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Israel feels like the only nation taking the importance and urgency of vaccination seriously. Here in Europe, articles are coming out complaining that the slow

Israel feels like the only nation taking the importance and urgency of vaccination seriously. Here in Europe, articles are coming out complaining that the slow vaccination could be harming the economy which, well, fucking duh. (https://www.brusselstimes.com/news/belgium-all-news/154626/coronavirus-slow-vaccination-campaign-could-cost-europe-close-to-90-billion-euros/ https://www.brusselstimes.com/news/belgium-all-news/154626/c...) Fast rollout. Involve pharmacies. Involve the army. Distribute widely and efficiently. Prepare for months before the vaccine is here. Follow-up campaign to convince vax holdouts. A real War Effort. There's barely any calls for volunteering here in Belgium. Hospitals and vaccination centers will complain to the government that they are understaffed but you seldom hear them urgently asking for new volunteers to assign to COVID teams and vaccination centers. We spent a ton of time debating whether the social bubble should be 2 or 3 large, whether kids should be 12 or 14 before they count for it, etc etc and those spending that time were the same people who didn't prepare for the eventuality of a vaccine, and started doing so in late December. Sorry this has veered off topic. The number of articles that can be summed up to "Vaccines work, are good, and israel is doing it right" frustrate little european me. :(

lnsru 6y ago
You perfectly expressed my feelings. Greetings from Germany!
- csunbird 6y ago
  From Germany here as well, I am extremely sad how the vaccine situation was handled, 3.3 percent of population over two months is an extremely bad metric, especially when the lockdown situation is being lengthened for another month. By this rate, people won't be vaccinated by 2021. The dashboard for Germany: https://impfdashboard.de/ https://impfdashboard.de/
  - bodyfour 6y ago
    It's important to not get too discouraged with "By this rate..." The rate is increasing and should continue to do so. More production capacity is coming online week by week.
kuu 6y ago
I think we all in Europe are in a similar situation (based in comments of friends of different countries), so it seems to me that is not because the internal organization of delivering / injecting the vaccine but the production of it. The production is going very slow, and therefore the rollout it's super slow...
- scrollaway 6y ago
  Europe has definitely dropped the ball in terms of supply, but looking at the numbers, I can't help but feel like at least Belgium couldn't actually distribute more if it had more to distribute. Just recently the country was boasting about being ahead of its own schedule and all I can think is "if you're ahead of schedule despite all of europe being dry on supplies, your schedule sucks, doesn't it?". It's very likely that europe failing to supply us is saving the jobs of other politicians who failed to organize us better.
  - corty 6y ago
    Belgium is as disorganized as you can get. Most of the time over the last 20 years they didn't manage to form a government, just an endless chain of interim solutions that quickly broke apart. It shows...
- pqs 6y ago
  Thanks for your comment. Production and delivery of vaccines is the bottleneck. Israel is a very small country, compared to the EU.
- dm319 6y ago
  There are a lot of analyses already about what has gone wrong with the European vaccine effort. It seems to be partly a mixture of being a bit stingy with procurement, being skeptical of new RNA vaccines, putting too much stock in sanofi and j&j, and requiring everything ratified by every country to proceed. In fact it was going so slowly that four countries decided to organise their own precurement, and that became the EU effort. So it seems mostly a problem of procurement/supply. A smaller country like Israel has a simpler logistical issue.
formerly_proven 6y ago
On the local level things seem to work, they're just not getting nearly enough vaccine. The machinery is there, it's just sitting idle in the parking lot. This is a huge, enormous screw-up which can be almost entirely pinned on promoting people that have achieved nothing but failures into EU offices, the latest and most egregious case of which is Ursula von der Leyen. Guess what, when you're promoting an incompetent moron who failed at every job so far into an office with actual power and responsibility, they're going to fuck things up. Previously they'd only promote idiots to Commissioner level or so, which was already pretty bad if you ask me, but not this bad. Not "billions worth of economic and innumerable social damage"-bad.
- corty 6y ago
  Up to now, no one dared to task the EU with something as important, because it was always clear from the start that the EU isn't capable of handling tasks that are complex, time-critical and important. But since the production chains of most vaccines are spread all over the EU, smaller members were afraid to be left out, larger members wanted a slice of the cake for their pharmaceutical industries (i.e. France) and the current EU leader von der Leyen was promoted there by Germany's chancellor Merkel, everyone was in a position where they just had to involve the EU.
jcfariadias 6y ago
You could be very well organised in terms of rollout and distribution. But every European country is having the same problem - shortage of production and provider's incapacity to distribute it without fail. Israel case is unique, because they payed more per vaccine, thus guaranteeing the supply needed to be able to mass vaccinate the population.
- scrollaway 6y ago
  And yet, we're ahead of schedule here: https://www.brusselstimes.com/news/belgium-all-news/154717/about-365-000-vaccinations-done-in-belgium-so-far/ https://www.brusselstimes.com/news/belgium-all-news/154717/a... Like I said in another reply: if you're ahead of schedule when your supplier is dry, your schedule is awful. Isn't it? It makes no sense otherwise. If we had 1 million vaccines to distribute right now, we couldn't. We have 150 "vaccination centers", all of which are converted testing centers but which makes only 10 percent or so of them full time; most of them are open a couple days a week. If you crunch down the numbers you end up very optimistically at the ability to distribute 250-350k vaccines per month... In a country roughly the same population as israel. Edit: i don't even sort of understand why I'm getting downvoted for sharing plain numbers.
- 1996 6y ago
  > they payed more per vaccine, thus guaranteeing the supply needed to be able to mass vaccinate Who could have guessed that paying the right price would guarantee the supply of a rare commodity everyone would want? :)
  - timrichard 6y ago
    Quite right. And on the flip side, who would have guessed that haggling down the price of a super cheap at-cost AZ dose and playing hardball on liability when everyone else was bending over backwards would result in delays and supply problems for the EU...
    - hef19898 6y ago
      Who would have thought ordering twice as many doses as needed wouldn't be enough for some? And who would have thought that ordering more, and above manufacturing capacity, would reduce availability?
bajsejohannes 6y ago
The bottleneck is vaccine production. It doesn't matter how fast you vaccinate. Sure, Israel did a great job negotiating for vaccines, but it's a zero-sum game so only a few countries could have pulled this off.
- ema 6y ago
  It's only a zero-sum game if more money wouldn't ramp the production up faster. This might be case but I whish people who say it's zero-sum would say why they think so.
  - bodyfour 6y ago
    Because nobody credible in the vaccine industry is saying "we could speed up XYZ if we had a bit more money." If they did, they'd find themselves buried under an avalanche of cash before they finished the sentence. The story right now is one of the entire industry ramping up production as fast as they possibly can with money being no object.
- bzbarsky 6y ago
  > The bottleneck is vaccine production Given claims like "I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April." from https://www.theguardian.com/global-development/2021/feb/14/we-took-a-huge-risk-the-indian-firm-making-more-covid-jabs-than-anyone https://www.theguardian.com/global-development/2021/feb/14/w... it seems like claiming that the bottleneck is production needs some serious caveats....
  - bajsejohannes 6y ago
    Huh, I hadn't seen this. Thanks for enlightening me. I'm curious where these 70M doses are bought but not approved. As far as I can tell, AstraZeneca is approved all over Europe.
    - bzbarsky 6y ago
kjakm 6y ago
The UK has (first-dose) vaccinated close to a quarter of the population now. Given the vast population difference between it and Israel it seems to be doing pretty well too.
- scrollaway 6y ago
  Yes I agree, the UK is also doing very well considering. It just baffles me that no other country is even in the same category as israel in terms of readiness, despite nine months to prepare.
  - peteretep 6y ago
    There’s just not that many countries as rich as Israel who could be, though? UK and UAE are doing pretty well. All EU countries are subservient to the EU on this, America and Canada are geographically huge and of course America has Covid and medicine as an outsized political issue, Oz and NZ don’t need to rush it ... I guess maybe the Asian tigers are lagging a bit here?
    - nopzor 6y ago
      i don’t think “rich” has much to do with it. look how much economic loss and fiscal stimulus many countries have endured, on a per capita basis. in the grand scheme of thing, relative to that, does it matter whether they pay 20$, 40$, 100$ etc per dose?
      - peteretep 6y ago
        Let's say you're buying two-three treatments per person to try and make sure you end up with one that works, at 2021 Q1 delivery prices of around $40 per treatment ... $100 per capita. And let's say you're Malaysia, so that's $3.2bn in total which is 10% GDP. If you wait until Q3, you can get a proven vaccine for $3 per person, so $90m instead, so going early is going to cost you ... $3.1bn? So that's still 10% of GDP ish. Not sure that's an easy sell.
DoingIsLearning 6y ago
What bothers me the most, is the delay in signing the vacine contracts with Pfizer and AstraZeneca. The US for all the criticism it can take, closed this negotiation in weeks. We spent a whopping 3 months arguing with pharma companies about price and liability before closing these contracts. There are people dying avoidable deaths while we allowed for this inertia. There are no serious media outlets pushing the European Comission for answers on this failing. There will be no hearing to find a cause for this failing. As a very pro-european citizen this made me very bitter, there could have been a strong EU wide vaccination programme and EU transnational solidarity but instead we see this blunder that will set us back for months probably +1 year of these lockdowns and economic damage.
- kevinstubbs 6y ago
  I imagine the US has a ton of leverage in such negotiations. Something along the lines of "give us a good price on this to make us look good or else maybe we'll actually do something about the ridiculous price gouging for medicine in this country." No pharma exec wants to be the one that killed the golden goose.
  - DoingIsLearning 6y ago
    Both the Netherlands, France and Germany, were already ready to close contracts, when the EC stepped in to do an EU wide contract. It absolutely makes sense to do an EU wide contract rather than depend on the solidarity of larger countries that order surplus. The issue is the EC went on a panel wide long discussion to then get to more or less a carbon copy of the initial german contract. Those were 3 months wasted that could have made a difference in ramping up vaccine manufacturing.
  - matt_o 6y ago
    It seems to me that, if negotiation leverage is the crucial factor here, then wouldn't the US and EU be in a similar spot? The EU's economy is roughly the same size as the US's[0], but the EU has roughly a little over 445 million citizens compare to the US's ~330 million. I would imagine that EU countries paying for the healthcare of 445 million citizens would be considered as quite a large "customer" for pharmaceutical companies and could strike a good deal. How does the US get an edge in negotiations over the EU? It feels that military power wouldn't factor here, but I'm having trouble coming up with other ideas. What else could it be? [0]: https://ec.europa.eu/eurostat/documents/2995521/10868691/2-19052020-BP-EN.pdf/bb14f7f9-fc26-8aa1-60d4-7c2b509dda8e https://ec.europa.eu/eurostat/documents/2995521/10868691/2-1...
mytailorisrich 6y ago
Israel is in a continuous state of war. It is both prepared and aware that a pandemic can disrupt your defences enough to make you an easy target. I think this played a big role in their response.
- eladFrizi 6y ago
  Israel has competition between several private healthcare providers. That fact makes them agile and efficient than most places in the world (e.g. Britain's NHS ). The army has nothing to do with the vaccine rollout.
  - mytailorisrich 6y ago
    That's quite irrelevant to the point. And in fact the UK are also doing very well with vaccine rollout (and the army is involved). In Israel, where everyone has received a military training and is ready to organise, the IDF is of course very involved in the vaccine rollout though the Home Front Command. The supply of the vaccine is also controlled by the government, not private healthcare providers. But my point was not even this. It was about how to consider the pandemic and its potential consequences as part of the internal government's discussions on how to respond and then the capacity to act quickly. I have no doubt that Israel has deemed Covid a very serious threat to national security and has thus mobilised accordingly using their experience of the de facto continuous state of war or at least high alert to organise and act quickly and effectively.
    - eladFrizi 6y ago
      IDF isn't involved in the vaccine rollout. And if your point was right, the lockdowns in Israel would have been much more effective and on time. The reality is the the first lockdown was removed too early, and the other lockdowns started too late with lame enforcement. Everyone who watches news in Israel can tell you that.
      - mytailorisrich 6y ago
amrx431 6y ago
India. It is an enigma that why is India's response to Covid-19 gets ignored. India to date has vaccinated more people than Israel and has one of the least CFR per capita.
- abhinav22 6y ago
  Very proud of the great success of India here. Was very worried they would have a calamity but they have managed it better than anyone else in my opinion
- scrollaway 6y ago
  You're right I haven't been looking at india's numbers. I'll keep a closer eye on it from now on.
- daliusd 6y ago
  Now I will get downvotes from India, but let's try: It is percent of population that matters not absolute number of vaccinated people. Israel is near 70%, while India is only 0.5% [1]. CFR per capita, while looks good (113.97 deaths per million) is not actually good compared to Mongolia (0.62 deaths per million)[2]. You know, who else is doing well - Belarus (195.31 deaths per million). I don't believe Belarus numbers as all countries around are burning (500+ deaths per million). Could it be that India is faking it as well? Based on corruption index [3] it is even worse than Belarus. sources: [1] https://ig.ft.com/coronavirus-vaccine-tracker/?areas=gbr&areas=isr&areas=usa&areas=eue&cumulative=1&populationAdjusted=1 https://ig.ft.com/coronavirus-vaccine-tracker/?areas=gbr&are... [2] https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/ https://www.statista.com/statistics/1104709/coronavirus-deat... [3] https://en.wikipedia.org/wiki/Corruption_Perceptions_Index https://en.wikipedia.org/wiki/Corruption_Perceptions_Index
  - amrx431 6y ago
    > It is percent of population that matters not absolute number of vaccinated people. Israel is near 70%, while India is only 0.5% [1]. Which is more commendable considering the vastness of the land itself. Israel == Delhi and surrounding reasons. Given the economic parameters of the country, it has better CFR than US, Italy, Germany and UK. Thats pretty amazing considering the health expenditure and wealth of US, Italy, Germany, UK is enormously high than India. As when number fudging that is not happening.You can look at data from independent foreign houses stationed in India.
rock_artist 6y ago
To give some balance. Just as I got my second jab and waiting the 10min needed for surveillance. (Tel Aviv, Israel) > Israel feels like the only nation taking the importance and urgency of vaccination seriously. It's a mixed situation here. * Israel supposedly paid 3 times more than others per shot (but if it works, it's cheaper than the economy losses). * Israel has free public health care. * All public health care databases are connected. * Pfizer gets very detailed annoymized dataset. * centralization means the health care also hospitalization covered by health care and connected to database. * Israel is a small country. I can easily cover it by 7hrs drive bottom top. All those helped get enough jabs. Yet, There's enough population that don't social distance / comply to basics such as wearing a mask (even indoor!). Some population even did huge events during lockdowns with zero enforcement. Hope this gives some proportion.
- scrollaway 6y ago
  Thanks for the added context!
- Papirola 6y ago
  thanks!
- jacquesm 6y ago
  > Israel supposedly paid 3 times more than others per shot More than that even, closer to a factor of 10. https://www.jpost.com/israel-news/the-cost-of-vaccinating-israel-nis-1-billion-655088 https://www.jpost.com/israel-news/the-cost-of-vaccinating-is... $47 / head! VS closer to $5 in other countries.
  - oblio 6y ago
    It's still cheap in the grand scheme of things.
  - maxerickson 6y ago
    The mRNA vaccines cost more everywhere. Given the better efficacy, I think the comparison doesn't boil down to a single number very well.
pa7x1 6y ago
Most developed countries seem to be able to deploy close to 100% of the vaccines provided so far, modulo whatever strategy they have chosen regarding keeping some amount of second doses in storage. So that doesn't seem to be bottleneck. Israel simply paid more and bought a larger amount of vaccines delivered earlier. Which is smart but it's not a strategy that all countries can replicate, not because we cannot afford it but simply because there is a bottleneck in production. There is not enough vaccines for all no matter how much we pay, so we would end up competing in price for no real speed up.
- scrollaway 6y ago
  I have yet to be convinced that paying the vaccine suppliers more is zero sum. More money potentially means more production / faster scaling up.
  - pa7x1 6y ago
    Vaccine production started way before the Phase 3 results were out. You cannot know ahead of time for which vaccines you should make a strong bet. Now we can prop-up production of the successful vaccines and they are doing so. Anyway, getting the first vaccines is always going to be zero-sum for the same reason getting first-row in a concert is zero sum.
    - ummonk 6y ago
      "You cannot know ahead of time for which vaccines you should make a strong bet." Actually you can. When dealing with a pandemic causing the level of disruption we've seen, you throw money at propping up production of every serious vaccine candidate, hoping that at least one of them works out.
      - oblio 6y ago
        Yeah, overpaying and betting on 20 candidates in parallel is the reasonable thing to do, even if you're cynical enough to not care about the loss of life or health. Every additional day of lockdown probably costs as much as the entire production lifecycle of a vaccine, including distribution. I think the EU economy contracted at least 5% in 2020. The EU GDP was $18.3 tn, so 5% is about $915bn. That's $2.5bn per day (!). And that's just the direct impact, the whole psychological, PTSD, etc. longer term impact probably makes that higher, I'd be shocked if the total cost isn't something like $3bn per day.
kharak 6y ago
Isn't the vaccination distribution a zero sum game between nation states? Supply is limited. Some countries will get it sooner than others. Europe lost the bit against several other powers. Not to my surprise, I must say.
- scrollaway 6y ago
  Is it zero sum? People keep saying that but if you give the suppliers more money, that allows them to scale up more and faster. It's not a given that they're just at 100 percent of their production capacity.
  - kharak 6y ago
    Actually, they do seem to be at their limit. There have been articles about this (which I merely glanced over). Scaling up manufacturing for vaccines, especially new RNA based ones, isn't something that scales infinitely with money. Not in the short or medium term, at least. In some cases, scaling up required downscaling of current production. Searched for the well written article I've seen, to link it here, but I'm only getting SEO bullshit.
  - bodyfour 6y ago
    Just about any part of production that could be scaled up by throwing money at the problem has had billions of dollars flowing in its direction.
- bzbarsky 6y ago
  > Isn't the vaccination distribution a zero sum game between nation states? It's complicated. Right now there are vaccines that have been purchased and produced but not delivered due to regulatory approval issues (70 million from just one manufacturer, according to https://www.theguardian.com/global-development/2021/feb/14/we-took-a-huge-risk-the-indian-firm-making-more-covid-jabs-than-anyone https://www.theguardian.com/global-development/2021/feb/14/w... ), vaccines being delivered but not used (see https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... "Supply used" statistics), and so forth. Blaming supply constraints is a great cover for these organizational and regulatory failings, though. "We don't have enough vaccine" sure sounds better than "we've only bothered to use 60% of the vaccine we got our hands on" (hello, Rhode Island and D.C.).
endymi0n 6y ago
While I agree with the sentiment, don‘t forget the elephant in the room is vaccine supply. It‘s just not arbitrarily scaleable and most vaccination centers in my EU country are sitting around idle. What some describe as smart moves by Israel is also rather selfish. It’s made possible by the fact that they are a rather small country that has a large support by major powers for historical reasons, but they made a pact with the devil here: They simply outbid everyone so the vaccine goes to them INSTEAD somewhere else (including Palestine). They sold all kinds of patient data on top in order to get where they are now. Vaccinating the 100x larger EU is simply a different beast. If the EU had been as "smart" as Israel here and bid as much, don‘t forget we‘d all be stuck at 5% vaccination speaking in absolute numbers of vaccine availability.
- josh_fyi 6y ago
  They got the deal by quickly offering Pfizer and Moderna (not the devil) whatever they asked: More money (but ~$40 instead of ~$20 per dose is trivial, to both sides), indemnification, and data.
  - smileybarry 6y ago
    It's $47 per head, not per shot[1]. It seems like we didn't overpay that much. 1: https://www.jpost.com/israel-news/the-cost-of-vaccinating-israel-nis-1-billion-655088 https://www.jpost.com/israel-news/the-cost-of-vaccinating-is...
- CyberRage 6y ago
  Israel vaccination speed is not only due to price. Israel was the first to order vaccines even before any published results. Israel is geographically small and has medium-low sized population which helps in logistics and effectiveness. I think there was a lot of skepticism in Europe initially regarding the vaccine while in Israel the demand was very high from the get-go.
  - AzzieElbab 6y ago
    That is really smart risk management. Even if they overplayed and even if the vaccines turned out to be garbage, the price is small compared to costs of lockdowns
jpxw 6y ago
You have the European Union to blame for this, I’m afraid.
- scrollaway 6y ago
  I clearly am blaming them. But I do think they're taking the hit where, had they done their job properly, several countries would be on the hot coals for not being ready to distribute appropriately.
- pandemic_region 6y ago
  That's a populist cheap shot thing to say I'm sorry. At least back it up with some hard numbers and facts that without EU things would have been much better. Or that the involvement of the EU lead to a worse outcome.
roelschroeven 6y ago
There's a limited supply. Sure, Europe could have negotiated better, or could have chosen to pay more and get more vaccine doses faster. But that just means other countries get less doses. As long as production isn't ramped up enormously, we're dealing with a zero sum game. I think we can look at countries that manage to get a sufficient supply with admiration. Envy, yes. I agree that in Belgium things are not as well organized as they should, as usual. They should for months they were preparing and plans would be ready and working by the beginning of January. But it turned out nothing was ready, debates about who to give the vaccine first were only starting instead of being started many months before. But at this point none of that really matters: it's simply not the bottleneck. Vaccination centers are ready for thousands of people per day, but only get 100 doses. By the way I've read and heard about calls for volunteers for hospitals and vaccination centers. Vaccination centers don't really need many people now though because of the low supply.
- ishjoh 6y ago
  If Europe were willing to pay higher prices it's possible that suppliers would have built more factories. In fact given the size of the EU and it's negotiating power that could have been a requirement of the deal, especially if the deal was made at the beginning of the pandemic, so I disagree that it has to be zero sum.
underdeserver 6y ago
Israel had a very good starting point - the 4 mandatory healthcare providers (Clalit, Maccabi, Leumit, Meukhedet), who due to a voucher system could only compete on service. They had every interest to digitize and improve efficiency over the past decade or so. That's why they did digitize - every resident has a digital medical file, and healthcare providers can easily track and report back to Pfizer and the ministry of health on side effects and efficacy (i.e. it's easy to look up who got the vaccine and when, when they get admitted to a hospital with COVID).
- tguvot 6y ago
  healthcare providers in Israel have centralized systems/databases for at least 20 if not 30 years the only "digitization" over past decade, it's shiny websites.
  - chaosite 6y ago
    You're right, the digitization effort was around 2000 or so. But you're presenting that as somehow being bad, while it's actually better than what a lot of other countries have.
    - tguvot 6y ago
      I don't present it as something bad. I adjust a timeline by a decade or so :) And as somebody who currently resides in USA, I am well aware that it's better compared to local state of affairs
lordnacho 6y ago
The thing I don't get is why not try to mass manufacture the candidates before we know they are effective? It seems the work of what drug to make was done really quickly, and most of the time is spent in the trials, and then mass production. Maybe I missed it, but you'd think with something so devastating we'd just make a bunch of candidates, get them out to the clinics for storage, and as soon as we thought a given candidate was effective start injecting everyone? And if a given drug doesn't work, what's a few billion?
- bodyfour 6y ago
  That is exactly what happened -- governments around the world paid for pre-approval manufacturing and the pharma industry has spent the last 6-8 months ramping up production. That's the reason we have any supplies at the moment. The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant. The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/ https://covidvax.live/
  - hef19898 6y ago
    10 times that! The site you linked is really nice! Not sure where they get the numbers from, but regardless a great resource. One of the more interessting metrics in there is "daily doses per mil", as it shows the difference between the vaccination campaigns. Would be even better if the also shwed when each campaign started.
    - bodyfour 6y ago
      Yeah it's an interesting visualisation of the data. I can't personally vouch for its exact accuracy -- every government reports their metrics on a different schedule and I guess they're building realtime estimates based on that. Certainly seems reasonable enough to look at for the broad trendline.
pid_0 6y ago
Why is this getting down voted? Anti-Israel users I guess? Mad that Israel has its shit together?
- Daho0n 6y ago
  I didn't vote but I wouldn't upvote a comment saying israel is doing good when they are a occupying power with first and second rate citizens. If they did good they would help the Palestinians first or equally, not let them die off.
  - pid_0 6y ago
    >when they are a occupying power with first and second rate citizens. If they did good they would help the Palestinians first or equally, not let them die off. This is objectively untrue though
- fortran77 6y ago
  There's a reason why my Israeli company won't do business with any Y Combinator company. This sentiment is common on Hacker News and across the parent organization. It comes from deep-seated hatred, and will hurt them in the end.
  - nir 6y ago
    ??? I'm pretty sure there are several YC startups with Israeli founders.
tehjoker 6y ago
Except for Palestinians of course where they refuse their legal duties as an occupying power to render medical aid. https://www.cnbc.com/2021/02/03/israel-giving-5000-vaccine-doses-to-palestinians-is-inadequate-hrw.html https://www.cnbc.com/2021/02/03/israel-giving-5000-vaccine-d...
- greenonions 6y ago
  Since when has 'law' applied to Israeli behavior in Palestine?
  - tehjoker 6y ago
    As a Jew, it makes me feel sick to see my people treat others as subhuman. My expectation is that of generosity, open democracy, freedom of religion, respect for international law, and demilitarization, but apparently US/Israeli geostrategy is having none of that.
    - YZF 6y ago
      I think it's an unreasonably high standard to expect Israel to vaccinate Palestanians in the occupied territories before Israelis. Going from that stance to saying (all?) Israelis treat Palestinians as subhuman is also a bit of a stretch. Are Americans treating Canadians as subhumans by not allowing Pfizer to ship vaccines from its US factory to Canada? In Judaism "the poor of your city" come first. What other country in the world is giving their bought vaccine allotment first to someone else or promoting anything that looks like worldwide equal distribution where every human on this planet has equal access? And sure, as a fellow Jew I'd like to believe we're better than everyone else, but hey, we're not. I guess maybe better than some. The complexity of the Palestinian/Israeli conflict can't be reduced to these simplistic terms. Anyone can take some specific incident or piece of data out of context and make their case around it, and all sides take every opportunity to do so while at the same time refusing to accept any responsibility to how they got to where things stand today. I do hope that once Israel has finished vaccinating its population it will extend the additional vaccines to the PA and to Gaza, I think it's in their own interest and it's the right thing to do.
jimbokun 6y ago
I think it's almost entirely a supply issue? Israel, UK and USA procured large amount of doses ahead of time, and now EU is having trouble getting enough doses for their population. That was my understanding.
- mjevans 6y ago
  It still seems far too slow in the US. 'Warp Speed' got us to the finish line, but all out of breath and without the need to still plan and execute taking advantage of the race's completion. Reminds me that historically 'we' got to the moon, and then like 50 years later are only reaching the point of maybe going back again, hopefully regularly this time.
  - jimbokun 6y ago
    According to this: https://ourworldindata.org/covid-vaccinations https://ourworldindata.org/covid-vaccinations US has fourth fastest vaccination rate per capita, behind Israel, UAE, and UK.
    - bushbaba 6y ago
      And is number 1 for total amount of covid vaccines given. That’s huge when you realize manufacturing capabilities don’t come online overnight. The us secured the large majority of supply.
- Redoubts 6y ago
  It’s weird because the NYT ran an article about how little we procured ahead of time, compared to the EU. And now they’re the ones fumbling it
- flemhans 6y ago
  In Denmark it's 100% a supply issue. There's vaccination centers set up all around the country which are being utilized at 1-5% capacity, just waiting for vaccines to arrive. They are upgrading the infrastructure even more despite that, anticipating being able to vaccinate 10% of the population per day.
2-tpg 6y ago
Israel has one of the best biowarfare offense and defense in the world. For them, Iran releasing a bioengineered pathogen is a legit threat. The El-Al flight that crashed in Amsterdam in 1992 was carrying materials to produce large quantities of Sarin for the purpose of testing gas masks. Israel is specifically suited to treat COVID as a test-run for a biowarfare attack. A real War Effort, because it is one.
- nir 6y ago
  Actually it's the HMO system here, much more than the military. Every Israeli, by law, has healthcare insurance. It works much like income tax - deducted automatically from your pay, varies according to income level, and is transferred directly to the HMO you pick among several options which compete (quite vigorously) with each other.
  - davidf18 6y ago
    Also, their PM and much of their leadership are ex-military in a country that cannot afford to lose a war and has been in many wars. The current PM Netanyahu was part of a special forces unit that saved a plane from terrorists. The head of that team was a former Israeli PM Ehud Barak. https://en.wikipedia.org/wiki/Sabena_Flight_571#Hijacking https://en.wikipedia.org/wiki/Sabena_Flight_571#Hijacking Compare leadership of France, Germany, etc.
  - siculars 6y ago
    Na. Lots of places have socialized medicine like Israel. Not many of them, if any of them, are having the successful rollout Israel is enjoying. The entire Israeli society is prepared for this sort of event more so than any other in the world. Civil society, healthcare (as you pointed out), military and, dare I say, even religious all work together to pull this off.
    - smileybarry 6y ago
      I agree with Nir, HMOs are carrying a huge amount of the load here (after the government supplying all those vaccines). You have 4 HMOs total -- one of them (Clalit) being huge -- so there's not much fragmentation; a very fast crew of health workers which allows us to reach that level of vaccinations/day; and an existing well-tested infrastructure for flu vaccines, which are in high demand each year. I don't think the military was involved yet, and religion was in fact working against vaccination efforts as a few anti-vax rabbis drove sectors of the Haredi population off. EDIT: Saw another comment about a person in uniform doing the immunization so I might've been wrong about the army's involvement. But either way most comments referring to military involvement mean i.e. wartime levels of involvement, military handing out gas masks door-to-door etc. We're not at the level that the army is a sizable force, from what I can tell. (Except immunizing their own soldiers of course)
mchusma 6y ago
The US also has almost no sense or urgency (maybe more than the EU, but pretty bad). Examples: - modernas main bottleneck is filling. They applied weeks ago to fill the same bottles with 15 doses instead of 10. The FDA has still not approved it. - the us prioritizes second doses over first doses. This creates a ton of cascading issues, including the fact that many places are storing half the doses for 28 days. Many people have reported getting the same lot number for the second shot. - the FDA takes 3 weeks to schedule approval meetings (after having reviewed the data enough to believe an EUA is warranted). -the FDA hasn't approved Astrazeneca, one of the last countries to do so. -our prioritization system is a mess. It's really hard to figure out who is eligible. "Healthcare workers" (which was supposed to be the first group) is vague, so of course what happened is what you would expect. I know about 100 people personally who have gotten the vaccine as healthcare workers. Only 1 works with COVID patients. Most of the others have less contact with people than grocery store workers. They should have just done covid ward workers first (<1M people) then go by age only. Super easy to know who is eligible. Our local hospital sat on doses from late Dec to late Jan because they didn't know who to give them to. After sitting on them for almost 30 days, they realized if all the doses went bad it would be a scandal so they just gave it to everyone on the property first come first serve.
- azinman2 6y ago
  I think you’re making a lot of assumptions that FDA approval/disapprovals are slow due to a sense of urgency. I’d like to see evidence for that, I’d personally assume it’s quite the opposite— they’re trying to get it as right as they can before doing something at scale that can’t be easily undone. If 15 doses lead to issues compared to 10, then you jeopardize all those vaccines which are slow and difficult to make. You also give people false sense of hope and possibly either get lower effectiveness or build public distrust. These are tough balancing acts.
  - zbrozek 6y ago
    It's really hard to grok why 15-vs-10 doses in a bottle should be a problem. Sure you've got the out-of-fridge time, but that hardly seems like an issue when the population is itching to get vaccinated.
siculars 6y ago
It's because at every level of government Israel plans for, practices and anticipates any type of scenario from nuclear war, to chemical attack to biological warfare. Rapidly distributing materials to the population is absolutely within the ability of the IDF and their civil counterparts. Vaccines fall into these categories. It also doesn't hurt that most of the over 18 population have been in the military and know how to follow orders. For those of you who would attribute the successful roll out to the latter, don't. It all starts with anticipating black swan events and being prepared for them.
chrismcb 6y ago
My take on it. No one believed Trump would do it, not wanted to give him a win. So there was little upfront planning. Then the vaccine was announced and people scrambled. Here in WA, a month after they got the first vaccines they decided to open songs vaccine centers. As if it was a new idea. Why weren't these ready to go day 1? Then there is the whole mess of who gets it. Should have been strictly by age. Instead there is a huge list of who can get it. And it was supposed to be done without discrimination. But because of the long list of exceptions, it makes it easy to discriminate. Then there was the whole save the second dose... No give everything out. While there are people who want to wait, that really isn't the problem. A freezer broke here, in the middle of the night and the put it a message in social media and delivered all the vaccines within hours. The stupid thing is, if they have the vaccine just to the elderly, we could practically go back to normal in like a month...

lnsru 6y ago

You perfectly expressed my feelings. Greetings from Germany!

csunbird 6y ago
From Germany here as well, I am extremely sad how the vaccine situation was handled, 3.3 percent of population over two months is an extremely bad metric, especially when the lockdown situation is being lengthened for another month. By this rate, people won't be vaccinated by 2021. The dashboard for Germany: https://impfdashboard.de/ https://impfdashboard.de/
- bodyfour 6y ago
  It's important to not get too discouraged with "By this rate..." The rate is increasing and should continue to do so. More production capacity is coming online week by week.

kuu 6y ago

I think we all in Europe are in a similar situation (based in comments of friends of different countries), so it seems to me that is not because the internal organization of delivering / injecting the vaccine but the production of it. The production is going very slow, and therefore the rollout it's super slow...

scrollaway 6y ago
Europe has definitely dropped the ball in terms of supply, but looking at the numbers, I can't help but feel like at least Belgium couldn't actually distribute more if it had more to distribute. Just recently the country was boasting about being ahead of its own schedule and all I can think is "if you're ahead of schedule despite all of europe being dry on supplies, your schedule sucks, doesn't it?". It's very likely that europe failing to supply us is saving the jobs of other politicians who failed to organize us better.
- corty 6y ago
  Belgium is as disorganized as you can get. Most of the time over the last 20 years they didn't manage to form a government, just an endless chain of interim solutions that quickly broke apart. It shows...
pqs 6y ago
Thanks for your comment. Production and delivery of vaccines is the bottleneck. Israel is a very small country, compared to the EU.
dm319 6y ago
There are a lot of analyses already about what has gone wrong with the European vaccine effort. It seems to be partly a mixture of being a bit stingy with procurement, being skeptical of new RNA vaccines, putting too much stock in sanofi and j&j, and requiring everything ratified by every country to proceed. In fact it was going so slowly that four countries decided to organise their own precurement, and that became the EU effort. So it seems mostly a problem of procurement/supply. A smaller country like Israel has a simpler logistical issue.

formerly_proven 6y ago

On the local level things seem to work, they're just not getting nearly enough vaccine. The machinery is there, it's just sitting idle in the parking lot. This is a huge, enormous screw-up which can be almost entirely pinned on promoting people that have achieved nothing but failures into EU offices, the latest and most egregious case of which is Ursula von der Leyen. Guess what, when you're promoting an incompetent moron who failed at every job so far into an office with actual power and responsibility, they're going to fuck things up. Previously they'd only promote idiots to Commissioner level or so, which was already pretty bad if you ask me, but not this bad. Not "billions worth of economic and innumerable social damage"-bad.

corty 6y ago
Up to now, no one dared to task the EU with something as important, because it was always clear from the start that the EU isn't capable of handling tasks that are complex, time-critical and important. But since the production chains of most vaccines are spread all over the EU, smaller members were afraid to be left out, larger members wanted a slice of the cake for their pharmaceutical industries (i.e. France) and the current EU leader von der Leyen was promoted there by Germany's chancellor Merkel, everyone was in a position where they just had to involve the EU.

jcfariadias 6y ago

You could be very well organised in terms of rollout and distribution. But every European country is having the same problem - shortage of production and provider's incapacity to distribute it without fail. Israel case is unique, because they payed more per vaccine, thus guaranteeing the supply needed to be able to mass vaccinate the population.

scrollaway 6y ago
And yet, we're ahead of schedule here: https://www.brusselstimes.com/news/belgium-all-news/154717/about-365-000-vaccinations-done-in-belgium-so-far/ https://www.brusselstimes.com/news/belgium-all-news/154717/a... Like I said in another reply: if you're ahead of schedule when your supplier is dry, your schedule is awful. Isn't it? It makes no sense otherwise. If we had 1 million vaccines to distribute right now, we couldn't. We have 150 "vaccination centers", all of which are converted testing centers but which makes only 10 percent or so of them full time; most of them are open a couple days a week. If you crunch down the numbers you end up very optimistically at the ability to distribute 250-350k vaccines per month... In a country roughly the same population as israel. Edit: i don't even sort of understand why I'm getting downvoted for sharing plain numbers.
1996 6y ago
> they payed more per vaccine, thus guaranteeing the supply needed to be able to mass vaccinate Who could have guessed that paying the right price would guarantee the supply of a rare commodity everyone would want? :)
- timrichard 6y ago
  Quite right. And on the flip side, who would have guessed that haggling down the price of a super cheap at-cost AZ dose and playing hardball on liability when everyone else was bending over backwards would result in delays and supply problems for the EU...
  - hef19898 6y ago
    Who would have thought ordering twice as many doses as needed wouldn't be enough for some? And who would have thought that ordering more, and above manufacturing capacity, would reduce availability?

bajsejohannes 6y ago

The bottleneck is vaccine production. It doesn't matter how fast you vaccinate. Sure, Israel did a great job negotiating for vaccines, but it's a zero-sum game so only a few countries could have pulled this off.

ema 6y ago
It's only a zero-sum game if more money wouldn't ramp the production up faster. This might be case but I whish people who say it's zero-sum would say why they think so.
- bodyfour 6y ago
  Because nobody credible in the vaccine industry is saying "we could speed up XYZ if we had a bit more money." If they did, they'd find themselves buried under an avalanche of cash before they finished the sentence. The story right now is one of the entire industry ramping up production as fast as they possibly can with money being no object.
bzbarsky 6y ago
> The bottleneck is vaccine production Given claims like "I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April." from https://www.theguardian.com/global-development/2021/feb/14/we-took-a-huge-risk-the-indian-firm-making-more-covid-jabs-than-anyone https://www.theguardian.com/global-development/2021/feb/14/w... it seems like claiming that the bottleneck is production needs some serious caveats....
- bajsejohannes 6y ago
  Huh, I hadn't seen this. Thanks for enlightening me. I'm curious where these 70M doses are bought but not approved. As far as I can tell, AstraZeneca is approved all over Europe.
  - bzbarsky 6y ago

kjakm 6y ago

The UK has (first-dose) vaccinated close to a quarter of the population now. Given the vast population difference between it and Israel it seems to be doing pretty well too.

scrollaway 6y ago
Yes I agree, the UK is also doing very well considering. It just baffles me that no other country is even in the same category as israel in terms of readiness, despite nine months to prepare.
- peteretep 6y ago
  There’s just not that many countries as rich as Israel who could be, though? UK and UAE are doing pretty well. All EU countries are subservient to the EU on this, America and Canada are geographically huge and of course America has Covid and medicine as an outsized political issue, Oz and NZ don’t need to rush it ... I guess maybe the Asian tigers are lagging a bit here?
  - nopzor 6y ago
    i don’t think “rich” has much to do with it. look how much economic loss and fiscal stimulus many countries have endured, on a per capita basis. in the grand scheme of thing, relative to that, does it matter whether they pay 20$, 40$, 100$ etc per dose?
    - peteretep 6y ago
      Let's say you're buying two-three treatments per person to try and make sure you end up with one that works, at 2021 Q1 delivery prices of around $40 per treatment ... $100 per capita. And let's say you're Malaysia, so that's $3.2bn in total which is 10% GDP. If you wait until Q3, you can get a proven vaccine for $3 per person, so $90m instead, so going early is going to cost you ... $3.1bn? So that's still 10% of GDP ish. Not sure that's an easy sell.

DoingIsLearning 6y ago

What bothers me the most, is the delay in signing the vacine contracts with Pfizer and AstraZeneca. The US for all the criticism it can take, closed this negotiation in weeks. We spent a whopping 3 months arguing with pharma companies about price and liability before closing these contracts. There are people dying avoidable deaths while we allowed for this inertia. There are no serious media outlets pushing the European Comission for answers on this failing. There will be no hearing to find a cause for this failing. As a very pro-european citizen this made me very bitter, there could have been a strong EU wide vaccination programme and EU transnational solidarity but instead we see this blunder that will set us back for months probably +1 year of these lockdowns and economic damage.

kevinstubbs 6y ago
I imagine the US has a ton of leverage in such negotiations. Something along the lines of "give us a good price on this to make us look good or else maybe we'll actually do something about the ridiculous price gouging for medicine in this country." No pharma exec wants to be the one that killed the golden goose.
- DoingIsLearning 6y ago
  Both the Netherlands, France and Germany, were already ready to close contracts, when the EC stepped in to do an EU wide contract. It absolutely makes sense to do an EU wide contract rather than depend on the solidarity of larger countries that order surplus. The issue is the EC went on a panel wide long discussion to then get to more or less a carbon copy of the initial german contract. Those were 3 months wasted that could have made a difference in ramping up vaccine manufacturing.
- matt_o 6y ago
  It seems to me that, if negotiation leverage is the crucial factor here, then wouldn't the US and EU be in a similar spot? The EU's economy is roughly the same size as the US's[0], but the EU has roughly a little over 445 million citizens compare to the US's ~330 million. I would imagine that EU countries paying for the healthcare of 445 million citizens would be considered as quite a large "customer" for pharmaceutical companies and could strike a good deal. How does the US get an edge in negotiations over the EU? It feels that military power wouldn't factor here, but I'm having trouble coming up with other ideas. What else could it be? [0]: https://ec.europa.eu/eurostat/documents/2995521/10868691/2-19052020-BP-EN.pdf/bb14f7f9-fc26-8aa1-60d4-7c2b509dda8e https://ec.europa.eu/eurostat/documents/2995521/10868691/2-1...

mytailorisrich 6y ago

Israel is in a continuous state of war. It is both prepared and aware that a pandemic can disrupt your defences enough to make you an easy target. I think this played a big role in their response.

eladFrizi 6y ago
Israel has competition between several private healthcare providers. That fact makes them agile and efficient than most places in the world (e.g. Britain's NHS ). The army has nothing to do with the vaccine rollout.
- mytailorisrich 6y ago
  That's quite irrelevant to the point. And in fact the UK are also doing very well with vaccine rollout (and the army is involved). In Israel, where everyone has received a military training and is ready to organise, the IDF is of course very involved in the vaccine rollout though the Home Front Command. The supply of the vaccine is also controlled by the government, not private healthcare providers. But my point was not even this. It was about how to consider the pandemic and its potential consequences as part of the internal government's discussions on how to respond and then the capacity to act quickly. I have no doubt that Israel has deemed Covid a very serious threat to national security and has thus mobilised accordingly using their experience of the de facto continuous state of war or at least high alert to organise and act quickly and effectively.
  - eladFrizi 6y ago
    IDF isn't involved in the vaccine rollout. And if your point was right, the lockdowns in Israel would have been much more effective and on time. The reality is the the first lockdown was removed too early, and the other lockdowns started too late with lame enforcement. Everyone who watches news in Israel can tell you that.
    - mytailorisrich 6y ago

amrx431 6y ago

India. It is an enigma that why is India's response to Covid-19 gets ignored. India to date has vaccinated more people than Israel and has one of the least CFR per capita.

abhinav22 6y ago
Very proud of the great success of India here. Was very worried they would have a calamity but they have managed it better than anyone else in my opinion
scrollaway 6y ago
You're right I haven't been looking at india's numbers. I'll keep a closer eye on it from now on.
daliusd 6y ago
Now I will get downvotes from India, but let's try: It is percent of population that matters not absolute number of vaccinated people. Israel is near 70%, while India is only 0.5% [1]. CFR per capita, while looks good (113.97 deaths per million) is not actually good compared to Mongolia (0.62 deaths per million)[2]. You know, who else is doing well - Belarus (195.31 deaths per million). I don't believe Belarus numbers as all countries around are burning (500+ deaths per million). Could it be that India is faking it as well? Based on corruption index [3] it is even worse than Belarus. sources: [1] https://ig.ft.com/coronavirus-vaccine-tracker/?areas=gbr&areas=isr&areas=usa&areas=eue&cumulative=1&populationAdjusted=1 https://ig.ft.com/coronavirus-vaccine-tracker/?areas=gbr&are... [2] https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/ https://www.statista.com/statistics/1104709/coronavirus-deat... [3] https://en.wikipedia.org/wiki/Corruption_Perceptions_Index https://en.wikipedia.org/wiki/Corruption_Perceptions_Index
- amrx431 6y ago
  > It is percent of population that matters not absolute number of vaccinated people. Israel is near 70%, while India is only 0.5% [1]. Which is more commendable considering the vastness of the land itself. Israel == Delhi and surrounding reasons. Given the economic parameters of the country, it has better CFR than US, Italy, Germany and UK. Thats pretty amazing considering the health expenditure and wealth of US, Italy, Germany, UK is enormously high than India. As when number fudging that is not happening.You can look at data from independent foreign houses stationed in India.

rock_artist 6y ago

To give some balance. Just as I got my second jab and waiting the 10min needed for surveillance. (Tel Aviv, Israel) > Israel feels like the only nation taking the importance and urgency of vaccination seriously. It's a mixed situation here. * Israel supposedly paid 3 times more than others per shot (but if it works, it's cheaper than the economy losses). * Israel has free public health care. * All public health care databases are connected. * Pfizer gets very detailed annoymized dataset. * centralization means the health care also hospitalization covered by health care and connected to database. * Israel is a small country. I can easily cover it by 7hrs drive bottom top. All those helped get enough jabs. Yet, There's enough population that don't social distance / comply to basics such as wearing a mask (even indoor!). Some population even did huge events during lockdowns with zero enforcement. Hope this gives some proportion.

scrollaway 6y ago
Thanks for the added context!
Papirola 6y ago
thanks!
jacquesm 6y ago
> Israel supposedly paid 3 times more than others per shot More than that even, closer to a factor of 10. https://www.jpost.com/israel-news/the-cost-of-vaccinating-israel-nis-1-billion-655088 https://www.jpost.com/israel-news/the-cost-of-vaccinating-is... $47 / head! VS closer to $5 in other countries.
- oblio 6y ago
  It's still cheap in the grand scheme of things.
- maxerickson 6y ago
  The mRNA vaccines cost more everywhere. Given the better efficacy, I think the comparison doesn't boil down to a single number very well.

pa7x1 6y ago

Most developed countries seem to be able to deploy close to 100% of the vaccines provided so far, modulo whatever strategy they have chosen regarding keeping some amount of second doses in storage. So that doesn't seem to be bottleneck. Israel simply paid more and bought a larger amount of vaccines delivered earlier. Which is smart but it's not a strategy that all countries can replicate, not because we cannot afford it but simply because there is a bottleneck in production. There is not enough vaccines for all no matter how much we pay, so we would end up competing in price for no real speed up.

scrollaway 6y ago
I have yet to be convinced that paying the vaccine suppliers more is zero sum. More money potentially means more production / faster scaling up.
- pa7x1 6y ago
  Vaccine production started way before the Phase 3 results were out. You cannot know ahead of time for which vaccines you should make a strong bet. Now we can prop-up production of the successful vaccines and they are doing so. Anyway, getting the first vaccines is always going to be zero-sum for the same reason getting first-row in a concert is zero sum.
  - ummonk 6y ago
    "You cannot know ahead of time for which vaccines you should make a strong bet." Actually you can. When dealing with a pandemic causing the level of disruption we've seen, you throw money at propping up production of every serious vaccine candidate, hoping that at least one of them works out.
    - oblio 6y ago
      Yeah, overpaying and betting on 20 candidates in parallel is the reasonable thing to do, even if you're cynical enough to not care about the loss of life or health. Every additional day of lockdown probably costs as much as the entire production lifecycle of a vaccine, including distribution. I think the EU economy contracted at least 5% in 2020. The EU GDP was $18.3 tn, so 5% is about $915bn. That's $2.5bn per day (!). And that's just the direct impact, the whole psychological, PTSD, etc. longer term impact probably makes that higher, I'd be shocked if the total cost isn't something like $3bn per day.

kharak 6y ago

Isn't the vaccination distribution a zero sum game between nation states? Supply is limited. Some countries will get it sooner than others. Europe lost the bit against several other powers. Not to my surprise, I must say.

scrollaway 6y ago
Is it zero sum? People keep saying that but if you give the suppliers more money, that allows them to scale up more and faster. It's not a given that they're just at 100 percent of their production capacity.
- kharak 6y ago
  Actually, they do seem to be at their limit. There have been articles about this (which I merely glanced over). Scaling up manufacturing for vaccines, especially new RNA based ones, isn't something that scales infinitely with money. Not in the short or medium term, at least. In some cases, scaling up required downscaling of current production. Searched for the well written article I've seen, to link it here, but I'm only getting SEO bullshit.
- bodyfour 6y ago
  Just about any part of production that could be scaled up by throwing money at the problem has had billions of dollars flowing in its direction.
bzbarsky 6y ago
> Isn't the vaccination distribution a zero sum game between nation states? It's complicated. Right now there are vaccines that have been purchased and produced but not delivered due to regulatory approval issues (70 million from just one manufacturer, according to https://www.theguardian.com/global-development/2021/feb/14/we-took-a-huge-risk-the-indian-firm-making-more-covid-jabs-than-anyone https://www.theguardian.com/global-development/2021/feb/14/w... ), vaccines being delivered but not used (see https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... "Supply used" statistics), and so forth. Blaming supply constraints is a great cover for these organizational and regulatory failings, though. "We don't have enough vaccine" sure sounds better than "we've only bothered to use 60% of the vaccine we got our hands on" (hello, Rhode Island and D.C.).

endymi0n 6y ago

While I agree with the sentiment, don‘t forget the elephant in the room is vaccine supply. It‘s just not arbitrarily scaleable and most vaccination centers in my EU country are sitting around idle. What some describe as smart moves by Israel is also rather selfish. It’s made possible by the fact that they are a rather small country that has a large support by major powers for historical reasons, but they made a pact with the devil here: They simply outbid everyone so the vaccine goes to them INSTEAD somewhere else (including Palestine). They sold all kinds of patient data on top in order to get where they are now. Vaccinating the 100x larger EU is simply a different beast. If the EU had been as "smart" as Israel here and bid as much, don‘t forget we‘d all be stuck at 5% vaccination speaking in absolute numbers of vaccine availability.

josh_fyi 6y ago
They got the deal by quickly offering Pfizer and Moderna (not the devil) whatever they asked: More money (but ~$40 instead of ~$20 per dose is trivial, to both sides), indemnification, and data.
- smileybarry 6y ago
  It's $47 per head, not per shot[1]. It seems like we didn't overpay that much. 1: https://www.jpost.com/israel-news/the-cost-of-vaccinating-israel-nis-1-billion-655088 https://www.jpost.com/israel-news/the-cost-of-vaccinating-is...
CyberRage 6y ago
Israel vaccination speed is not only due to price. Israel was the first to order vaccines even before any published results. Israel is geographically small and has medium-low sized population which helps in logistics and effectiveness. I think there was a lot of skepticism in Europe initially regarding the vaccine while in Israel the demand was very high from the get-go.
- AzzieElbab 6y ago
  That is really smart risk management. Even if they overplayed and even if the vaccines turned out to be garbage, the price is small compared to costs of lockdowns

jpxw 6y ago

You have the European Union to blame for this, I’m afraid.

scrollaway 6y ago
I clearly am blaming them. But I do think they're taking the hit where, had they done their job properly, several countries would be on the hot coals for not being ready to distribute appropriately.
pandemic_region 6y ago
That's a populist cheap shot thing to say I'm sorry. At least back it up with some hard numbers and facts that without EU things would have been much better. Or that the involvement of the EU lead to a worse outcome.

roelschroeven 6y ago

There's a limited supply. Sure, Europe could have negotiated better, or could have chosen to pay more and get more vaccine doses faster. But that just means other countries get less doses. As long as production isn't ramped up enormously, we're dealing with a zero sum game. I think we can look at countries that manage to get a sufficient supply with admiration. Envy, yes. I agree that in Belgium things are not as well organized as they should, as usual. They should for months they were preparing and plans would be ready and working by the beginning of January. But it turned out nothing was ready, debates about who to give the vaccine first were only starting instead of being started many months before. But at this point none of that really matters: it's simply not the bottleneck. Vaccination centers are ready for thousands of people per day, but only get 100 doses. By the way I've read and heard about calls for volunteers for hospitals and vaccination centers. Vaccination centers don't really need many people now though because of the low supply.

ishjoh 6y ago
If Europe were willing to pay higher prices it's possible that suppliers would have built more factories. In fact given the size of the EU and it's negotiating power that could have been a requirement of the deal, especially if the deal was made at the beginning of the pandemic, so I disagree that it has to be zero sum.

underdeserver 6y ago

Israel had a very good starting point - the 4 mandatory healthcare providers (Clalit, Maccabi, Leumit, Meukhedet), who due to a voucher system could only compete on service. They had every interest to digitize and improve efficiency over the past decade or so. That's why they did digitize - every resident has a digital medical file, and healthcare providers can easily track and report back to Pfizer and the ministry of health on side effects and efficacy (i.e. it's easy to look up who got the vaccine and when, when they get admitted to a hospital with COVID).

tguvot 6y ago
healthcare providers in Israel have centralized systems/databases for at least 20 if not 30 years the only "digitization" over past decade, it's shiny websites.
- chaosite 6y ago
  You're right, the digitization effort was around 2000 or so. But you're presenting that as somehow being bad, while it's actually better than what a lot of other countries have.
  - tguvot 6y ago
    I don't present it as something bad. I adjust a timeline by a decade or so :) And as somebody who currently resides in USA, I am well aware that it's better compared to local state of affairs

lordnacho 6y ago

The thing I don't get is why not try to mass manufacture the candidates before we know they are effective? It seems the work of what drug to make was done really quickly, and most of the time is spent in the trials, and then mass production. Maybe I missed it, but you'd think with something so devastating we'd just make a bunch of candidates, get them out to the clinics for storage, and as soon as we thought a given candidate was effective start injecting everyone? And if a given drug doesn't work, what's a few billion?

bodyfour 6y ago
That is exactly what happened -- governments around the world paid for pre-approval manufacturing and the pharma industry has spent the last 6-8 months ramping up production. That's the reason we have any supplies at the moment. The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant. The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/ https://covidvax.live/
- hef19898 6y ago
  10 times that! The site you linked is really nice! Not sure where they get the numbers from, but regardless a great resource. One of the more interessting metrics in there is "daily doses per mil", as it shows the difference between the vaccination campaigns. Would be even better if the also shwed when each campaign started.
  - bodyfour 6y ago
    Yeah it's an interesting visualisation of the data. I can't personally vouch for its exact accuracy -- every government reports their metrics on a different schedule and I guess they're building realtime estimates based on that. Certainly seems reasonable enough to look at for the broad trendline.

pid_0 6y ago

Why is this getting down voted? Anti-Israel users I guess? Mad that Israel has its shit together?

Daho0n 6y ago
I didn't vote but I wouldn't upvote a comment saying israel is doing good when they are a occupying power with first and second rate citizens. If they did good they would help the Palestinians first or equally, not let them die off.
- pid_0 6y ago
  >when they are a occupying power with first and second rate citizens. If they did good they would help the Palestinians first or equally, not let them die off. This is objectively untrue though
fortran77 6y ago
There's a reason why my Israeli company won't do business with any Y Combinator company. This sentiment is common on Hacker News and across the parent organization. It comes from deep-seated hatred, and will hurt them in the end.
- nir 6y ago
  ??? I'm pretty sure there are several YC startups with Israeli founders.

tehjoker 6y ago

Except for Palestinians of course where they refuse their legal duties as an occupying power to render medical aid. https://www.cnbc.com/2021/02/03/israel-giving-5000-vaccine-doses-to-palestinians-is-inadequate-hrw.html https://www.cnbc.com/2021/02/03/israel-giving-5000-vaccine-d...

greenonions 6y ago
Since when has 'law' applied to Israeli behavior in Palestine?
- tehjoker 6y ago
  As a Jew, it makes me feel sick to see my people treat others as subhuman. My expectation is that of generosity, open democracy, freedom of religion, respect for international law, and demilitarization, but apparently US/Israeli geostrategy is having none of that.
  - YZF 6y ago
    I think it's an unreasonably high standard to expect Israel to vaccinate Palestanians in the occupied territories before Israelis. Going from that stance to saying (all?) Israelis treat Palestinians as subhuman is also a bit of a stretch. Are Americans treating Canadians as subhumans by not allowing Pfizer to ship vaccines from its US factory to Canada? In Judaism "the poor of your city" come first. What other country in the world is giving their bought vaccine allotment first to someone else or promoting anything that looks like worldwide equal distribution where every human on this planet has equal access? And sure, as a fellow Jew I'd like to believe we're better than everyone else, but hey, we're not. I guess maybe better than some. The complexity of the Palestinian/Israeli conflict can't be reduced to these simplistic terms. Anyone can take some specific incident or piece of data out of context and make their case around it, and all sides take every opportunity to do so while at the same time refusing to accept any responsibility to how they got to where things stand today. I do hope that once Israel has finished vaccinating its population it will extend the additional vaccines to the PA and to Gaza, I think it's in their own interest and it's the right thing to do.

jimbokun 6y ago

I think it's almost entirely a supply issue? Israel, UK and USA procured large amount of doses ahead of time, and now EU is having trouble getting enough doses for their population. That was my understanding.

mjevans 6y ago
It still seems far too slow in the US. 'Warp Speed' got us to the finish line, but all out of breath and without the need to still plan and execute taking advantage of the race's completion. Reminds me that historically 'we' got to the moon, and then like 50 years later are only reaching the point of maybe going back again, hopefully regularly this time.
- jimbokun 6y ago
  According to this: https://ourworldindata.org/covid-vaccinations https://ourworldindata.org/covid-vaccinations US has fourth fastest vaccination rate per capita, behind Israel, UAE, and UK.
  - bushbaba 6y ago
    And is number 1 for total amount of covid vaccines given. That’s huge when you realize manufacturing capabilities don’t come online overnight. The us secured the large majority of supply.
Redoubts 6y ago
It’s weird because the NYT ran an article about how little we procured ahead of time, compared to the EU. And now they’re the ones fumbling it
flemhans 6y ago
In Denmark it's 100% a supply issue. There's vaccination centers set up all around the country which are being utilized at 1-5% capacity, just waiting for vaccines to arrive. They are upgrading the infrastructure even more despite that, anticipating being able to vaccinate 10% of the population per day.

2-tpg 6y ago

Israel has one of the best biowarfare offense and defense in the world. For them, Iran releasing a bioengineered pathogen is a legit threat. The El-Al flight that crashed in Amsterdam in 1992 was carrying materials to produce large quantities of Sarin for the purpose of testing gas masks. Israel is specifically suited to treat COVID as a test-run for a biowarfare attack. A real War Effort, because it is one.

nir 6y ago
Actually it's the HMO system here, much more than the military. Every Israeli, by law, has healthcare insurance. It works much like income tax - deducted automatically from your pay, varies according to income level, and is transferred directly to the HMO you pick among several options which compete (quite vigorously) with each other.
- davidf18 6y ago
  Also, their PM and much of their leadership are ex-military in a country that cannot afford to lose a war and has been in many wars. The current PM Netanyahu was part of a special forces unit that saved a plane from terrorists. The head of that team was a former Israeli PM Ehud Barak. https://en.wikipedia.org/wiki/Sabena_Flight_571#Hijacking https://en.wikipedia.org/wiki/Sabena_Flight_571#Hijacking Compare leadership of France, Germany, etc.
- siculars 6y ago
  Na. Lots of places have socialized medicine like Israel. Not many of them, if any of them, are having the successful rollout Israel is enjoying. The entire Israeli society is prepared for this sort of event more so than any other in the world. Civil society, healthcare (as you pointed out), military and, dare I say, even religious all work together to pull this off.
  - smileybarry 6y ago
    I agree with Nir, HMOs are carrying a huge amount of the load here (after the government supplying all those vaccines). You have 4 HMOs total -- one of them (Clalit) being huge -- so there's not much fragmentation; a very fast crew of health workers which allows us to reach that level of vaccinations/day; and an existing well-tested infrastructure for flu vaccines, which are in high demand each year. I don't think the military was involved yet, and religion was in fact working against vaccination efforts as a few anti-vax rabbis drove sectors of the Haredi population off. EDIT: Saw another comment about a person in uniform doing the immunization so I might've been wrong about the army's involvement. But either way most comments referring to military involvement mean i.e. wartime levels of involvement, military handing out gas masks door-to-door etc. We're not at the level that the army is a sizable force, from what I can tell. (Except immunizing their own soldiers of course)

mchusma 6y ago

The US also has almost no sense or urgency (maybe more than the EU, but pretty bad). Examples: - modernas main bottleneck is filling. They applied weeks ago to fill the same bottles with 15 doses instead of 10. The FDA has still not approved it. - the us prioritizes second doses over first doses. This creates a ton of cascading issues, including the fact that many places are storing half the doses for 28 days. Many people have reported getting the same lot number for the second shot. - the FDA takes 3 weeks to schedule approval meetings (after having reviewed the data enough to believe an EUA is warranted). -the FDA hasn't approved Astrazeneca, one of the last countries to do so. -our prioritization system is a mess. It's really hard to figure out who is eligible. "Healthcare workers" (which was supposed to be the first group) is vague, so of course what happened is what you would expect. I know about 100 people personally who have gotten the vaccine as healthcare workers. Only 1 works with COVID patients. Most of the others have less contact with people than grocery store workers. They should have just done covid ward workers first (<1M people) then go by age only. Super easy to know who is eligible. Our local hospital sat on doses from late Dec to late Jan because they didn't know who to give them to. After sitting on them for almost 30 days, they realized if all the doses went bad it would be a scandal so they just gave it to everyone on the property first come first serve.

azinman2 6y ago
I think you’re making a lot of assumptions that FDA approval/disapprovals are slow due to a sense of urgency. I’d like to see evidence for that, I’d personally assume it’s quite the opposite— they’re trying to get it as right as they can before doing something at scale that can’t be easily undone. If 15 doses lead to issues compared to 10, then you jeopardize all those vaccines which are slow and difficult to make. You also give people false sense of hope and possibly either get lower effectiveness or build public distrust. These are tough balancing acts.
- zbrozek 6y ago
  It's really hard to grok why 15-vs-10 doses in a bottle should be a problem. Sure you've got the out-of-fridge time, but that hardly seems like an issue when the population is itching to get vaccinated.

siculars 6y ago

It's because at every level of government Israel plans for, practices and anticipates any type of scenario from nuclear war, to chemical attack to biological warfare. Rapidly distributing materials to the population is absolutely within the ability of the IDF and their civil counterparts. Vaccines fall into these categories. It also doesn't hurt that most of the over 18 population have been in the military and know how to follow orders. For those of you who would attribute the successful roll out to the latter, don't. It all starts with anticipating black swan events and being prepared for them.

chrismcb 6y ago

My take on it. No one believed Trump would do it, not wanted to give him a win. So there was little upfront planning. Then the vaccine was announced and people scrambled. Here in WA, a month after they got the first vaccines they decided to open songs vaccine centers. As if it was a new idea. Why weren't these ready to go day 1? Then there is the whole mess of who gets it. Should have been strictly by age. Instead there is a huge list of who can get it. And it was supposed to be done without discrimination. But because of the long list of exceptions, it makes it easy to discriminate. Then there was the whole save the second dose... No give everything out. While there are people who want to wait, that really isn't the problem. A freezer broke here, in the middle of the night and the put it a message in social media and delivered all the vaccines within hours. The stupid thing is, if they have the vaccine just to the elderly, we could practically go back to normal in like a month...