The US was a world leader in vaccination. What went wrong?

“The United States started its vaccination drive with a structural advantage. It had the most generous supply of Covid vaccines, along with Israel, thanks to investments made to procure doses before the vaccines were approved for emergency use by the US Food and Drug Administration.”

“Demographics may also be holding the US back to a degree. America has more young people than most Western European countries: About 16 percent of Germany’s population is under 18 versus about 22 percent of the US’s, to give one example. Children under 12 are still not eligible for vaccines in the US (or anywhere else), which may be partly depressing its vaccination share.
But there is more to the story than supply quirks or demographic trends.

Compared to a country like Portugal, now a world leader in Covid vaccinations, the United States’ vaccination rates for its eligible population are not particularly strong, either. In Portugal, 99 percent of people over age 65 are fully vaccinated; in the US, the share is closer to 80 percent. Those disparities persist in the younger age cohorts: 85 percent of Portuguese people ages 25 to 49 are fully vaccinated versus less than 70 percent of the Americans in the same age range.

Another big difference that explains that divergence is one of culture and politics. Covid vaccinations have become, like so much of America’s pandemic response, polarized along political lines. As of July, 86 percent of Democrats said they were vaccinated, according to a Kaiser Family Foundation survey, while only 54 percent of Republicans said the same. One in five Republicans said they would “definitely not” get the vaccine.

“This political divide over vaccines has contributed to the US falling behind European countries when it comes to coverage levels,” Josh Michaud, associate director of global health policy at the Kaiser Family Foundation, told me.

There are pockets of vaccine hesitancy in Europe, especially in Germany and France, but nothing on the scale of what we have seen in the United States. In Portugal, as reflected in its exemplary vaccination rate, skeptics have a very low public profile.

“We don’t need to convince people to get vaccinated,” Gonçalo Figueiredo Augusto, who studies public health at NOVA University Lisbon, told me over Zoom. “People want to.””

In Portugal, There Is Virtually No One Left to Vaccinate

“Portugal’s health care system was on the verge of collapse. Hospitals in the capital, Lisbon, were overflowing and authorities were asking people to treat themselves at home. In the last week of January, nearly 2,000 people died as the virus spread.

The country’s vaccine program was in a shambles, so the government turned to Vice Adm. Henrique Gouveia e Melo, a former submarine squadron commander, to right the ship.

Eight months later, Portugal is among the world’s leaders in vaccinations, with roughly 86% of its population of 10.3 million fully vaccinated. About 98% of all of those eligible for vaccines — meaning anyone over 12 — have been fully vaccinated, Gouveia e Melo said.”