents returning to the country can now either go into quarantine in government-specified hotels or they can choose to wear an electronic bracelet so they can fulfil isolation requirements at home.
On Sunday, Israel also approved a plan to inoculate Palestinian labourers who have permits to work in Israel or in settlements in the occupied West Bank, according to media reports. The country is being urged to vaccinate Palestinians in the Israeli-occupied West Bank and the Gaza Strip, most of whom have not been vaccinated.