Three ways to ensure Israelis take the COVID-19 vaccine - analysis

The World Health Organization offers recommendations for how to convince the public to get inoculated. The Jerusalem Post adapts them to Israel.

A woman holds a small bottle labeled with a "Coronavirus COVID-19 Vaccine" sticker and a medical syringe, October 30, 2020. (photo credit: REUTERS/DADO RUVIC/FILE PHOTO)
A woman holds a small bottle labeled with a "Coronavirus COVID-19 Vaccine" sticker and a medical syringe, October 30, 2020.
The coronavirus vaccine is on its way to Israel, with some doses likely to arrive as early as this month. 
But once approved by the Health Ministry, will Israelis take it?
The World Health Organization (WHO) shared recommendations for how to convince the public to get inoculated last week in a report called, “Behavioral considerations for Acceptance and Uptake of COVID-19 Vaccines.” 
The report is based on a meeting by members of the WHO Technical Advisory Group on Behavioral Insights and Sciences for Health with the WHO Department of Immunization, Vaccines and Biologicals.
The recommendations center on three categories: Creating an enabling environment, harnessing social influences, and increasing motivation – all which can be adapted to and apply in Israel. 
Here is what the government and Health Ministry can do now to help ensure mass vaccinations:
1 - Make vaccination easy and quick
“Is the vaccination being given in a close by, convenient place?” WHO asks. “Is it time consuming to be vaccinated? Is booking easy and accessible? Are vaccinations delivered at a time of day that is convenient?”
All of these are also questions for Israel to consider before it begins administering COVID-19 vaccines. 
The vaccines should be given out by the local health funds, both by appointment and on a walk-in basis – no referral required. 
If in the beginning the vaccines need to be rationed and prioritized, then the criteria for priority vaccination should be widely publicized in multiple languages. 
As was done with the flu vaccine this year, people who the country really wants to see vaccinated should be contacted by their health fund and given an appointment. Otherwise, appointments should be able to be easily made online or by telephone. A dedicated phone number should be available to assist those who need it.
Since elderly people are expected to be among the top priorities for vaccination, senior living centers and day programs should be set up as vaccination hubs through the assistance of Magen David Adom, enabling residents and visitors to be inoculated on the spot. MDA should also set up mobile vaccination centers similar to the drive-in testing centers in areas where health funds are more spread out.
WHO also talks about ensuring those who are considering vaccination be provided with relevant and easy-to-understand information. This could mean providing printed information at all health funds, prominent in the waiting rooms, for patients to read while they are waiting for other appointments. 
Although it would be illegal to require vaccinations, getting vaccinated can be the “default.” In Israel, for example, the default in schools is to vaccinate all students unless their parents object and opt them out of it. This process, WHO has explained, increases vaccination rates. 
As of now, looking at the eligibility for the largest Phase III clinical trials, there are no studies that include volunteers under the age of 12 or pregnant women. As such, there could be a delay in distributing the vaccine to these populations until safety data are available. Vaccines should not be used for people not included in the clinical trials.
However, once children are eligible to be vaccinated, offering the vaccine in schools could increase compliance. 
2 - Harness social influences and influencers 
Multiple types of people can facilitate or discourage vaccination, including political and religious leaders, as well as the media. 
“Predominant narratives in the media can … skew people’s perception of what the majority believe and do,” wrote WHO. “For example, anti-vaccine sentiments expressed by relatively small but vocal groups may be promoted, so that they are erroneously seen as capturing a widespread or even majority view.”
During coronavirus, when social distancing is encouraged and gatherings forbidden, perceptions are largely based on what people see on social media or TV and less through direct interaction, WHO noted. As such, these platforms carry even greater responsibility.
One can recall widespread interviews at the beginning of the pandemic with former Health Ministry director-general Yoram Lass, who compared the pandemic to seasonal flu and said health officials were overreacting. Over time, his appearances began to wane. But he had already influenced many.
Now is the time to express caution in our communication. It is good to communicate a variety of ideas – science is not always black and white and is ever evolving, and it is important to ask tough questions about issues such as safety and long-term side-effects – but also to ensure they are as balanced and accurate as possible.
On Thursday, Facebook said it would begin removing posts “containing false claims about these vaccines that have been debunked by public health experts” in an effort to stop misinformation from becoming widespread.
This information, according to a blogpost by the social media giant, could include false claims about the safety, efficacy, ingredients or side effects of the vaccines. 
“For example, we will remove false claims that COVID-19 vaccines contain microchips, or anything else that isn’t on the official vaccine ingredient list,” the network said.
The move goes beyond what the company has done to handle misinformation about coronavirus in general or other vaccines in particular up until now, in which it has labeled those posts as “false” or “partially false” and then downranked them, making them less visible in people’s news feeds.
Facebook’s efforts should be applauded, but also carefully monitored. The company itself admitted at the end of its blog post that, “It’s early and facts about COVID-19 vaccines will continue to evolve.” 
An October survey by the Israel Democracy Institute, found that only around 30% of Israelis have had trust in Prime Minister Benjamin Netanyahu to manage the coronavirus crisis. In contrast, nearly 70% had faith in former coronavirus commissioner Prof. Ronni Gamzu.
Health professionals will likely be the first people eligible to receive the COVID-19 vaccine. These people could be the best PR for inoculation. The Health Ministry should make efforts to highlight the effect of the vaccine on doctors and nurses who are willing, and these health professionals should be encouraged talk about safe vaccination – assuming they think it is – with their patients.
But politicians do have a role. 
Former presidents Barack Obama, George W. Bush and Bill Clinton have volunteered to get the COVID-19 vaccine on camera to promote confidence in the vaccine's safety for the public, CNN reported last week. US President-elect Joe Biden said he would also get vaccinated publicly.
In Israel, it is possible that Netanyahu and Health Minister Yuli Edelstein will be the first in Israel to receive the coronavirus vaccine outside of clinical trials, Channel 12 reported on Friday. 
Earlier in the week, when asked by Ynet whether or not he would be among the first to be inoculated, Edelstein said, “On the one hand, of course, we must set a personal example and get vaccinated. On the other hand, I ask myself what is right, if we say half a million vaccines, do I take the vaccine and not someone at risk?”
3 - Increase motivation 
Finally, WHO explained that “motivation to get vaccinated is usually the result of factors, such as perceived risk and severity of infection, confidence in vaccines, values and emotions.”
According to WHO, if people perceive that they are at low risk for contracting COVID-19 or experiencing serious symptoms, they will be less motivated to take the vaccine.
Last week, coronavirus commissioner Prof. Nachman Ash disseminated a statement in which he raised a red flag about growing infection in the Arab sector. He shared that a number of new patients from the Arab sector who are being hospitalized in serious condition are younger than expected. At the time, a 41-year-old was being treated at Emek Medical Center in Afula, a 48-year-old at Hadassah-University Medical Center in Jerusalem, a 40-year-old at Baruch Padeh Medical Center in Poriya (near Tiberias), a 68-year-old at Holy Family Hospital in Nazareth, a 54-year-old at EMMS Nazareth Hospital, a 57-year-old at Carmel Medical Center in Haifa and a 52-year-old at Sheba Medical Center in Tel Hashomer – all of them in serious condition.
Rather than just sharing numbers, the families of these victims should be asked if the country can see their faces. Humanizing the reality that a certain percentage of young people will get really sick or even die could go a long way in motivating people to be vaccinated.
In addition, the social benefits of vaccination should be enunciated. 
In 2013-2014, when Gamzu managed the polio outbreak, he reportedly understood the need to communicate clearly with all sectors, including the ultra-Orthodox and Arab sectors, and he met personally with opinion leaders in these communities.
“The polio crisis was defined as an emergency... and the crisis was handled through mobilization of, and cooperation among, many players – doctors and experts, HMOs, local governments and others,” a senior official told Israeli media then.
Ultimately, some 980,000 children were vaccinated against polio between August 2013 and January 2014, and the disease caused no injuries or deaths.
Vaccination does not only protect the individual who is inoculated, but also helps establish herd immunity – protecting others in the community, including their family and friends. This herd immunity is what will allow Israelis to return to work and play more like they did before the crisis.