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I live in Indonesia.

In Indonesia, the government prohibits the private sector from distributing vaccines, as far as I'm aware. So the government distribute vaccines, and the process is extremely slow. Currently, only 5% of Indonesians are vaccinated, and the number of cases is skyrocketing.

Why not just allow corporations or hospitals to buy and distribute vaccines?

Are most countries in the same situation as Indonesia?

If so why?

I read that Singapore allows people to buy vaccine but do so really really late. Also Singapore doesn't allow people to go to Singapore and buy vaccine. Of course, allowing people to do just that means they can make tons of money. So why not?

https://www.google.com/search?q=singapore+covid+deaths&oq=singapore+covid+death&aqs=chrome.0.0j69i57j0l8.3280j0j4&sourceid=chrome&ie=UTF-8

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  • Hei, how should I edit this question?
    – user25908
    Jul 10 '21 at 4:40
  • I think it's very focused already
    – user25908
    Jul 12 '21 at 8:47
  • Do corporations usually have employees who can give vaccines in Indonesia? Jul 13 '21 at 20:48
  • I know hospitals usually distribute vaccines. Even government public hospitals distribute vaccines. I mean I know because when I have babies we vaccinate in hospitals. My governments want to create an entirely new distribution channel and that's very slow.
    – user25908
    Jul 14 '21 at 11:00
  • Sure, but I was asking about the corporations you mentioned. Jul 14 '21 at 14:59
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In Germany there is a system involving some of the usual commercial entities, but under government regulation.

The residents were classified into priority groups based on risk factors. The main criteria were age groups, which the government already knew, but health insurance companies informed the government which people were at elevated risk compared to their age because of pre-existing medical conditions. (They did not tell the state the diagnosis, just the risk level.) With that, people in a priority group got a letter confirming their status.

At first, the vaccine was only available in government-run vaccination centers to people from the highest priority group. There were many complains about how this was organized -- people who were in the priority group were told to go to a website, or to call a hotline which was always busy, etc. Also, mobile teams went into retirement homes.

Some months later, when most of the top priority group had their vaccination and more vaccine became available, general practitioner physicians were allocated a relatively small number of doses per week through pharmacies. They could use those by the formal priority groups and by their professional judgement as to the risk factors of their patients.

Then there were reports of possible side effects of AstraZeneca. Combined with a generally greater availability, there was more AstraZeneca than could be used. Moderna and Pfitzer were still in short supply. The government and scientists thought that taking AstraZeneca now was still less risky than waiting weeks or months for another vaccine, so they gave AstraZeneca to anybody who wanted it.

In recent days the other vaccines have become available in sufficient numbers that anyone who wants a vaccination can get it with minimal delay. It has also become possible for companies to vaccinate their employees. (Larger companies tend to have physicians on contract for workspace health issues, and those are also involved in the annual flu vaccination season. Now they could do COVID vaccines, too.)

The bottleneck was vaccine production, not distribution. Proposals to involve this group or that group in distribution fell short while there wasn't enough to distribute.

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    If the cost of production is low, how can there be shortage?
    – user25908
    Jul 9 '21 at 5:51
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    @obfuscated, the startup cost of production is considerable. One cannot simply switch a production line for aspirin to mRNA vaccines. The western governments subsidized vaccine factories a year ago, long before the vaccines were approved, in a gamble that some of them would work. Some did, some didn't. A very few governments ordered enough from each of the most promising types for their citizens, most spread their bets.
    – o.m.
    Jul 9 '21 at 6:08
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    @obfuscated: In addition, the new production lines had startup problems, with unpredictable weekly deliveries. But as companies gain experience, this becomes less of a problem. Western governments still have contracts for many millions of vaccines, but won't need all of them. These will likely go to the poorest countries. Indonesia is more successful and will likely need to buy its own vaccines.
    – MSalters
    Jul 9 '21 at 7:15
  • @obfuscated cost is not the only factor regulating availability of any given product. Besides capacity constraints, there is also the matter of contracts - we already know that poorer countries were severely disadvantaged in the contracts for the vaccines Jul 9 '21 at 9:19
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    In what way does this answer the question? The question was, why don't governments get private companies involved in distribution. You seem to have said distribution is not relevant in Germany. It does not touch why Indonesia does not let private companies distribute.
    – puppetsock
    Jul 13 '21 at 20:37
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In the book Systems of Survival by Jane Jacobs, she makes the case that there are two main systems of ethics that the world operates on. She labels these Guardian and Trade.

Caveats: These systems are not intended to be exhaustive systems of ethics, but only to show the features that distinguish the two. And I won't be doing the complete thing here. If you want more, please read the book.

The Trade system is appropriate to people getting their living by making stuff and trading goods and services. The archetype is a store keeper. This system contains things like openness to innovation, optimism, industriousness, etc.

At the top of the Trade list is Shun Force. This is primary because introducing force into a trade will, at best, distort the trade away from win-win. At worst it becomes something like mugging or piracy or a protection racket or something of that nature.

The Guardian system is appropriate to people getting their living by getting and holding control of territory. That is to say, most forms of government and associated features. It contains things like loyalty, honor, prowess, ostentation, and being fatalistic.

At the top of the Guardian system is Shun Trade. This is because the Guardian must wield force as part of his job. The Guardian is the soldier, the police officer, the border guard, etc. For a Guardian to participate in trade as part of his job is, at best, suspect. If you are tasked to guard a territory, and you start trading it away, the best that people will think of you is that you are a bad guard and that you are flirting with treason.

Rather than trade, Guardians are directed to use largesse, which is a very different thing. Not simple charity, but rather, as reward for and inducement to loyalty. The Roman soldier who came home victorious got rewarded with land. The political guy who helps bring an election victory winds up with a cabinet post.

Each system is shown to be self reinforcing. If you follow all the precepts of the system appropriate to your job, you come out being respected and doing a good job. If you fail at some of them, you wind up failing at your task. Think of a shop keeper who carried a gun and used it as part of his shop-keeping. Think of a soldier who was constantly trying to bargain away the territory he was to guard.

The book deals with many cases where people have improperly followed the precepts of the side they were supposedly on, or that mixed the two sides. Police given quotas and rewards for lots of arrests, and they wind up inventing reasons to arrest innocent people. The Mafia being incredibly industrious and hard working (a Trade side virtue) but using it to control territory (a Guardian side virtue). And several other examples. Staying to your side works. Straying outside rapidly causes huge problems, and quickly after that disasters.

What is the relevance?

Government wields force. That's necessary since they control the territory. Value neutral here. Not saying they are moral or not moral to do so. Just that they in fact do so. They are Guardians. So they have a huge tendency to look at those who follow the Trade path as suspect and contaminated. Successful governments have an incredibly strong tendency to see free market (that is, for profit) activity as automatically tainted with disloyalty. In the mind of a Guardian, the calculation goes like so. If they were loyal they would be doing it to benefit the government, not to make money. The examples of people who "sold out" and betrayed their home territory are so numerous as to be cliche. And Guardians revile them all very intensely.

So governments see COVID-19 vaccines as something to be given to those who have been loyal, or that it would be valuable to encourage them to be loyal. This is why, for example, some politicians have floated suggestions that certain political divisions should get vaccines first, completely differently from those who have the most urgent medical need. They are trying to reward loyalty, and encourage others to be loyal.

So it is only natural that governments don't want any distribution of vaccines outside of government controlled channels. For-profit activities are seen as suspect, and they want to do it on largesse. And the efficiency of distribution is only a very minor, very low priority consideration for them.

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    This answers make the most sense
    – user25908
    Jul 14 '21 at 11:05
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Vaccines are important essentials in today's situation. In this emergency, vaccines are directly managed by the government just like other necessity, such as salt. Imagine that if someone sells unknown vaccines to people and claims that the vaccines are effective and have no side effects, will you believe in it? In the eyes of the governments, it's their responsibility to test the effectiveness and security of the vaccine and get people vaccinated. There is less guarantee of safety if things are pushed to free market, especially for these basic necessities. And vaccines are also more difficulty to check than salt. The vaccine trade has almost risen to the state of national diplomacy.

Many countries are able to product vaccines now. It's sure that there are always surplus vaccines can be purchased. It is worth noting that China has claimed that all Chinese citizens will be vaccinated and the vaccinating pace is staggering. Not mention the effectiveness of Chinese vaccines, the production of Chinese vaccine must be sufficient. We can also see this in western countries for its huge order of vaccines (Consumption will drive production), which adopt a more advanced technology. However, with the increasing competition between USA (other western countries) and China (Russia), the purchase action of vaccines seems also picking sides.

What's sure is that the country who has vaccines is more likely to satisfy its important partners first. I don't know the structure of your country. But if your government can't get enough vaccines, will corporations or hospitals get more than the government?

It is said that the mRNA vaccines is hard to preservation. If your country use mRNA vaccines, it is also related to the storage capacity.

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  • I think you might have misunderstood the question. It appears to me that in this answer you contrast an unregulated market with direct state control. But "free market" in the question does not imply a lack of regulation, at least not to me. The mRNA comment is definitely relevant - many Western countries identified the need for a cold chain early, and prepared for mRNA distribution in advance of large-scale production. Indonesia with all its islands will have a distribution challenge.
    – MSalters
    Jul 13 '21 at 15:11
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    Salt is a government-regulated necessity?
    – CGCampbell
    Jul 13 '21 at 15:31
  • Do a Google search for fake vaccines in china and see the power of communism. Filter the search to include only results previous to 2019 and note that it is in no way related to COVID-19.
    – puppetsock
    Jul 13 '21 at 19:50
  • Also: Is salt only ever distributed by governments? Why would that be?
    – puppetsock
    Jul 13 '21 at 20:38
  • Ming dynasty control salt in ancient china
    – user25908
    Jul 14 '21 at 11:03

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