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Supply vs. demand: Which countries reach their COVID-19 vaccination points?



We recently calculated that the United States is close to the “COVID-19 vaccine relocation point” – ie. the point at which the supply of vaccines may begin to exceed demand. We also noted that national averages can mask important country differences. We have therefore tried to understand where countries fall on this spectrum; such differences are important for understanding how best to target efforts to increase vaccine coverage across the country.

To this end, we looked at the proportion of adults with at least one dose of vaccine per country, the daily rates of the first doses administered (using a 7-day moving average) and how this rate has changed in the last week (see methods). We were particularly interested in identifying countries that may still have a relatively low vaccine coverage (ie less than 50% of adults 1

8 years of age or older), combined with evidence of a decrease in first dose administration, as these countries may pose the greatest challenges to achieving sufficient vaccine coverage in the United States

As of April 29, among the 50 countries and DC, we find that:

The proportion of adults who received at least one dose of the vaccine was 55% overall and varied significantly in the country from a low of 41% (Alabama) to a high of 74% (New Hampshire). In addition, there is evidence of a decline in the rate of new absorption in most countries. The daily dose of the first dose nationally is 451 per 100,000, ranging from 136 per 100,000 (Mississippi) to 889 (Rhode Island). Most states (31 out of 51) vaccinate below the national rate, reflecting the fact that vaccination rates are usually higher in larger states (eg California and Pennsylvania). In addition, the first dose rate per 100,000 in the last week decreased for the United States as a whole (-27%) and for almost every state (45 out of 51) (see Table 1).

At the upper end of the vaccine coverage spectrum, more than 60% of the adult population received at least one dose in 12 countries. These countries are mainly in the northeast (8 out of 12). Seven have a vaccination coverage of at least 65%, and all but 2 (New Hampshire and New Mexico) administer first doses well above the US rate. Eight of the 12 countries have seen a drop in the first dose in the last week, suggesting that these countries may be approaching or reaching demand saturation, albeit at relatively high levels of vaccination and rates of administration. .

At the lower end of the vaccine coverage spectrum, less than 50% of the adult population received at least one dose in 13 countries, including 6 that were below 45%. Nine of these countries are in the south, and overall the daily rate of first vaccination per 100,000 is below the national rate. Moreover, most experience a decrease in the rate of the first doses administered. This suggests that these countries are not only approaching or reaching their critical points, but also at relatively low levels of vaccination.

The rest of the countries that fall between these two extremes are mainly in the Midwest and to a lesser extent in the South and West.. In about half of these conditions, between 55% and 60% of adults have received at least one dose. All but one had a drop in the percentage of the first doses given in the last week.

Countries that demonstrate a combination of low overall vaccination coverage, together with slow and declining vaccine uptake, are of greatest concern. There are 13 countries with less than 50% coverage with at least one dose, all of which vaccinate their adult populations below the national rate. Twelve of these states have also seen a decline in the rate at which adults have been vaccinated in the past week. They include 3 states (Alabama, Louisiana and Mississippi) with a vaccination coverage of less than or less than 42%, the lowest in the country, each of which vaccinates with about half of the total US percentage. These are the countries that are potentially the furthest from reaching sufficient levels of vaccine coverage and may be at risk of future outbreaks if levels do not increase significantly.

Discussion

As in the United States as a whole, most countries appear to be at or near COVID-19 vaccine exceedance points – the point where their supply exceeds demand. Although this may not be such a concern for countries that have already vaccinated large proportions (> 60%) of their adult populations with at least one dose, about one in four countries has not yet reached 50%, which is quite below coverage levels will probably be needed to reduce the risk of outbreaks ahead. In addition, the vaccination rate in these countries is below the national rate. The fact that most of these countries are also seeing a decline in the first dose rate suggests that they will be important targets for targeted efforts to generate growing demand for vaccines.

Methods
Vaccination data were obtained from the Johns Hopkins University Civic Impact Centers, which collect state-level vaccination data from both the Centers for Disease Control and Prevention (CDC) and the COVID-19 dashboard. Data on the elderly population (aged 18 and over) were obtained from the state population in 2019 through characteristics from the US Census Bureau. We calculated both the 7-day moving average for the first doses administered and the proportion of the adult population who received at least one dose for each state and the United States as a whole (excluding territories and doses administered through federal facilities for general U.S. calculations). ). We used these moving averages to calculate the rate at which the United States and the United States administered the first doses per 100,000 adults. The weekly changes in the rate of the first doses administered were calculated using the percentage change from the current rate (April 29, 2021) to the rate of 7 days prior. Finally, we categorized countries by region using the classifications of the Census Bureau regions and departments in 2010.


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