This issue of Healthcare Foresight seeks to understand what the sentiments are among some KPMG health leaders as to whether or not their jurisdictions will reach 80 percent vaccinated - estimated to be the required level to achieve herd immunity by some experts1 - so we asked: “What’s the likelihood of 80 percent of your population receiving its first vaccination dose by the end of 2021?”
Broadly speaking, there’s reason for hope among these responses as five of our eight respondents (from Australia, Canada, China, the Netherlands, and the United Kingdom) said achieving this ambition will be likely, while two others said it would be close, but possible (those in the United States and Saudi Arabia). Despite the recent start of vaccination programs in many of these jurisdictions, there’s a common trajectory of positivity and cautious optimism among the group, with significant progress made since the beginning of the new year.
What will be critical to achieving this ambition? A common denominator emerges - a reliable supply from manufacturers, public confidence and trust in the vaccine (not just vaccines in general – but a vaccine’s effectiveness against variants), and the ability to align the entire continuum in vaccine delivery – from manufacturer, to distributor, to the providers that administer the shot and the public’s ability to get in the queue. This optimism is tempered by some early challenges with reliability in supply chains, structural challenges that include rural/remote distribution for large geographies (such as in Australia and Canada), and vaccine hesitancy.
While there’s reason to be hopeful in the representative KPMG firms, who primarily hail from high-income countries, as our Global Head of Healthcare Dr. Anna van Poucke has written, for global recovery, it’s critical that low-and-middle income countries not be left out of the progress and that “no one’s safe until we’re all safe”, as she wrote in a blog post following the World Economic Forum’s Davos Agenda in February.
Here’s what KPMG leaders said in early March based upon the sentiment in their jurisdictions, domestic statistics, their conversations with clients, and peering through the lens of their own experience:
I do think it is likely 80 percent of our population will be vaccinated by the end of 2021. The Australian Government has set a strategy for a phased vaccination rollout which has commenced based on priority need. Australia’s response to public health orders has demonstrated a level of public trust and compliance which you may not expect with ordinary vaccination programs. However, this is no ordinary situation and the level of disruption felt by individuals may provide clear benefits for people in considering vaccination for COVID-19 and ensuring life gets back to normal relatively quickly.
No doubt, the rollout will not be without its challenges. Australia has a unique population demographic due to its geographic spread and this may provide challenges with supply chain and distribution of vaccines in later rounds of vaccination. As the rollout becomes more dispersed with administration by GP’s and other health practitioners the tyranny of distance in rural and remote locations of Australia may have unexpected impacts on distribution, supply chain and access of skilled workforce to administer.
National Sector Leader, Health, Ageing & Human Services
I think it is likely – Canada had been slow off the mark given shortages of vaccine in January and February but expects to have completed 80 percent by the Fall. We’re optimistic, but challenges will include serving remote, Indigenous and vulnerable communities as well as coordination across the multitude of organizations involved from logistics providers to public health units through to family physicians.
Partner, National Health and Life Sciences Industry Leader
KPMG in Canada
It’s likely. COVID-19 is well controlled in China, the infection rate is at a very low level. The Chinese government is consulting with the public and arranging vaccinations in an orderly manner. National mass vaccinations started in February 2021 and by the end of February, China's vaccinations exceeded 52.5 million doses, and the vaccination rate is about 3.6 percent. The cumulative number of vaccinated people in Beijing reached 5.9 million, about 28 percent of the population by 10 March 2021. It is likely that the first dose coverage rate in China could reach 80 percent by the end of 2021.
Head of Healthcare
KPMG in China
It’s likely. After a slow start at the beginning of 2021, vaccination progresses. When no new mutations of the virus arise that require major modifications in the approved vaccines it should be possible to accomplish a high vaccination rate by September. The combination of mass testing and vaccination will bring more freedom around July or August.
Head of Healthcare
KPMG in the Netherlands
Not likely. As of 9 March 2021, approximately 5.55 million people in Germany have been provided with initial vaccination (approximately 8 percent of the population with a minimum age of 16 years). One major challenge is the perception of certain vaccine’s effectiveness (especially against variants), as so far many vaccine doses have been left unutilized. In addition, the pace of vaccinations needs to increase significantly. While the technical feasibility is certainly there, the timely availability of the vaccines will be particularly important.
Head of Healthcare
KPMG in Germany
Likely (but close) – but, at about 60 to 70 percent considering the rollout of more than 100 vaccination sites across all regions in Saudi Arabia, but predominantly in main cities (Jeddah, Riyadh, Dammam). In addition, vaccines will be available at pharmacies around the Kingdom for free. There is enough stock, so we are ready for administering at large scale. The challenge lies in driving the traffic to vaccination sites, currently about 8 percent of the population is registered to take the vaccine. A key enabler will be building the awareness of the population to proceed and have confidence with vaccination.
Head of Healthcare
KPMG in Saudi Arabia
Not likely (but close). As of March 7, 2021, the U.S. has distributed a total of 116.4 million doses to its states, districts and territories, according to the Centers for Disease Prevention and Control. Estimates vary but based on current vaccination trends, infection rates and mortality statistics it is expected that roughly 60 to 75 percent of the US population (~225 million) will receive at least one dose of the vaccine by the end of 2021, with children being the last group to receive it (starting in summer 2021 or later). Roll out of vaccinations have initially been slower than the government’s original targets due to a variety of factors including distribution issues, storage constraints and vaccine hesitancy. Now that the US Food and Drug Administration has approved of the Johnson and Johnson COVID-19 vaccine, distribution will likely remain high and gradually increase.
Eveline van Beek
Managing Director, Advisory
KPMG in the U.S.
Very likely. The UK moved early and strategically on both vaccine procurement and regulatory approval processes, with innovative approaches to partnership, co-investment and rolling reviews. This flexibility has ensured a robust supply chain with access to 367 million doses to-date at an investment of £11.7 billion ($16.2B USD) through to 2023. A key enabler in the UK’s rapid and successful deployment has been the clear population stratification and targeting of the most vulnerable and high-risk groups, together with the broad engagement of non-traditional providers to accelerate this – from volunteer helpers to retired doctors, working in venues adapted from racecourses to sports stadiums in order to provide maximal capacity.
Head of Healthcare
KPMG in the UK
1 McNeil D.G. Jr. (2021 March 9) How Much Herd Immunity Is Enough? New York Times.https://www.nytimes.com/2020/12/24/health/herd-immunity-covid-coronavirus.html