Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel’s COVID-19 vaccination program

Abstract

As of March 31, 2021, Israel had administered 116 doses of vaccine for COVID-19 per 100 population (of any age) – far more than any other OECD country. It was also ahead of other OECD countries in terms of the share of the population that had received at least one vaccination (61%) and the share that had been fully vaccinated (55%). Among Israelis aged 16 and over, the comparable figures were 81 and 74%, respectively. In light of this, the objectives of this article are: To describe and analyze the vaccination uptake through the end of March 2021 To identify behavioral and other barriers that likely affected desire or ability to be vaccinated To describe the efforts undertaken to overcome those barriers Israel’s vaccination campaign was launched on December 20, and within 2.5 weeks, 20% of Israelis had received their first dose. Afterwards, the pace slowed. It took an additional 4 weeks to increase from 20 to 40% and yet another 6 weeks to increase from 40 to 60%. Initially, uptake was low among young adults, and two religious/cultural minority groups - ultra-Orthodox Jews and Israeli Arabs, but their uptake increased markedly over time.In the first quarter of 2021, Israel had to enhance access to the vaccine, address a moderate amount of vaccine hesitancy in its general population, and also address more intense pockets of vaccine hesitancy among young adults and religious/cultural minority groups. A continued high rate of infection during the months of February and March, despite broad vaccination coverage at the time, created confusion about vaccine effectiveness, which in turn contributed to vaccine hesitancy. Among Israeli Arabs, some residents of smaller villages encountered difficulties in reaching vaccination sites, and that also slowed the rate of vaccination.The challenges were addressed via a mix of messaging, incentives, extensions to the initial vaccine delivery system, and other measures. Many of the measures addressed the general population, while others were targeted at subgroups with below-average vaccination rates. Once the early adopters had been vaccinated, it took hard, creative work to increase population coverage from 40 to 60% and beyond.Significantly, some of the capacities and strategies that helped Israel address vaccine hesitancy and geographic access barriers are different from those that enabled it to procure, distribute and administer the vaccines. Some of these strategies are likely to be relevant to other countries as they progress from the challenges of securing an adequate vaccine supply and streamlining distribution to the challenge of encouraging vaccine uptake.

Is stronger religious faith associated with a greater willingness to take the COVID-19 vaccine? Evidence from Israel and Japan

“…Moreover, initially there was widespread antivaccination messaging among ultra-Orthodox Jews [2,20]. However, their limited access to reliable information about new scientific developments from television, the Internet and mainstream media limited the ability to counter these messages [31].…”

“…After we completed this study, COVID-19 vaccines became available in Israel. Nevertheless, vaccine hesitancy was strong among ultra-Orthodox Jews, who had high infection rates [31]. However, after opening special vaccination sites in these communities, and promoting respectful discussion between health experts and the rabbis of the ultra-Orthodox communities, vaccination rates increased dramatically [1].…”

Elapsed time since BNT162b2 vaccine and risk of SARS-CoV-2 infection: test negative design study

“…Israel was among the first countries to initiate a large scale vaccination campaign on 20 December 2020. A large proportion of the population were quickly immunised, partly because of the centralised health services and the decision to use only one vaccine, achieving early control over the spread of the virus 101112. Up to 26 July 2021, more than 5.2 million Israelis were fully vaccinated with two doses of the Pfizer-BioNTech vaccine 13.…”

An analysis of the COVID-19 vaccination campaigns in France, Israel, Italy and Spain and their impact on health and economic outcomes

“…In contrast, lower rates of childhood vaccinations among some groups within the ultra-Orthodox Jewish community have been described in other studies [78] . The concealment of some details of the purchase agreement with Pfizer may have also contributed to a decline in public confidence in government policy around the vaccine [79] .…”