Does Good National Governance Boost COVID-19 Vaccination? Cross-Country Evidence
Abstract BackgroundAs herd immunity by universal vaccination is essential to end the COVID-19 pandemic, the COVID-19 Vaccine Global Access (COVAX) facility has been established to provide developing countries with subsidized vaccines. However, a critical issue is that the developing countries also need to effectively deploy vaccines to citizens. Although this argument suggests positive effects of good national governance on vaccination coverage, to the best of our knowledge, there is no such evidence. The goal of this study was to examine the association between the national governance index and vaccination coverage, particularly among developing countries.MethodsUsing cross-country data, an ordinary least squares regression was conducted to examine the association between the national governance index and two outcome variables on vaccination—the number of days until the administration of the first dose in the country since December 2019 and the number of doses per 100 citizens as of the end of July 2021. The results were compared between the model including all countries and the model including only non-OECD countries. We also examined the influence of governance on the selection of vaccine manufacturers.ResultsA one standard deviation increase in the national governance index was associated with 9.1 days (95%CI: -15.76, -2.43) earlier administration of vaccines in the country, and a 12.1 dose increase (95%CI: 4.76, 19.34) per 100 citizens. Results also showed that these associations were larger in the non-OECD sample and indicated the role of governance in the type of vaccine that is predominantly administered in the country.ConclusionThe provision of subsidized vaccines alone is not sufficient to control the spread of infection in developing countries; logistical and administrative support should also be offered, especially in countries with low governance indices.Trial registrationNot applicable.