Israel’s COVID-19 vaccine rollout success provides examples for Ontario to emulate

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Israel’s world-leading success in vaccinating a higher proportion of its population than any other country against COVID-19 has valuable lessons for Ontario, a new report by the province’s pandemic science advisers says.

Jurisdictions across Canada and around the globe have been looking to Israel, which has administered five million doses to its population of nine million, including about one million people who are fully vaccinated with two doses.

Ontario’s COVID-19 Science Advisory Table released a report on Monday that says while Israel is much smaller and more densely populated than Ontario, the province should look to emulate key components of its vaccine rollout.

Among the lessons Ontario could adopt, the report says, is Israel’s simplified system for deciding who would be prioritized for the vaccine, which made age the single determining factor, except for health care workers and first responders.

Israel was also able to break down large containers of Pfizer-BioNTech vaccine, which must be stored at -70 C in special freezers, into smaller batches, using containers that look like pizza boxes to transport them to remote sites.

Israeli health officials set up decentralized vaccination centres, in hospitals, pharmacy chains, pop-up centres and drive-thru sites. A centralized IT system governed the booking of vaccinations, with text-message reminders sent about appointments and second doses, with a 24/7 call centre. Local community nurses and paramedics were drafted to help with the rollout.

The country also launched a campaign against vaccine hesitancy, consulting faith leaders and vaccinating Prime Minister Benjamin Netanyahu first, in a nationally televised event.

Israel’s vaccination rate of 56 per cent leads the world, Our World in Data notes, with the next closest country, the United Arab Emirates, at 34.8 per cent. Just 2.5 per cent of Canada’s population has received at least one dose.

Retired general Rick Hillier, the head of Ontario Premier Doug Ford’s vaccine task force, said Ontario’s plans already include much of what is in the report, which echoes the content of a call he participated in with the Israeli Health Minister and a team of the country’s health officials last week, alongside Mr. Ford, his Health Minister Christine Elliott, and other cabinet ministers.

“I said to the Premier after [the call], the good news is, the vast majority of what he talked about, we’ve already included, either in the operation or in the planning,” Mr. Hillier said in interview.

A obvious key difference between Ontario and Israel, Mr. Hillier points out, is that Israel has received millions more doses of Pfizer vaccine, and that shipments to Canada have been delayed as the company expands its Belgian plant, forcing clinics here to shut down.

Mr. Hillier said he believed the province might still hit its Feb. 5 goal of vaccinating all long-term care and high-risk retirement homes, depending on how many vaccines arrive this week.

“I think we still have a good chance of meeting that deadline,” he said. “But if not we’re going to be really, really close. And the only reason we wouldn’t is because we’ve had to wait till vaccines arrive.”

In Ottawa on Monday, federal ministers said Canada is putting together options to retaliate if Europe breaks its promise not to cut off the country’s shipments of COVID-19 vaccines, though Europe appears to be keeping that promise at least for now. Canada is only getting about one-fifth of previously planned shipments of the Pfizer-BioNTech vaccine this week and next, but Procurement Minister Anita Anand said the companies are still promising to get four million doses shipped to Canada by the end of March, and all 40 million Canada has ordered by next fall.

Nathan Stall, a geriatrician and assistant scientific director of the province’s science table, said while vaccine supply is clearly an issue, Israel enacted some changes that maximized its ability to inoculate quickly.

He said Ontario was too slow to figure out how to repackage and transport the Pfizer vaccine and get it into long-term care homes sooner. Ontario was not able to move the vaccine out of hospitals until Jan. 5, even though Pfizer had issued instructions on how to do this Dec. 18, Dr. Stall said. He said the delay was a “real miss,” and that recent deadly outbreaks in long-term care could have been prevented.

“They treated this as an emergency and they vaccinated as fast as possible,” Dr. Stall said of Israel’s move to prioritize vaccinations for seniors, rather than a list of different groups.

Isaac Bogoch, an infectious-diseases specialist at Toronto’s University Health Network who sits on Ontario’s vaccination task force, said the province first needs more vaccines. He said the province will eventually be in a position to have a much greater supply, with plans to incorporate many of the same approaches as Israel, including using primary-care providers and pharmacies.

“They’re going to be very actively involved when we have the vaccine such that we can scale this up to way more people. In addition to that, we also have plans for mass vaccines sites,” he said, adding that all 34 public-health units have submitted plans to use spaces such as community centres.

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