The first year of COVID-19 vaccine distribution has been marked by impressive efforts in scores of countries but also a troubling lack of supply for the world’s poorest nations. Widely used vaccines, mostly from China and the West, have proven highly effective at protecting immunized individuals from hospitalization and death. Evidence also shows that they can reduce the risk of infection, though how long that protection lasts is still undetermined. For countries with broad access to vaccine doses, this has meant the crucial ability to curb outbreaks of a disease with an official death toll of more than five million people and an actual death toll that is likely much higher.
As of November, half of the global population has received at least one dose of a COVID-19 vaccine. (Most are adults.) Roughly 40 percent has been fully vaccinated. The world’s two most populous countries have made remarkable progress: more than three-quarters of China’s population has been fully vaccinated, and more than half of India’s has received at least one dose. In late October, India celebrated administering its billionth dose after a slow and rocky start to its vaccination campaign.
Breaking down progress by countries’ income levels underscores the global divide: the majority of doses administered have been in higher-income countries, while only 4 percent of people across all low-income countries have gotten at least one dose. African countries are by a wide margin the farthest behind, with many relying on donations through the global COVAX initiative or directly from countries such as China and the United States.
However, some nations have proved to be outliers. South Africa has struggled to obtain doses along with its neighbors despite being among the wealthiest on the continent, while Cambodia stands out among its low-income peers, with more than three-quarters of its residents immunized.
“There is a stat that has remained remarkably stable since the first vaccines were approved in December 2020,” says CFR’s Thomas J. Bollyky. “Just ten countries have administered three out of every four shots.”
Wealthier nations ramped up their pledges to donate doses in recent months, particularly at U.S. President Joe Biden’s COVID-19 summit and the Group of Twenty’s (G20’s) meeting in Rome. Yet, those promises have been slow to translate to deliveries; and because of supply delays, COVAX has already announced it will fall short of its target to deliver two billion doses—primarily to poorer countries—in 2021. Meanwhile, the decision of some wealthy countries to begin administering booster shots while many elsewhere are still unvaccinated has sparked fierce debate over who to prioritize.
The still-high number of unvaccinated people raises concerns about the possibility of the emergence of new variants that could prove more resilient against current vaccines. To speed up vaccination rates, many governments and businesses around the globe have issued mandates, which have convinced some people to get immunized and prompted others who are hesitant about the vaccines to protest. Moreover, the availability of COVID-19 vaccines is gradually being expanded to children, with teens the first to gain access in many countries.
Although achieving herd immunity—when most of a population has been vaccinated and is immune to a particular disease—is unlikely, experts say, global efforts continue with the aim of providing people a high level of protection and reaching a point where the new coronavirus is manageable.