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

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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At the Shangri-La dialogue in Singapore last week, U.S. Secretary of Defense Pete Hegseth said that the United States would be expanding its defense partnership with India. His statement was in line with U.S. policy over the last two decades, which, irrespective of the party in power, has sought to cultivate India as a serious defense partner. The U.S.-India defense partnership has come a long way. Beginning in 2001, the United States and India moved from little defense cooperation or coordination to significant gestures that would lay the foundation of the robust defense partnership that exists today—such as India offering access to its facilities after 9/11 to help the United States launch operations in Afghanistan or the 123 Agreement in 2005 that paved the way for civil nuclear cooperation between the two countries. In the United States, there is bipartisan agreement that a strong defense partnership with India is vital for its Indo-Pacific strategy and containing China. In India, too, there is broad political support for its strategic partnership with the United States given its immense wariness about its fractious border relationship with China. Consequently, the U.S.-India bilateral relationship has heavily emphasized security, with even trade tilting toward defense goods. Despite the massive changes to the relationship in the last few years, and both countries’ desire to develop ever-closer defense ties, differences between the United States and India remain. A significant part of this has to do with the differing norms that underpin the defense interests of each country. The following Council on Foreign Relations (CFR) memos by defense experts in three countries are part of a larger CFR project assessing India’s approach to the international order in different areas, and illustrate India’s positions on important defense issues—military operationalization, cooperation in space, and export controls—and how they differ with respect to the United States and its allies. Sameer Lalwani (Washington, DC) argues that the two countries differ in their thinking about deterrence, and that this is evident in three categories crucial to defense: capability, geography, and interoperability. When it comes to increasing material capabilities, for example, India prioritizes domestic economic development, including developing indigenous capabilities (i.e., its domestic defense-industrial sector). With regard to geography, for example, the United States and its Western allies think of crises, such as Ukraine, in terms of global domino effects; India, in contrast, thinks regionally, and confines itself to the effects on its neighborhood and borders (and, as the recent crisis with Pakistan shows, India continues to face threats on its border, widening the geographic divergence with the United States). And India’s commitment to strategic autonomy means the two countries remain far apart on the kind of interoperability required by modern military operations. Yet there is also reason for optimism about the relationship as those differences are largely surmountable. Dimitrios Stroikos (London) argues that India’s space policy has shifted from prioritizing socioeconomic development to pursuing both national security and prestige. While it is party to all five UN space treaties that govern outer space and converges with the United States on many issues in the civil, commercial, and military domains of space, India is careful with regard to some norms. It favors, for example, bilateral initiatives over multilateral, and the inclusion of Global South countries in institutions that it believes to be dominated by the West. Konark Bhandari (New Delhi) argues that India’s stance on export controls is evolving. It has signed three of the four major international export control regimes, but it has to consistently contend with the cost of complying, particularly as the United States is increasingly and unilaterally imposing export control measures both inside and outside of those regimes. When it comes to export controls, India prefers trade agreements with select nations, prizes its strategic autonomy (which includes relations with Russia and China through institutions such as the Shanghai Cooperation Organization and the BRICS), and prioritizes its domestic development. Furthermore, given President Donald Trump’s focus on bilateral trade, the two countries’ differences will need to be worked out if future tech cooperation is to be realized.