Thread by @bopinion

Britain will have vaccinated half its adult population by the end of this week, administering 40 vaccine doses per 100 people.

The EU average is around 12. The gap has become embarrassing, and the political atmosphere tense trib.al/LmXRaF4

EU leaders have blamed a dearth of supply for their problems, but that’s only part of the picture.

Some of the world’s most vaunted health-care systems have done a poor job of delivering the vaccines they do have trib.al/LmXRaF4

🇮🇱Israel and 🇬🇧the U.K.’s successes are instructive. Both:

➡️Made the right bets and secured early contracts
➡️Have efficient electronic health records systems
➡️Handled the logistics well trib.al/LmXRaF4

🇨🇭Switzerland, meanwhile, has managed only around 13 doses per 100 people. Despite having one of the most admired health-care systems:

💉Many are unsure of where to register for a shot
⏳Long time lags with little clear government communication trib.al/LmXRaF4

Switzerland's slow rollout can by explained by:

➡️Supply constraints, after dithering over price and failing to secure enough supply early on
➡️Lack of transparency and digitization of health records trib.al/LmXRaF4

There is one remarkable contrast: West Virginia, one of the poorest states in the U.S., has one of America’s best vaccination programs.

In fact, if it were a country, it would rank around seventh in the world for vaccinations trib.al/LmXRaF4

While the U.S. is delivering around 34 vaccine doses for every 100 people, West Virginia is at nearly 39 per 100, thanks to two big advantages:

➡️Strong central leadership
➡️An electronic health record system
➡️Using local pharmacies trib.al/LmXRaF4

One oddity is the Netherlands, whose health-care system is considered among the best in the world and also has a high-quality electronic health record system.

Its vaccination rate is 11. What went wrong? trib.al/LmXRaF4

In a word, decision-making. The Netherlands was the last in the EU to start vaccinating and stockpiled doses rather than administering them.

Strong central leadership may have been better suited to handling the crisis than its consensus-based system trib.al/LmXRaF4

Centralized decision-making has been less of a problem lately in the U.S., where the federal government has been efficient in distributing supply to the states.

But local rollout has had mixed results, huge inequities and even missing doses
trib.al/LmXRaF4

On average, U.S. states are still using only 75% of the supply they have available.

The U.S. is also having trouble reaching racial minorities in some areas, which is also often the case with flu vaccines trib.al/LmXRaF4

In Europe, the approval of the AstraZeneca vaccine should help ease supply pressures and ensure enough doses to vaccinate 70% of the adult population by the summer.

The rest will rely on delivery trib.al/LmXRaF4