Israel’s Speedy Vaccination Campaign Faces Test in Returning to Normal

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Israel’s Speedy Vaccination Campaign Faces Test in Returning to Normal

TEL AVIV—Israel lifted restrictions on most commerce and public activity, opening malls, markets and museums—and requiring the use of a pass to document vaccination status for some activities.

Sunday’s moves illustrate how Israel, which rolled out the world’s fastest Covid-19 vaccination campaign, is combining incentives and threats to get the rest of its population vaccinated—and how it learned from missteps.

The nation is reopening after having some of the worst infection rates for months, as many flouted lockdowns, and more recently, a British variant of the disease ran rampant. Commercial activity largely sputtered to a halt. “For Rent” signs have proliferated on the once-bustling seaside avenues of this city.

The opening up and use of what officials are calling green passports, which allow people to enter gyms and hotels and eventually embark on quarantine-free travel, set up a test for one of the most closely watched countries during the pandemic: Can Israel return to relative normalcy without slipping back into peak infection rates and overwhelming its healthcare system?

Israel says it’s on track to vaccinate everyone over 16 by the end of March. To understand how the small country has vaccinated more of its population than any other so quickly, WSJ visited clinics that are giving shots to young and middle-aged citizens. Photo: Tamir Elterman for The Wall Street Journal

To strike that balance, officials are warning those who shun the national vaccination campaign that they will be shut out of everyday activities. “Anyone who does not get vaccinated will be left behind,” Israel’s health minister Yuli Edelstein said.

As thousands of people rushed to download the “green passport” documents, the website crashed Saturday night. The Health Ministry said people could use their vaccination certificates in the meantime.

At the Carlton Hotel in Tel Aviv, 12 couples were expected to check into rooms that have reopened to people who have received two shots of the vaccine. Yossi Navi, the hotel’s general manager, said he expects more in the next few weeks as Israelis understand hotels are open again and the weather improves.

With roughly nine million people, about the same as New York City, Israeli authorities were able to focus on a compact geographic footprint. Israel’s advanced and fully digitized healthcare system, in which every citizen by law belongs to one of four healthcare providers, also sped the drive by identifying citizens in target groups and reaching them with phone calls, text messages and mobile apps. A deal between the Jewish state and Pfizer Inc. and BioNTech SE, which developed the Covid-19 vaccine, became the centerpiece of Israel’s vaccination campaign.

Cultural hubs and malls have reopened, and Jerusalem residents gathered at a shopping boulevard.

Photo: abir sultan/Shutterstock

Pfizer agreed to provide enough vaccines to fuel the drive. In exchange, Israel agreed to provide health data to the New York-based drugmaker to better understand the vaccine’s impact. Israel also offered a higher price than many other countries, more than double or triple what the U.S. and Europe are paying.

After initially offering shots to medical workers and people over 60, Israel has gradually reduced the eligible age range. Earlier this month, the vaccine became available to the general public. Now, 49% of Israelis have received at least one shot and 33% are fully vaccinated, almost entirely with the Pfizer vaccine.

Getting to this point entailed stumbles that fueled infections and forced the country into a string of lockdowns.

Although Israel fared relatively well in the first wave of the disease, Israeli public health experts say Prime Minister Benjamin Netanyahu’s government bowed to public pressure from businesses and reopened too early, especially the school system. A crippling summer wave boosted cases to about 4,000 a day, and they later peaked in January during the third wave at around 10,000 cases a day.

In September, Israel became the first developed nation to enter a second lockdown. The government allowed only essential businesses to remain open, closing restaurants, hotels and gyms and limiting outdoor gatherings. The cumulative effect of the lockdowns is estimated by the government to have cost the Israeli economy billions of dollars.

Health officials blamed a third year-end wave largely on mass travel to Dubai, after the United Arab Emirates and Israel normalized a diplomatic relationship and opened travel links. Israel declined to require returning travelers to quarantine on arriving back in Israel, fearing the move would chill ties. When infections began to rise, Israel was slow to cut off international flights and quarantine travelers, and a British variant breached the borders. In January alone, Israel reported 30% of its total coronavirus deaths.

A woman shows her vaccination status to enter a gym in Tel Aviv.

Photo: ronen zvulun/Reuters

Israeli health officials caution a full return to normal now could be months, if not years, away.

As long as children under 16 can’t be vaccinated, they will continue to spread the virus, these health officials said. They also aren’t sure how successful the vaccine is against the variants.

The government has had one powerful weapon in its campaign—the vaccine itself. According to data released Saturday by the health ministry, the risk of death from coronavirus falls 98.9% two weeks after both shots of the Pfizer vaccine. Israel also found that, in the same period after two shots, serious illness decreased by 99.2%, morbidity by 95.8%, and hospitalization by 98.9%. The figures are compared with a nonvaccinated group.

In the early days of its campaign, Israel increased the speed of the inoculation drive by giving out leftover doses to anyone who showed up for them.

While Israel raced ahead, it also faced pressure to supply vaccines to the Palestinians for humanitarian reasons. Israeli officials have acknowledged that failing to reach immunity in the West Bank and Gaza could hamper Israel’s efforts.

So far it has donated 5,000 vaccines to the Palestinian Authority and delivered 2,000, and officials have said they would look into supplying more once Israel’s population is fully vaccinated. Last week, it allowed 1,000 doses of the Sputnik vaccine from Russia to be sent to Gaza, part of 10,000 doses Russia provided for the Palestinians. The Palestinian Authority also has agreements under the World Health Organization’s Covax program to receive vaccines for 60% of its population.

Israel’s vaccine campaign still confronts obstacles, mainly among those resisting it: many young people as well as swaths of the country’s ultraorthodox and Arab populations.

A survey published Tuesday by Israel’s Channel 12 found that 25% of Israelis say they have no intention of being vaccinated. Among those who haven’t, 41% said they feared side effects, 30% said they weren’t sure if the vaccine is effective, and 27% said they would do it soon.

Beyond the green passport system, Israeli cities and towns are offering their own sweeteners to drive inoculations.

The ultraorthodox city of Bnei Brak served Cholent, a traditional beef stew, to those who showed up for shots. Tel Aviv city set up a mobile vaccination center in Dizengoff Square, a popular nightlife spot, and is offering free drinks to anyone who gets vaccinated. In Holon, a suburb southeast of Tel Aviv, the city has hired DJs to create a party-like atmosphere to lure people over 16 for shots. Israel also sent a mobile van to the country’s south near hiking trails to attract nature lovers.

Many Israelis on Sunday were returning to activities and habits they haven’t experienced in months.

Mike Korda, the owner of boutique fitness gym Locker Room, said he had lost 50% of his clients over the course of the pandemic. He reopened on Sunday and is requiring anyone who returns to the gym to upload their vaccination certificates into the fitness center’s app, where they book classes.

Returning to normal isn’t easy, he said as he awaited the lunchtime rush. “Now the challenge is to get everybody back.”

Covid-19 Vaccines

Write to Felicia Schwartz at Felicia.Schwartz@wsj.com

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