Vaccination in Pandemic: Speed Matters

This blog is written by Anabella Abadi M. and Gustavo Fajardo.

Excerpt: Vaccination campaigns have started at a slow, uneven pace in the region. Accelerating them is extremely valuable, in terms of lives saved and economic activity. Governments must identify the factors that limit the speed of campaigns and make determined investments to address them.

Vaccination policy must be governed by the principle that each day counts, in a very literal sense. There is great value in getting vaccinated early. A simple (and perhaps a little naïve) exercise can help us understand the value of vaccinating a person, say, three months earlier: At the peak of the pandemic in the region, the mortality rate reached 0.03% of the population in a 30- day period. At that rate, speeding up vaccination by three months means reducing the risk of death by 0.1% for an average person (the numbers are even more dramatic for older age groups). That benefit is difficult to express in monetary terms, but any reasonable calculation would show that it is far higher than the prices being paid for the doses (between 3 and 44 USD)). In this connection, an IDB study with calculations for Latin America estimates that ending the pandemic three months earlier “would bring a profit of almost USD 35 billion in economic terms alone”. The benefits of vaccinating quickly are so high that they justify greater expenditures and greater tolerance to certain risks than observed so far. In addition, a year of pandemic has taught us that containment and control measures are very costly and of questionable effectiveness.

The good news is that vaccination campaigns have already begun in virtually all Latin American countries. The bad news is that the initial pace has been slower than desired, although with great heterogeneity. The percentage of the population that has received at least one dose to date ranges from less than 1% in some countries to more than 10% in others (see Image 1). Chile is an exceptional case of success, having deployed one of the fastest vaccination campaigns worldwide.

Image 1. Percentage of the total population that has received at least one dose (as of March 24, 2021)

Note 1: The data presented were calculated using the latest available data by country as of March 24, 2021.
Source: OWID and authors.

If we make projections based on the current vaccination rate, most countries in the region will apparently not even be able to vaccinate their total priority population this year (see Table 1) and will not achieve herd immunity before 2023 or later.

Table 1. Days needed to fully immunize 70% of the population (estimates as of March 22, 2021)

Note 3: For the projection of the days needed, we used the average daily vaccination rate of the last 14 days.
Source: authors, with data from OWID, Clark et al. (August 2020, The Lancet) and WHO.

The slow rate observed in these first months is partly due to factors that are not specific to the region. In fact, in continental Europe the start has also been slow, with 10% of the population partially vaccinated to date (not too different from the best-performing Latin American countries). Production and regulatory issues are expected to be smoothed out over time. Still, many uncertainties remain, and governments need to actively strive to accelerate the pace of campaigns.

Given the need to accelerate efforts, we must ask ourselves, what is the main limiting factor: the ability to distribute and administer vaccines, or their availability? Surely it is a bit of both. Some data seem to reveal differences in deployment capabilities to administer vaccines quickly. Chile is an example of outstanding performance. Up to a full 2% of the population has been vaccinated in one day during most active campaigns. This contrasts with the rest of the region, with no country coming even close to these numbers. Uruguay has vaccinated 1% of inhabitants in certain days, while the rest of the countries, in their most active campaign days, have been able to vaccinate 0.5% of the population or less. To improve in this area, there is some room for adjustment: number of vaccination sites, number of qualified vaccinators, working days and hours, registration and appointment systems, information strategies, etc. The rules for proceeding in an orderly manner and respecting the priority for certain groups are important, but they should not affect the overall pace of the campaign. It is important to keep in mind that every day counts, in a very literal sense.

Furthermore, vaccine availability is also an important factor in the speed of progress, and may be even more so in the near future. In some countries in the region, daily data on doses administered show an uneven behavior, which seems to suggest inventory problems. And several countries have not yet closed on purchases of enough doses to vaccinate their entire population. This represents a huge risk. Most nations that have made rapid progress in their vaccination campaigns (Israel, Chile, USA, United Kingdom) have concluded agreements for a number of vaccines for several times their population. Given the uncertainty about the effectiveness of the different vaccines and the excess demand vs. production capacity, these aggressive, diversified purchasing strategies have allowed them to reduce the risk and get a head start. As it stands, countries of the region must remain active buyers and seek agreements that diversify their portfolio of potential suppliers. It would be ideal to use cooperation mechanisms between countries to coordinate purchases together and avoid pricing wars. Unfortunately, experience so far shows that this is not a very likely prospect.

Even investing in production facilities can be profitable at this point. A recent study by a group of economists and statisticians estimates that expanding production capacity by an additional billion units could accelerate widespread immunization of the world’s population by four months, with benefits estimated at approximately USD 800 per unit.

Many uncertainties remain even about the course of the pandemic in the coming months. Among them, one certain fact stands out, however: The best investment a country can make today is to vaccinate its population quickly. And governments in the region must act accordingly.