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Fireworks lighted up the New York City skyline on June 15 when the Centers for Disease Control and Prevention announced that 70% of adults in the state were at least partially vaccinated. But many parts of the world are a long way from any celebration, for an assortment of different reasons. The consequences of the variation in vaccine distribution, and the disparity of what will constitute success in different parts of the world, could roll on for many years. This in turn will make the global economic recovery less predictable and more uneven.
Even in the very long term, the levels of vaccination that various countries manage to reach—and the vaccines that they use to get there—might have lingering impacts on financial and economic conditions around the world. Those with lower vaccination rates may have to live with the disease, rather than almost wholly eradicate its spread, a reality that could include large parts of the U.S.
Intriguingly, many of the countries that were most successful in containing the spread of the virus through social and state controls, including many in East Asia, have lagged in vaccination. Meanwhile, more open countries that struggled to control people’s behavior during the pandemic—like the U.K. and the U.S.—were most able to rapidly develop highly effective vaccines, perhaps thanks to more innovative and adept academic and corporate institutions.
Mainland China is perhaps the best example of a part of the world with a very different definition from much of the western world of what constitutes success against Covid-19. The country has now distributed over a billion vaccine doses, concentrated in major cities where infection from international exposure is most likely. But there have been no significant moves toward opening the country to international travel.
Beijing is still committed to a zero-tolerance approach to outbreaks, and it isn’t clear that the vaccines being used—overwhelmingly the domestically developed Sinopharm and Sinovac offerings—are well-positioned to meet that goal. Data from Uruguay and Chile, both using Sinovac, show high levels of efficacy at preventing hospitalization and death, but lower levels at preventing symptomatic infection.
If transmission is possible even after the population is overwhelmingly vaccinated, and the political stance toward outbreaks doesn’t change, the economic impacts will mount. Before the pandemic, Chinese spending on outbound tourism was significant and growing. For Southeast Asia in particular, the loss of tourist income is already becoming semipermanent. Many developing economies will likely end up using the Chinese vaccines, meaning any limits to their ability to prevent transmission will be relevant across large swaths of the world.
Even with vaccines plentiful, areas where takeup is limited may be vulnerable to persistent outbreaks, especially of more transmissible variants of the virus. A large-scale international survey conducted by Imperial College London between March and May found that 62% of American respondents broadly trusted Covid-19 vaccines. That is higher than the 47% of Japanese or South Koreans, but low compared to the 87% and 83% in the U.K. and Israel respectively, which also have advanced vaccine-distribution programs.
The sharp geographic differences in where vaccines have been adopted worsens the outlook for potential regional outbreaks. In Hawaii and four states in the Northeastern U.S., over 65% of the population has had at least one dose of a Covid-19 vaccine. But in 15 states, 11 of which are in the South, the rate is below 45%.
Hong Kong is perhaps the most extreme example of a territory where low vaccination and high expectations are entwined. The city aspires to zero Covid-19 cases, like the Chinese central government, but takeup rates are very low. Only around 11% of those over 80 years old are vaccinated, even though vaccines have been available since February. Factors contributing to such hesitancy include distrust of the government, misinformation in local media and the fact that Hong Kong has never seen large numbers of deaths or strict lockdowns.
Discrepancies among countries’ efforts to control the spread of the virus, to develop effective vaccines and to persuade people to take them will long be studied by historians and policymakers. Debates over the pandemic and its aftermath promise to put a 21st-century spin on old disputes over the relative merits of state control and private innovation, and what constitutes effective governance.
Write to Mike Bird at Mike.Bird@wsj.com
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Appeared in the June 26, 2021, print edition as ‘A Revised Understanding Of Effective Leadership.’