In Brief

What to Know About the Global COVID-19 Vaccine Rollout So Far

Several countries stand out for their success in delivering coronavirus vaccinations, while most of the world is struggling to figure out how to get immunizations into more arms.

The pressure is on for countries to vaccinate people against the new coronavirus disease, COVID-19: close to fifty million doses have been administered in the month since the first vaccines were approved for use. But with a global population of nearly eight billion, that’s only a small first step. Even in countries that have stocks of the vaccine, the rollout has been laggard; it is yet to begin in many others. It could take years for most of the world’s population to be immunized, especially as new strains of the virus present greater challenges.

Where has COVID-19 vaccination already started?

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Generally, wealthier countries that were able to make advance purchase agreements with vaccine makers, particularly domestic manufacturers, have been the first to start COVID-19 vaccinations. China, European Union states, Israel, Russia, the United Kingdom, and the United States are among the dozens of countries where vaccination campaigns are underway.

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China and Russia are also sending their vaccines across the Middle East and Asia—vaccine diplomacy that could forge stronger partnerships with countries in those regions, including longtime U.S. allies. President Joe Biden has vowed to increase U.S. vaccine supplies as well as boost international cooperation in his first days in office, starting with rejoining the World Health Organization (WHO).

At the same time, many lower-income countries have not even begun COVID-19 vaccination, losing out to wealthy nations on bids for supplies or waiting for more cost-effective options, such as vaccines by the University of Oxford and British-Swedish company AstraZeneca and by U.S. firm Johnson & Johnson. (Most approved vaccines require two doses, while Johnson & Johnson’s is expected to require only one.) WHO chief Tedros Adhanom Ghebreyesus berated vaccine makers for prioritizing profits over equitable global access.

Some countries with severely limited supplies are home to large numbers of refugees or displaced people, vulnerable groups that collectively number around seventy million worldwide: Jordan, for example, became the first nation to administer COVID-19 vaccines to refugees, a move that UN officials have urged other countries to follow.

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Which countries have been most successful?

Israel. Within just two weeks of starting vaccinations, Israel had already reached close to 15 percent of its population, the fastest pace in the world. The government reportedly paid high premiums for its vaccine supplies, and ordered doses early. It also has a fully digitized universal health-care network, making it easier to identify priority groups and carefully track vaccinations, and a relatively small population, at around nine million people.

United Arab Emirates. Like Israel, the UAE has a small population and a universal health-care system, presenting similar logistical advantages. The Gulf nation has been administering not only vaccines by U.S.-based Moderna and U.S. and German partners Pfizer and BioNTech, but also one developed by China’s Sinopharm, delivering doses to nearly one-fifth of its ten million people by mid-January. Also contributing to the rapid rollout have been efforts to boost public confidence, including an Islamic ruling in favor of COVID-19 vaccines by the country’s Fatwa Council.

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Which countries have been struggling?

Canada. Though Canada preordered enough vaccine doses to immunize its population several times over, its distribution has been sluggish and fragmented. Provinces and territories, rather than the federal government, are responsible for deciding priority groups and figuring out the logistics for reaching thirty-eight million people. Medical experts say residents of long-term care facilities were neglected in the initial round, despite some provinces having enough doses.

United States. The lack of a synchronized federal approach has also impeded the U.S. rollout: by late January, less than half of doses distributed to states had been administered, with local officials and health professionals describing the same challenges faced by Canada and others. Still, the country has among the highest rates of doses administered per capita, and Biden has announced plans for a more centralized pandemic response, which includes administering one hundred million doses in his first one hundred days in office.

When is most of the world’s population expected to be protected from COVID-19?

It will likely take years for the majority of the world’s population to become immunized against COVID-19. Gavi, the Vaccine Alliance, is aiming to distribute two billion doses worldwide by the end of this year.

Researchers have modeled different scenarios for vaccine distribution, finding that with an efficient distribution network, even large countries such as Australia could achieve high vaccination rates within a couple of months. CFR’s Thomas J. Bollyky, Jennifer Nuzzo, and Prasith Baccam suggest that, in the United States, the Biden administration should model its vaccination campaign on bioterrorism preparedness efforts that followed the 9/11 attacks.

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