Weighing the success of the various vaccine rollout strategies

Decentralization of supply management led to better results

Alexandre MassauxVaccines are seen as the key to ending the COVID-19 crisis. But creating a vaccine is one thing; having enough of it for the population is another. Here comes the problem of supply management.

From the beginning of the crisis, many pharmacy laboratories worldwide tried to develop a vaccine against the virus. Some of them have been successful. Among the most used vaccines, three are from U.S. companies – Moderna, Pfizer (in co-operation with Germany) and Johnson & Johnson – one from a British-Swedish company (AstraZeneca), one from Russia (Sputnik V) and three from China (CanSino, Sinopharm and Sinovac).

The early results of the vaccination campaign reveal some lessons. The companies producing the vaccines are concentrated in very few countries, like the United States, China, the United Kingdom and Russia. Other countries are dependent on these supplies.

And the European Union’s strategy of distribution shows that centralization hasn’t been efficient.

On May 18, with 58.9 per cent of its population fully vaccinated, Israel led the way. They were followed by the U.S. with 37 per cent of the population fully vaccinated and the U.K. with 30 per cent. If we only look at the share of the population given at least one dose, the respective numbers are 62.8 per cent, 47.2 per cent and 54.1 per cent.

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For the U.K. and the U.S., these high rates can be linked to producing vaccines in competitive circumstances. In the U.S., this success can be related to the deregulation of the development of the vaccine. According to one report, “The Food and Drug Administration (FDA) has allowed private and public laboratories to develop coronavirus test kits before obtaining emergency use authorization.”

More power was given to states to oversee the testing kits being developed and the laboratories using them. Major American laboratories succeeded in creating a vaccine that’s now exported to many countries.

But bureaucratic restrictions in some countries have hindered the development of vaccines from promising laboratories: the renouncement of the vaccine candidate developed by the Institut Pasteur in France is an example.

For Israel, the key to success was the structure of its health-care system. Its four health maintenance organizations (HMOs) are independent and decentralized. The Friedrich Naumann Foundation remarked that: “They run small medical centres all over the country, mostly organized on the municipal level, that can treat basic cases quickly and efficiently – releasing hospitals of congestion. This decentralized network of municipal medical centers of the HMOs allows quick and flexible organization of the vaccination campaign across the country.”

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To secure vaccines, the Israeli government adopted a pro-business strategy.

The European Union chose a more regulated and centralized strategy, which failed. The negotiations for vaccine acquisition were made by European Union institutions more than by member states. Cohesion was prioritized rather than speed. Most European countries had around 14 per cent of their population fully vaccinated by mid-May. Only Malta with 32.5 per cent and Hungary with 28.5 per cent have good scores. Hungary secured vaccines by buying from a variety of sources – and the strategy paid off.

Canada experienced some difficulties early on in receiving enough doses to ensure an efficient vaccine campaign.

Clearly, a more decentralized approach leads to better results.

Canadian pharmacies have played a significant role in the vaccine rollout. And in the U.S., pharmacies are an essential element of the vaccination strategy.

Alexandre Massaux is a research associate with the Frontier Centre for Public Policy.

Alexandre is a Troy Media Thought Leader. For interview requests, click here.


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