Vaccination goal setting and access to Covid-19 vaccines

One of the marks of the Covid-19 pandemic is the extraordinary speed of vaccines development and availability. This came about as a result of a number of factors including early release of the genetic sequence of the SARS-CoV-2 virus (10 January 2020), rapid action by developers and manufacturers (by May there were nearly 200 candidate vaccines in development), ‘lucky’ timing in term of readiness of the novel nucleic acid vaccine platform, and contracts that shouldered many of the risks associated with manufacturing and development (by June more than $5 billion in contracts were in place and that increased to more than $12 billion by August).

In addition, some countries set vaccination goals early in the pandemic and before vaccine characteristics were known. These goals drove their contracts. This note puts forth a brief analysis of Covid-19 vaccination goals. There has been a lot of discussion about contracts and equitable access, but we have not seen much analysis on the impact of goal setting.

Below is a table of the country and regional Covid-19 vaccination goals as of March 2021. The goal is presented as a percentage of total population and shows the achievement end date (year/month) of the goal. Some countries have intermediate goals which are not shown. The information is taken from public sources.

As can be seen, countries tend to have either a vaccination goal of around 20% that targets high-risk populations or a goal of around 60-80% that targets herd immunity (estimated by the European CDC to be 67%).

If we take a closer look the goals, we can see that there are differences in when goals were set. The US government had vaccination goals made public in early May and ACT-A/COVAX followed at the end of May. The EU goals were set a few months later in August.

In terms of progress on achieving goals, below is a chart that shows the number of doses delivered compared to the goal as of early April 2021. There are significant differences.

The above shows a point in time but it doesn’t show the trajectory of countries being on track to achieve their goals. If we look at the doses that would be needed each month (assuming linear deliveries) for the goal to be achieved by the goal end date, the unequal trajectory is clear.  

Countries that set their goals earlier and that have more ambitious goals in terms of achievement date and targets are more on track to achieve their goals. First deliveries of vaccine were made to nearly all countries by March, but countries with higher goals and contracts had earlier access (even starting in December) and received larger monthly quantities. We know the situation is not only a result of goal setting - there are multiple reasons for the unequal distribution of Covid-19 vaccines. It does seem, however, that goal setting could be an important yet overlooked component of vaccine availability.

As our analysis is based on information publicly available, we suggest there be a closer look at goal setting for the rest of 2021 and 2022 as one of the tools to help drive equitable access to Covid-19 vaccines moving forward.

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