ABSTRACT
Background: Scarcity in supply of COVID-19 vaccines and severe international inequality in their allocation present formidable challenges. These circumstances stress the importance of identifying the conditions under which self-interested vaccine-rich countries will voluntarily donate their surplus vaccines to vaccine-poor countries. Methods: We develop a game-theoretical approach to identify the vaccine donation strategy that is optimal for the vaccine-rich countries as a whole; and to determine whether the optimal strategy is stable (Nash equilibrium or self-enforcing agreement). We examine how the results depend on the following parameters: the fraction of the global unvaccinated population potentially covered if all vaccine-rich countries donate their entire surpluses; the expected emergence rate of variants of concern (VOC); and the relative cost of a new VOC outbreak that is unavoidable despite having surplus doses. Results: We show that full or partial donations of the surplus stock are optimal in certain parameter ranges. Notably, full surplus donation is optimal if the global amount of surplus vaccines is sufficiently large. Within a more restrictive parameter region, these optimal strategies are also stable. Conclusions: Our results imply that, under certain conditions, coordination between vaccine-rich countries can lead to significant surplus donations even by strictly self-interested countries. However, if the global amount that countries can donate is small, we expect no contribution from self-interested countries. The results provide guidance to policy makers in identifying the circumstances in which coordination efforts for vaccine donation are likely to be most effective.
ABSTRACT
The design principles of institutions that visibly and significantly affect citizens' lives are likely to be politically salient. Popular support for these principles is in turn crucial for institutional viability and effectiveness. Transboundary pandemics are a case in point. Understanding citizens' preferences regarding the design of international alliances set up to mass-produce and distribute vaccines is likely to determine citizens' subsequent cooperation with vaccination campaigns. This study explores Germans' preferences for international COVID-19 vaccine alliance design principles. We conducted a conjoint experiment at a recurring cognitive moment in many pandemics' cycles, between the initial outbreak and a more devastating but still-unknown second wave, when infection rates were very low, yet no policy solutions had been developed. We analyzed preferences regarding four building blocks: (1) alliance composition (size; EU-centrism), (2) alliance distribution rules (joining cost; vaccine allocation), (3) vaccine nationalism (cost per German household; coverage in Germany) and (4) vaccine producer confidence (origin; type). Distribution rules, political ideology and personal perceptions of pandemic threat matter little. But a larger alliance size and dominant EU-country composition increase alliance support. And vaccine nationalism is key: support increases with both lower costs and larger coverage for own-nation citizens. Moreover, support goes down for Chinese and American producers and increases for Swiss and especially own-nation producers. In sum, a realist and technocratic outlook is warranted at the cognitive stage in pandemic cycles when no solutions have been found, yet the worst already seems to be over, as national self-interest reigns supreme in popular attitudes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11077-021-09435-1.
