If you look at data on vaccine launches in Latin America, there is a clear case: Chile. The country vaccinated just over 12% of its population, lagging behind the United States and well ahead of all its neighbors, according to national data compiled by Our World in Data.
Chile started with some advantages. It does not have a massive population like China (there are only 19 million Chileans) or a vast mass of impenetrable land like Russia or Brazil. It is a relatively wealthy nation, with a seat among the richest countries in the OECD. But, as Chilean international relations researcher Veronica Diaz-Cerda points out, Chile is not so well off as to be unable to negotiate lower prices with vaccine manufacturers.
Chile also made some important decisions – both in the short and long term – that put it in a position to outperform other countries with comparable population sizes, geographies and economic conditions.
In fact, it has the eighth best vaccination rate in the world, among countries with populations over 100,000. (A handful of small island nations – such as Seychelles, Cayman Islands and Bermuda – have outgrown it.)
Which begs the question: what did Chile get right that so many of its peers have yet to discover?
Buying vaccines early and often
First, it closed initial deals with several vaccine manufacturers, including Chinese Sinopharm, American Pfizer and British AstraZeneca. Chile has already ordered enough doses to vaccinate its population twice.
“Our strategy does not depend only on a vaccine, which has given the country a greater variety of vaccination options,” said Juan Carlos Said, an internal medicine specialist at Hospital Sótero del Río, outside Santiago. “We signed these agreements at the beginning of the pandemic, so we received vaccines earlier than in other countries.”
He pointed out that Chile also agreed to host vaccine tests for Sinofarm and AstraZeneca, which gave political leaders an extra influence in their negotiations to secure the first doses.
A robust primary health care system
Then, the country already had a comprehensive primary health care system ready to deliver vaccines when they arrived. “We have a primary care center for every 40,000 people, and we have them in every corner of the country, so for us it is not a problem to reach the entire population very quickly,” said Soledad Martínez, assistant professor of public health at the University of Chile .
Chile’s system follows the model of the United Kingdom’s National Health System, with local clinics that are responsible for a particular patient community. Health professionals serve the same patients year after year. They regularly deliver vaccines to these patients for things like flu, hepatitis B, HPV and other illnesses. All of these existing relationships have made mobilizing the Covid-19 vaccine effort much easier.
“You know everyone,” said Martínez. “You know the local leaders. You know where to do this. If you need a stadium or a big gym, you already have it. “
Rejecting incorrect Covid-19 information
Finally, Chile was spared the worst wave of false news and misinformation that threatened vaccination efforts elsewhere. “We don’t have a strong anti-xxx movement in Chile,” said Martínez. “We see them making a noise on Facebook, but in the end it doesn’t quite represent a very significant percentage of the population.”
Martínez suggested that Chile’s primary care system helped to build trust between health professionals and the communities they visit regularly. She also pointed out that, unlike other countries, the existence of the pandemic has not become a contentious political issue. “In Chile, we have a very monolithic opinion: it is true. Coronavrius exists. You can attack with vaccines, ”she said. “There is really no debate about this among the political elite.”
Said and Martínez agreed that if there is a lesson that other countries can draw from the success of the early vaccine in Chile, it is the importance of having broad access to health. “You cannot face a pandemic without a strong public health system that provides basic care to the entire population,” said Said.