The other challenge of vaccination

09 of June 2021
Mauren esquivel

June 9, 2021. Starting the sixth month of 2021 and 19 months after the World Health Organization (WHO) assigned COVID-19 its level of maximum alert; already some countries or regions begin to make flexible their protocols and attempt a he came back to normal, even with mega-concerts in NY to celebrate the rebirth after the pandemic. These decisions, of course, have been made for the control of infections, and low levels of mortality; for example in the United Kingdom they reported on June XNUMX a day with zero deaths from COVID-19 For the first time since March 2020. Along with the United States, and the United Kingdom, the European Union, Israel, South Korea, Iceland, or Canada are also added by taking this type of measure.

Most of these countries have not only managed to contain the virus and reduce transmissibility through good application of protocols, but also through an intense vaccination campaign, except for Canada and South Korea, which have not yet reached 10%. of the population with complete vaccination schedules; the other countries lead in vaccination, the European Union on average has 21%, Iceland 29.81%, the United States and the United Kingdom 41%, and Israel 59.37%; according to the data of  Our World in Data for the first week of June. As a reference, in the world, the percentage of the population with a complete vaccination scheme is barely 6%.

Although to be fair, and although 199 countries have already started the vaccination process, the performance of the countries is linked to their economic capacity to acquire doses and apply them, in fact 52% of people who have received at least one dose are from high-income countries; and being more specific, 49% belong to Europe and North America. Thus, contrasts are beginning to be found, such as that low-income countries have an average of only 1.5% of their population with at least one dose.

In our region the contrasts are also great, because while Chile has 44% of its population with a complete scheme, and Uruguay with 31%, leading the region. There are countries like Honduras and Guatemala with less than 1% of their population with complete vaccination schedules. This considering the countries that have available data. The two largest economies, Mexico and Brazil, have similar performances with 11%. While in Central America, El Salvador and Costa Rica reach almost 13% coverage with a complete scheme, surpassing the country with the highest per capita income in the region, Panama, which reaches 9% of the population with a full scheme.

Graph 1: Relationship between GDP per capita PPP and percentage of population with complete COVID-19 vaccine scheme in the first week of June.

Source: Own calculations with data from the World Bank 2020 and Our World in Data.

But in addition to the access to a constant flow of vaccines that countries may have to accelerate vaccination and which has been linked to the income level of the countries, the challenge that has been encountered is the participation and decision of people to get vaccinated. Thus, while some countries suffer from a lack of vaccines, in other countries like the United States the problem is the population's doubts about getting vaccinated, even when the vaccines are free and available in most urban centers, practically in every pharmacy or public space, with high collaboration with the private sector, even with the availability of deciding the brand of vaccine that one wants.

These doubts of the population in the United States have slowed down daily vaccination, which went from a maximum of 1 dose per 100 people on April 13 to a level of 0.29 doses per 100 people in the first week of June, and not all the states are doing the same; This jeopardizes President Biden's goal of having 70% of his population vaccinated by the 4 July.

Using data from Facebook's “Data for Good” initiative that together with the universities of Maryland and Carnegie Mellon follow up on these aspects through a world surveyIt is found that in states such as Wyoming, 32% of those surveyed doubt to get the vaccine, in Idaho it is 28% who doubt it, while in New Jersey it is only 11%, or in Washington state with 14%. So it is no coincidence that both Wyoming and Idaho are from the states with vaccination coverage below 35% and with greater lags, while in New Jersey the complete schemes reach 50.4% of the population, and in the state of Washington 48.7%, being one of the states that lead the vaccination rates. In fact there is 15 states where less than half the population has received a dose; and there is a fear that after the summer the contagions will reappear. And the distribution of these states, most of the southeast, coincides with high percentages of people who hesitate to get the vaccine.

Looking at the behavior in the United States, and knowing that many of the phenomena that have occurred in other countries have also been reproduced in our region, what can we expect about people's participation in vaccination processes? The aforementioned survey shows us that for the month of May, in Guatemala 21% doubted to get the vaccine, 22% in Nicaragua, 14% in Honduras, 13% in El Salvador, 15% in Costa Rica, and 22% in Panama. But just as in the United States there are differences within countries, for example in Escuintla (Guatemala) the number rises to 27%, in Cortés (Honduras) 17%, in San Salvador (El Salvador) 15%, in León ( Nicaragua) 24%, in Guanacaste (Costa Rica) 20%, and in Chiriquí (Panama) 21% doubt about getting vaccinated.

Graph 2: Percentage of people who have doubts about getting vaccinated against COVID-19.

Source: Own calculations with data from Carnegie Mellon University, University of Maryland, and Facebook for the month of May.

When asking people about the causes for doubting about vaccination, 5 reasons are listed: 1) fear of possible side effects; 2) doubts about the efficacy of the vaccine; 3) the belief that they don't need it; 4) they are concerned about the cost of vaccines; and 5) vaccination goes against their beliefs. Most of these reasons or cognitive biases will require effective communication strategies, transparency, credibility and trust, to generate the correct incentives that facilitate countries to bring vaccination to the majority of the population and reach a point close to the herd immunity that guarantees us a return to normalcy before the pandemic. But in the region, are we ready to address these challenges?

Already Costa Rica Older adults, teachers and other people who refuse to be vaccinated have been identified, some of these in health areas of Cañas, Bagaces, Santa Cruz, Nandayure, Jicaral, Abangares, Tilarán and Upala, in the province of Guanacaste, where as According to the data from "Data for Good" it was one of the areas of the country with the greatest doubts to get vaccinated. Knowing this information and what has happened in the United States, we can say that in the region we are in time to plan and implement better campaigns against misinformation and fear, with public-private alliances, to encourage vaccination, and reduce the rejection of vaccination. vaccine. There are no excuses, you have to start working on the strategy to mitigate this risk; Well, there are no spaces for improvisation if the pandemic is to be overcome.