With the COVID-19 vaccines now widely available and in use, many of us have been eager to see them reach frontline healthcare workers, residents of long-term care facilities, and other priority groups so they can be protected. But vaccine rollout has been slow, and lags far behind richer countries.
In this article, we explore the determinants of vaccine rollout at the country level and examine their effects on health outcomes. Ordinary least squares regressions and multivariable regressions reveal that a number of factors are significantly associated with the rate at which vaccines are distributed. These include the extent to which a country’s population is trusting of government, its economic status, and the degree of political stability (Appendix Table A.3, columns 1 through 3).
We evaluate the impact of these and other factors on the optimal vaccination prioritisation strategy to achieve a fast, safe, and equitable rollout. For example, we find that vaccinating groups with high levels of daily interactions (e.g., scheduled professions or those with underlying health risks) first results in up to 7% fewer total fatalities. However, when children are excluded from the vaccination target, prioritising them by interaction alone appears to dissipate these benefits. Vaccinating elderly people first, on the other hand, leads to up to 11% fewer fatalities. The dynamic vaccination allocation approach we propose (RbPAD) performs very well when vaccination rollout is slow and coverage is high, and does even better than the best of the nine possible permutations of single call strategies by age or interactions.