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January 5, 2021


MEXICO: Early steps on vaccination belie challenges to come

BY Nicholas Watson

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The government is touting its achievement as the first Latin American country to begin vaccinating its population against Covid-19; the first vaccinations of frontline medical personnel started on 24 December using the Pfizer-BioNTech vaccine. The government has also signed a series of large-scale vaccine contracts, including with AstraZeneca, CanSino Biologics, and via the Covax initiative. Yesterday, 4 January, the local Cofepris regulator approved the AstraZeneca vaccine for emergency use. President Andres Manuel Lopez Obrador (AMLO) has a special interest in ensuring a speedy vaccination campaign because of its expected positive effect on the economy, which will in turn be critical for the governing National Regeneration Movement (Morena) party’s chances in the June mid-terms and state elections. However, the vaccination roll-out will be subject to numerous challenges, while the current Covid-19 caseload means that the health crisis is very far from over.

Numbers and plans

So far, under 50,000 medical personnel have received a first dose of the Pfizer vaccine. The pace of vaccinations should now pick up, albeit relatively modestly; the government expects 700,000 people – largely medical personnel – to be covered by the end of January. However, the plan envisages a significant ramp-up after the end of this month, with the entire population over 60 – around 12mn people – to be vaccinated by the end of March. This looks ambitious, particularly if Covid-19 testing capability is taken as a proxy for vaccination implementation capacity – and given the government’s haphazard handling of the pandemic from the outset.

The government has over 77m doses of the AstraZeneca vaccine on order (covering over 38mn people), though these are not expected to begin arriving until March. Health authorities seem to be banking on approval of the CanSino vaccine, which is still at trial stage, but which the government’s Covid-19 czar Hugo Lopez-Gatell says will deliver 2mn doses over January. However, there has been some confusion over how many actual CanSino doses have been pre-agreed in total. The advantage of CanSino is that only one dose is needed and that it does not require a super-cold supply chain, unlike the Pfizer vaccine (for which 34mn doses are on order). The storage issue also makes the AstraZeneca vaccine attractive in the Mexican context.

Political dimensions

The risk of distribution bottlenecks and logistical challenges could be compounded by the government’s own strategy to prioritize the elderly in remote and rural communities for the first vaccinations, with – perhaps counterintuitively – the over 60s in major urban areas at the end of the line for the initial phase of the plan. There could be a clientelist dimension to this strategy since AMLO a) insists that the vaccine must “start from the bottom” with the poorest, and b) he wants to use his social programs for the elderly as the framework to reach this demographic.

Any political overtones to the vaccination roll-out could reflect AMLO’s concern that economic reactivation is likely to be hesitant in the early part of 2021, especially since Mexico City and the neighboring Mexico state in late-December returned to the “red” level in the government’s Covid-19 traffic light system. The public health situation remains critical, and things are likely to get worse before they get better, leaving AMLO reliant more on campaign promises of a recovery to come rather than solid economic advances.

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