Israel has already immunized about 647,000 people against Covid-19, a whopping 7% of its more than 9.2 million residents — more than any other country in the world per capita, according to the Israeli Ministry of Health.

The ministry boasted that it vaccinated more people in the first nine days of its campaign that than its total infections. Israel has had about 420,000 confirmed Covid-19 infections, according to data compiled by Johns Hopkins University.

“We are ahead of the world in bringing and giving the vaccines. Israel is the world champion in vaccines, in first place by a lot,” Prime Minister Benjamin Netanyahu said Tuesday. “My mission now is to ensure that we will continue at this pace and we are working on it together.”

In stark contrast, the U.S. has vaccinated roughly 0.8% of its population of 331 million against Covid-19 as of Wednesday, according to the Centers for Disease Control and Prevention. But the agency cautions that the figure could lag actual vaccinations as states report the data. Still, federal officials have acknowledged in recent days that the rollout has been slower than desired.

While Israel’s population is just slightly larger than New Jersey’s, the nation’s success in rapidly rolling out the first doses to a large portion of its population could hold lessons for countries like the U.S.

Dr. Jonathan Reiner, professor of medicine and surgery at George Washington University school of medicine and health services, on Thursday pointed to Israel as a potential model for the world.

“Israel is leading the world. They are vaccinating, on a per capita basis, 15 times faster than the United States,” he said on CNN. “They’ve already vaccinated 20% of their population over the age of 60. It would be as if we had already vaccinated about 15 million Americans over the age of 60.”

Centralized system

Israel’s main advantage is its centralized health-care system, said Eran Segal, a computational biologist at the Weizmann Institute of Science in Rehovot, Israel. Segal has been closely monitoring Israel’s response since the beginning of the pandemic.

“As someone who lived for about a decade in the U.S., I know that in the U.S., it’s much more scattered. There are probably thousands of organizations,” he said in a phone interview.

Segal noted that Israel, in contrast, has a more simplified insurance system, too, with just four health maintenance organizations. Segal noted that Israel’s health-care system is highly digital, with everyone over age 18 legally required to register with one of the four HMOs. He added that Israel’s government has coordinated well with the HMOs and local officials, calling in army medics to assist where needed.

In the U.S., the first days of the rollout were marred by confusion among governors and state officials over how many doses each state was receiving. Eventually, Gen. Gustave Perna, who oversees logistics for President Donald Trump’s vaccine program Operation Warp Speed, took the blame for the miscommunication.

While distribution has progressed more smoothly since then, states are administering shots at a slower-than-expected pace. Dr. Leana Wen, former Baltimore health commissioner, said it’s not clear what’s slowing the process. She noted that the federal government could help states set up more supplemental vaccination sites.

Vaccination ‘field clinics’

Segal said Israel established field clinics to distribute the vaccine. The Israeli Ministry of Health said Monday that the country will open 150 so-called vaccination complexes.

Health Minister Yoel Edelstein said in a statement this week that Israel is the first country to repackage doses of the vaccine into more easily transportable containers that allow the country to move the vaccines outside of hospitals and into more accessible clinics. “This way we will reach everywhere around the country without losing precious vaccines and Israel will be the leading country worldwide in vaccination,” Edelstein said.

In the U.S., most vaccinations are being administered in hospitals or medical centers where health-care workers are receiving the first doses. Recently, some outpatient urgent-care centers have begun vaccinating their staff, too.

CVS Health, Walgreens and other pharmacy chains have also partnered with the federal government to distribute shots to residents at long-term care facilities, though the CDC says the program is not yet fully up and running. The U.S. has signed contracts with pharmacy chains to administer the vaccines at retail locations across the country once the program expands to include members of the general public, but the program hasn’t launched yet.

President-elect Joe Biden on Tuesday said his administration will “set up vaccination sites and send mobile units to hard to reach communities.”

“This is going to be the greatest operational challenge we’ve ever faced as a nation,” he said this week. “We’re going to get it done. It’s going to take a vast new effort. It’s not yet underway.”