Tiny Asian countries and the British territory Gibraltar are nearing widespread immunity against COVID-19 and are gaining a sense of normalcy, proving it pays to be small and have a steady supply of shots if you want to zip ahead in the global vaccination race.
Seychelles, an archipelago in the Indian Ocean, quickly got shots into more than two-thirds of its roughly 100,000 inhabitants. It welcomed back tourists in late March without requiring a quarantine, though travelers must present a negative coronavirus test.
It took Bhutan less than two weeks to administer an initial dose of vaccine in over 90% of its eligible adults. The Himalayan kingdom of roughly 750,000 people relied on field tents and an army of health workers and volunteers who walked from village to village to administer shots.
Both countries leveraged donated vaccines, mainly from India, and their diminutive size to zoom to the top of the per-capita chart.
“Our strength lies in our smallness and the inherent value of solidarity,” Bhutan Health Minster Dechen Wangmo tweeted.
Not to be outdone, Gibraltar — a tiny U.K. territory on the southern tip of Spain — vaccinated nearly all of its adults after it received a steady cadence of Pfizer/BioNTech doses from the British government. Restaurants are filling up and mask mandates are being eased or lifted altogether, giving the rest of Europe a glimpse of what’s possible if they get their rollouts moving.
While big countries in the European Union have suffered from shipment delays and other hiccups, having a small population and predictable access to vaccines have been “key factors for success,” said Krishna Udayakumar, the founding director of the Duke Global Health Innovation Center.
“Having public health and care delivery systems that are organized and able to implement vaccination programs at scale are also important, like in Israel,” he said.
Israel leveraged its centralized health system and secured plenty of Pfizer doses in exchange for medical data, making the Middle East nation of 9 million a kind of clinical testing ground for the shots. It has given at least one shot to more than 60% of its population and is gradually returning to normal, with Jerusalem seeing Easter crowds as nationwide cases decline. President Biden’s advisers hope those experiences entice Americans to roll up their sleeves.
“Look at the relationship between vaccination and the number of cases. In Israel, 61.8% have received at least one dose. We are not there yet, but we can get there,” Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said at a recent White House coronavirus briefing.
Four in 10 Americans have received an initial dose from a robust rollout of Pfizer and Moderna two-shot vaccines despite problems with the one-shot Johnson & Johnson option, while the United Kingdom managed to get doses into nearly half of its population by delaying second doses of the two-shot vaccines by up to a dozen weeks.
That makes both countries relatively high achievers compared to sluggish rollouts in Canada and the European Union.
The U.S. recently loaned 4 million doses of the AstraZeneca vaccine to its North Americans neighbors —2.5 million to Canada and 1.5 million to Mexico. Unlike many peer countries, American regulators haven’t approved the one-shot vaccine yet.
The White House says the U.S. will focus on the rest of the world after it serves Americans who want to get vaccinated.
As of Thursday, nearly 219 million vaccines had been administered in the U.S., according to the Centers for Disease Control and Prevention. Nearly 41% of the U.S. population has received at least one dose, while almost 27% are fully vaccinated.
Mr. Biden said the U.S. will have enough doses for every American adult who wants the vaccine by the end of the May. The administration will be under pressure to share more of its largesse if doses aren’t used or earmarked for booster shots or children later in the year.
Dr. Fauci has said “a global pandemic requires a global response.”
“The fact is that as long as there’s active dynamics of infection somewhere in the world, there always is somewhat of a threat that variants will emerge in those parts of the world and, because we’re such an interconnected planet here, that it might actually be an issue that we will have to deal with,” he told reporters.Chile, meanwhile, enjoys a high vaccination rate that is slightly ahead of the U.S.’s, but it is struggling with a surge in cases.
The surge in transmission comes after the country reopened around the holidays and an increase in travel during the Southern Hemisphere’s summer.
The South American country hasn’t reached herd immunity despite early progress, and there are some concerns that a widely used vaccine, the Coronavac from China, generally staves off severe disease but has a lower efficacy than other vaccines, including the Moderna and Pfizer shots in the U.S.
It is “multiple factors that are adding up to a difficult situation,” Dr. Udayakumar said. “Vaccines are important but we can’t let early vaccination success make us complacent to the broader measures that are still necessary.”