Also read Part I, II, III , IV  and V of our series 'Global vaccination'.

Chile

Chile expects the pandemic to be over by mid-2021. Despite the current high infection rates and full hospitals, the country is optimistic about the future because it is currently one of the world's vaccination champions. In Chile, more than 3 million people – 16 per cent of the Chilean population –  received the first dose in just 21 days in February. The conservative government of Sebastian Piñera aims to vaccinate 80 per cent of Chileans by June to achieve herd immunity.

How can this success in Chile be explained? Because there was a clear vaccination strategy from the beginning.

First, there are clear responsibilities: Since May 2020, a special government envoy has been responsible for negotiating with laboratories and purchasing vaccine worldwide. He reports directly to the president and has the mandate to focus on diversification. Chile therefore purchased a wide variety of vaccines from different manufacturers (20 per cent BioNTech / Pfizer, 60 per cent Sinovac, 20 per cent AstraZeneca).

Secondly, the government quickly built confidence in the vaccines through scientific cooperation: all vaccines were tested in clinical trials in Chile in 2020. Chilean academics worked closely with the relevant foreign laboratories and also visited the sites where they were developed in China, Europe and the US. This has been widely reported by politicians and the media. The population therefore has great confidence in the vaccines, which are considered ‘Chilean-tested’. Hence, the willingness to vaccinate is high, while the number of anti-vaxxers is low.

Thirdly, Chile is a country that has financial reserves. It was thus able to quickly approve a budget of USD 300 million for the purchase of vaccines. In addition, Chile financed the clinical trials of the vaccines in its own country and received preferential purchasing treatment in return.

Fourth, there is a coherent political discourse and a clear communication strategy: ‘The vaccines are safe.’ And: ‘Getting vaccinated is an expression of my solidarity with my fellow human beings and my contribution to protecting all our lives.’ The president, ministers and media speak with one voice on Covid-19, there is no public confusion. An updated vaccination calendar is announced weekly. Almost every Chilean already knows his or her vaccination date.

Fifth, an efficient nationwide logistics system was quickly established: The State Institute of Public Health was in charge of setting up the vaccination centres and developing the vaccination calendar. Without much bureaucracy, it opened around 1,300 vaccination centres in the 5,000-kilometre-long country in currently unused sports halls, theatres as well as in public institutions. As a result, up to 80,000 people in Chile can be vaccinated every day.

Chile is on the right track. Nevertheless, there are still two major risks. Until June, the virus still has a lot of time to spread. The risk of another health catastrophe before herd immunity is achieved is real. Moreover, it is unclear how much safety the vaccine of the Chinese manufacturer Sinovac, which is mainly used in Chile, offers in case of the new mutations. So far, studies show 52 per cent protection against the ‘conventional’ coronavirus.

Simone Reperger, FES Office Santiago de Chile

United States of America

The month of March will be decisive for the success of the US vaccination strategy. It started with good news, as a third vaccine has just been approved by the Food and Drug Administration (FDA) for use. The new vaccine from the US pharmaceutical company Johnson&Johnson has the advantage of being easier to use and store. A single vaccination is sufficient and it does not require special refrigeration. The company is expected to deliver 20 million vaccine doses by the end of the month. Meanwhile, it has also emerged that its rival Merck will help Johnson&Johnson produce vaccine. The deal was brokered by the White House. Vaccine supplies from other manufacturers like Pfizer-BioNTech and Moderna will also increase significantly this month. Pfizer announced it would be able to ship 13 million doses a week by the middle of the month, up from five million in early February. Moderna plans to double its supply to more than 10 million doses by the end of the month. Together, this means that by the end of March, the US will have enough vaccine to immunise about 130 million Americans, about 40 per cent of the total population.

Since Joe Biden has become US president and made the fight against the pandemic a top priority, the powerhouse nation has been able to unleash its forces. The goal is to become the vaccination world champion. No expense or effort is spared. The Biden administration is under pressure to succeed, so since 20 January the entire power and resources of the US federal government have been used to fight the pandemic.

To improve coordination, the president convened a Covid-19 Response Team. As one of his first official acts, Biden signed a presidential executive order rescinding the US withdrawal from the World Health Organisation, as well as ten other executive orders to combat the pandemic. Among other things, he ordered the introduction of masks in public transport and activated the ‘Defence Production Act’ to force companies to produce materials such as N95 masks and protective clothing needed to fight the pandemic.

As of the beginning of this week, 51.8 million Americans had already received a vaccination, 26.2 million of them already the second dose. This means that 15.6 percent of the population is currently partially vaccinated and 7.9 percent fully vaccinated. More than 1.8 million vaccine doses are administered daily. This means that President Biden has already exceeded his self-imposed target of at least one million vaccine doses per day.

Of course, there are also problems with the massive expansion of the vaccination programme. Right now, very large vaccination centres are being created in urban centres where thousands of people can be vaccinated every day – often without leaving their cars. The only question is how to reach those who do not want to be vaccinated or who are simply not well informed. Metropolitan areas like Washington DC also face technical hurdles in getting appointments.

The administration does not want to give the impression that certain parts of the population are being favoured or disadvantaged. It is already clear that vaccination rates of non-white Americans are proportionally lower and that social inequality in vaccination is perpetuated. Therefore, work is underway on reaching areas where the medical infrastructure or vaccination readiness is particularly poor.

If the current pace of vaccination continues, the majority of Americans could actually be vaccinated by the summer. President Biden announced on Tuesday that every adult in the US who wants to can be vaccinated by the end of May. So far, the President’s words were followed by action.

Knut Dethlefsen, FES Office Washington DC

Denmark

Denmark is the frontrunner in Covid-19 vaccination within the European Union. Nursing homes are now fully protected. About half a million vaccinations have been given. This corresponds to 8.34 vaccine doses per 100 inhabitants. There are 5.8 million people living in Denmark, of whom just under six percent have received a first shot, and just under three percent have already received the full protection of two doses.

Other risk groups should follow in the next ten weeks. These are mainly people older than 70 and 60. By the end of June, the Danish government wants to have vaccinated the entire country, or at least be able to offer everyone the same. To achieve this goal, however, up to 100,000 vaccinations must be administered every day.

The vaccination campaign and enormous pressure from the population have now prompted the Danish government to relax restrictions. Shops are to be allowed to reopen from March. Zoos and open-air museums will let visitors in if they can prove a negative Covid-19 test. Doing sports with up to 25 people will also be allowed again. Students will be allowed into face-to-face classes if they have two tests in a week with negative results.

Although the British, more contagious variant of the virus has gained the upper hand in Denmark, the government is going down this path of relaxations. Corona fatigue in the population is apparently forcing them to do so, even though the price could be high. Scientists have calculated various models for the social democratic government under Prime Minister Mette Frederiksen.

They now calculate that the number of Covid-19 patients who will have to be treated in hospital will be just under 900 by mid-April. That is four times more than the current figure of around 240 hospitalised patients. The prime minister calls this path a policy of ‘calculated risk’, which accepts a third wave as long as the health system holds out. She wants to move away from the precautionary principle, which is about preventing as many infections as possible.

Progress in the vaccination campaign is giving her political backing. All vaccinated persons are registered in a database of the State Serum Institute. Appointments are available via the digital personal number and the e-health record, which every Dane has, as well as everyone who has a right of residence in Denmark. With this data, offers for vaccination are made to the insured. Appointments are made digitally via the central website vacciner.dk.

The initial phase of the campaign showed, however, that the electronic personal number and digital medical record are not infallible. Too many vaccination offers were sent out. The resulting strong demand for appointments temporarily paralysed access to the central website for appointments. Apart from this, however, the country benefits from its digital health infrastructure because, in order to classify risk groups, the authorities can draw on digital patient records.

Every person who is vaccinated against Covid-19 in Denmark is to receive a digital vaccination card. The e-vaccination card was already in preparation, its introduction is now to be accelerated. Even though no privileges are to be associated with proof of vaccination, a debate about ‘vaccination privileges’ is also developing in Denmark. Some sectors of the economy hope that with this e-vaccination passport, public life in Denmark will return to normal. The first beneficiaries of the digital vaccination passport are at least already certain: foreign travel for business people should become easier.

Dr Philipp Fink, FES Office NordicCountries