What the data show about vaccine supply and demand in the most vulnerable places

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The detection of the Omicron variant has drawn renewed attention and new urgency to the global Covid-19 vaccination campaign, which experts say remains one of the most powerful tools at our disposal to prevent further variants. dangerous.

Most of the rich countries have vaccinated a significant portion of their population and have moved quickly to the booster phase. But a year after the vaccine’s global launch, the gap between vaccination rates in high-income and low-income countries is bigger than ever.

Poorly vaccinated countries face several challenges. At the start of the deployment process, some countries were unable to obtain enough doses to immunize their residents, and many still face shortages. In others, the offer is only part of the story. A New York Times analysis of available data highlights countries where infrastructure problems and the level of public willingness to be vaccinated may be greater barriers than supply.

Which countries have used the largest share of the doses dispensed to them?

Sources: dose data provided by Airfinity; data on doses administered from Our World in Data.

Note: Data as of December 2, 2021, when the global average vaccination rate was 45%. The circles are sized according to the population of the country. Figures marked with an asterisk * were calculated using a number of doses administered that was last reported over two weeks ago. Countries which did not report dose data in the last 30 days are not shown.

Some countries with lower than average immunization rates use most of the vaccine doses they have available, and some do not. Most countries with high immunization rates have used most of the doses given to them; they are grouped together on the right side of the graph above.

If a country is using most of its available doses but still has a low overall immunization rate, it is a sign of a supply problem, experts say: The country is not receiving enough doses to immunize its consenting population. These countries are further to the right side of the below-average immunization section in the table.

If a country with a low vaccination rate uses a smaller share of the doses it has available, this suggests that demand in the country is low, experts say, or that there is a lack of infrastructure to distribute the vaccines. These are countries that are falling more to the left.

“There may be various reasons for the low use of the vaccine,” said Dr. Amesh Adalja, infectious disease specialist at the Johns Hopkins Center for Health Security. “The most obvious is just the lack of doses, and that would be represented by countries using whatever they get.”

Share of available doses used in least vaccinated countries

Countries with immunization rates below the global average rate are shown.

100 doses were delivered per 100 people

50

ten

Low income countries

RWAUsed 71% of doses book

TGO36%

TJK98%

MOZ88%

UGA

GIN68%

ELS

FAC

LBR

GNB96%

AFG

SOM

ETH

HMI

BFA

OMD

MLI

TNS

HTI

SSD

TCD

Lower-middle-income countries

KIRUsed 40% of doses book

PHL61%

UZB78%

NIC77%

BOWL60%

BARREL86%

INDIANA89%

HND87%

TRM43%

NPL70%

ZWE57%

MMR64%

BGD81%

VUT59%

MDA84%

COM85%

SLB49%

PAK94%

UKR98%

DZA50%

LSO53%

SINCE58%

DJI

SWZ66%

GHA

KEN

SEN

ZMB

BEN

NGA

PNG

CMR

Sources: data on doses delivered from Airfinity; data on doses administered from Our World in Data.

Note: Data as of December 2, 2021, when the average global vaccination rate was 45%. Figures marked with an asterisk * were last reported over two weeks ago. Countries which did not report dose data in the last 30 days are not shown.

Uneven distribution

At the start of the pandemic, when drug makers were just starting to develop vaccines, wealthier countries were able to pre-order enough to cover their populations several times over, while others struggled to get doses.

Now experts say those early purchases have led to continued discrepancies in immunization rates.

“In terms of equity, things are worse than six months ago as we see disparities in vaccine purchases translating into disparities in immunization coverage,” said Andrea Taylor, researcher at Duke University. who studied the purchase agreements.

The advance of the richest countries in terms of immunization has kept them in the lead

The circles are sized according to the population of the country.

Income group

Moo

Lower middle

Upper average

High

Sources: Immunization data from local governments via Our World in Data; World Bank income classifications and gross domestic product data.

Figures marked with an asterisk * were last reported over two weeks ago.

The richest countries, including the United States, have donated more than 700 million doses to low-income countries, according to UNICEF. Experts say donations are crucial for improving vaccination rates around the world and slowing the progression of the coronavirus and, in turn, new variants, which can cause epidemics even in highly vaccinated populations.

“We are entering a third calendar year of cycles of Covid-related closures and reopenings, triggered in large part by the steady and predictable emergence of new variants,” said Benjamin Schreiber, deputy head of the Global Immunization Program of the UNICEF. “The more the virus continues to spread unchecked, the greater the risk of the emergence of deadly or contagious variants. Immunization equity is not charity; it is an epidemiological necessity.

What does hesitation look like

Low demand just means that people in a given country who have good access to vaccines do not show up for the vaccine. Experts say the reasons people refuse to be vaccinated vary widely across the world.

“Each country and community has its own problems and there is no one-size-fits-all approach,” said Mr. Schreiber.

For some, the reluctance is less about mistrust of vaccines than mistrust of their governments, said Kaveh Khoshnood, epidemiologist at Yale University.

“There are countries in the world where people just don’t trust their government,” he said, “because governments sometimes lie, they’re not transparent, they don’t really share information. ‘information with the general public’.

Others may be more skeptical about where their vaccines are coming from, such as those who only have access to vaccines from China, Dr Khoshnood said. “People may be somewhat hesitant or reluctant or not fully trust the Chinese vaccine because they feel there is not enough information about its effectiveness,” he said.

Converting doses into vaccines

It is also possible for a country to have high demand and an adequate supply “but have difficulty delivering these doses to the population due to transport constraints, cold chain storage” and other logistical problems. said Bill Moss, director of International Vaccine Access. Johns Hopkins University Center.

In countries with large rural populations, the success of a vaccine deployment may come down to the number of people available to administer the vaccines. In other words, “human infrastructure,” said Dr. Sheela Shenoi, an infectious disease specialist at Yale University.

“Like what we have experienced here in the United States, any system of health care delivery will depend on the number and types of people qualified to provide services,” she said. “Even if there is a vaccine supply, if you don’t have the people to deliver that supply, it won’t be successful.”


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