When the first COVID-19 vaccines were approved for emergency use in December 2020, healthcare systems across the Unites States needed to rapidly design and implement their own approaches to distribute COVID-19 vaccines equitably and efficiently. This new role has required Beth Israel Lahey Health (BILH) to develop new strategies and build large operational teams to organize and successfully vaccinate more than 14,000 patients a week across Eastern Massachusetts. In an Insight article published in JAMA Health Forum, Leonor Fernandez, MD, Assistant Professor of Medicine in the Department of Medicine at Beth Israel Deaconess Medical Center (BIDMC) and Peter Shorett, MPP, Chief Integration Officer at BILH, identify five key lessons about health equity that have emerged from BILH’s vaccination campaign for the health system’s approximately 1.6 million patients.