Why America Is Doing Better Than Europe at Vaccinating

But despite lost doses and frustrating vaccine websites, the U.S. is vaccinating its residents faster than any member of the European Union—which may be surprising, given that so many European health-care systems are touted as being more efficient than America’s. As of this writing, the U.S. has vaccinated 15.9 people out of every 100, while Germany has vaccinated just five, France has reached four, and Croatia less than three. The U.S. government, finally, appears to have done something right.

Still, this story is more about the foibles of the European Union than the triumph of the United States. The EU worried that if it left each of its member countries to acquire vaccines for itself, smaller and poorer nations wouldn’t be able to buy enough. European leaders bet that, by negotiating for vaccines as a bloc, they could match America’s purchasing power.

The U.S. pursued vaccine procurement through Operation Warp Speed, a massive new public-private partnership. But the EU opted to handle negotiations through its executive branch, the European Commission. And unfortunately for Europeans, the commission wasn’t very good at its assigned task. It turns out that a deliberative body built for leisurely trade negotiations doesn’t move quickly during a public-health crisis. “The commission has gone from procuring printer paper to procuring this astonishingly large set of vaccines,” says Scott Greer, a health-policy professor at the University of Michigan.

The Trump administration’s Operation Warp Speed didn’t worry about the cost of the vaccines or whether the vaccine companies could be held liable for side effects. The Europeans focused on trying to get a low price for the vaccines, and on making sure the vaccine companies could be sued if the vaccines caused problems. The U.S. threw money at the problem, flooding vaccine makers with billions of dollars in subsidies to increase the speed of vaccine testing and manufacturing. Unlike the EU, the U.S. and the U.K. bought millions of doses of various vaccine candidates last summer, without knowing which ones would be effective. “The U.S. and the U.K. locked in their supplies before they knew the vaccine was going to work,” Lawrence Gostin, a professor of global-health law at Georgetown University, told me. “The EU was more risk-averse.”

The FDA was also faster to approve the vaccines than its European counterpart, the European Medicines Agency, which wanted to be extra sure that the vaccines were safe. The U.K. and the U.S. made deals with vaccine companies much earlier than the EU did, putting the EU weeks, if not months, behind. The EU is “a tanker,” not “a speedboat,” European Commission President Ursula von der Leyen said recently.

Once it finally approved the vaccines, the EU realized that it had bought too few doses. In July, the U.S. ordered 600 million doses of the Pfizer vaccine. The EU put in its order four months later—for half as many doses, The Guardian reported. “More [vaccines] could have been ordered, and faster,” German Health Minister Jens Spahn admitted earlier this month. And when vaccine makers in Europe had manufacturing issues in late January, Europe’s vaccine shortage intensified, causing clinics from Madrid to Paris to Lisbon to cancel vaccination appointments. U.S. vaccine manufacturers, meanwhile, have kept up with demand better than those in China or even Canada, Bloomberg’s Noah Smith points out.

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