Public Goods and Collective Action: The Case of Global Vaccination Campaigns

We all remember the horrors of the early days of COVID-19, particularly in 2020, before scientists developed vaccines and made them available worldwide. The arrival of the COVID-19 vaccines, compulsory in many places, quickly became one of the most controversial topics in recent times. There were heated “discussions” between pro and anti-vax campaigners that still play out every day. Although not universally popular, global vaccination campaigns are arguably examples of public goods, delivered to everybody without expectation of payment.

For this article, we are putting aside any ethical considerations about whether vaccines work, are safe, and should be compulsory, alongside any other issues raised by anti-vax campaigners. We are purely looking at whether global vaccination campaigns qualify to be considered a public good.

What Are Public Goods?

Public goods are goods and services that governments (or other organisations) provide to all members of a society free of charge. Typical examples of public goods include roads, parks, schools, and streetlights provided by local councils and central government.

It is important to establish that the word good is simply used here as a synonym for product, not an indication that all public goods provide positive (i.e. “good”) effects. Public goods may offer positive effects in some ways (for example, health), but negative in others (for example, cost). Public goods may have unequal effects on different people. For instance, street lighting will be positive for most people who go through an area, neutral for people who never visit there, and negative for anybody suffering from a bright streetlamp shining through their bedroom window.

Global public goods are those that provide benefits that cross national boundaries, for example, the eradication of smallpox and biodiversity.

A Brief Summary of the Covid-19 Vaccination Programme

Most readers will remember the global panic that occurred in 2020 with the arrival and rapid spread of Covid-19. The year began with Helen Branswell, science journalist for Statnews, tweeting “Not liking the look of this”. This turned out to be the classic understatement of the year.

Not liking the look of this. https://t.co/uqmeQ8if06

— Helen Branswell 🇨🇦 (@HelenBranswell) January 2, 2020

As of April 2024, there had been 704 million reported Coronavirus cases worldwide, leading to 7 million deaths. The UK saw 24.9 million cases and 232,000 deaths. Worldometer no longer tracks Coronavirus case numbers, so this is the latest available consolidated data.

Vaccine development progressed rapidly. “This is evolving science. You are seeing sausages being made — in front of the world’s eyes,” declared Yale vaccine researcher Saad Omer. Scientists went from a viral sequence to an approved vaccine in 11 months. The drug companies then had to produce the vaccines at breakneck speed, to have them ready as quickly as possible to benefit the world’s population.

Best quote of the day: "This is evolving science. You are seeing sausages being made — in front of the world's eyes." — @SaadOmer3 on the #Covid19 vaccine news.

— Helen Branswell 🇨🇦 (@HelenBranswell) December 8, 2020

In the UK, NHS, local government and the voluntary sector worked together to deliver the Covid-19 virus. On 8 December 2020, at University Hospital, Coventry, Margaret Keenan became the first person in the world to receive a vaccine. At its peak, more than 4,000 accredited vaccination sites operated across seven regions of the NHS and 153 local authorities.

Do Global Vaccination Campaigns Qualify as Public Goods?

Let’s establish how well global vaccination campaigns meet the essential characteristics of public goods.

1. Non-excludability – all potential users can derive a benefit. While there may be doubts by some relating to a vaccine’s safety and effectiveness, and restrictions placed on who qualifies for a vaccination (for some time the vaccine wasn’t made available to children in many places), as a whole, all potential recipients of a vaccine are likely to benefit.
2. Non-rivalry – users don’t need to compete for the benefit, as it’s freely available. Countries have endeavoured to make sufficient vaccines available to their populations, so there is no need to compete between members of a population for a dose. Of course, there was considerable competition between nations establishing a pecking order for vaccine distribution in the early days of the COVID-19 vaccine before supply chains were fully set up.
3. Non-diminishability – stock of the free good doesn’t diminish each time someone uses it. Technically, vaccines fail this characteristic – you can’t re-use a particular vaccine dosage once somebody receives it. However, Covid vaccines have been made in sufficient quantity, that stocks have continually been replenished as needed.
4. Non-rejectability – beneficiaries can’t reject the use of the free good. This is a particularly important characteristic when considering vaccination campaigns, and the rules vary by location. However, this characteristic is met in jurisdictions that introduce a mandate for compulsory vaccination.
5. Non-marginal cost – once supplied, the marginal cost of supplying the good for each person is zero. Governments (or organisations like the World Health Organisation) face a cost for each dose of vaccine, meaning that technically vaccines fail this characteristic. However, the vaccines are produced on such a large scale that the marginal cost of an additional dose is small. Also, in the case of large-scale vaccinations like those for COVID-19, vaccines were purchased for entire populations, and every person who avoids their vaccination is unlikely to save their government any money – it any already been committed.

Overall, global vaccination campaigns meet most of the requirements to be a public good, although this is tenuous for a few characteristics. You can arguably consider vaccines to be a public good.

Other Factors Affecting Whether Global Vaccination Campaigns Can Be Considered Public Goods

One issue that has an impact on whether you can consider global vaccination campaigns to be a public good is that the vaccines are generally developed by private pharmaceutical companies. In the case of COVID-19, there was fierce competition between the companies to be the first to develop a viable vaccine and have it available for use. Nations also competed to be the first to have an effective vaccine available for their population.

As Cihan Yüksel argued in the International Journal of Public Finance, COVID-19 led to an element of “vaccine nationalism” as nation-states tried to secure health products first to accelerate national recovery.

The World Trade Organization (WTO) has a Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement to reduce international trade barriers and to ensure that the enforcement of intellectual property rights doesn’t form an obstacle to trade. In 2001, the Doha Declaration stated some provisions of the TRIPS Agreement could be further bent to promote access to medicine for all. Yet, the larger countries didn’t agree to do this in 2020-2021. Although agreements were eventually made between manufacturers in rich countries and governments in poor countries, this took time. International organizations helped poorer countries lessen the discrepancies in vaccination roll-out. The World Bank contributed more than $10 billion to assist with the process.

Yüksel disputes the idea that the COVID-19 vaccine is a public good, due to the disparity between rich and poor countries in vaccine availability. He argues that an inability to finance vaccines by poor countries, while rich countries stockpiled vaccine doses, made Covid vaccination a national issue, rather than a global one.

However, the development of the COVID-19 vaccines was not all private sector. Much of the funding and scientific research on which the development of the vaccines was based came from governments. A UK paper suggested that 97–99% of the funding for the Oxford-AstraZeneca Covid-19 vaccine came from public sources, including governments and philanthropic organizations.

Were Those Who Opted Out of Covid Vaccination Free Riders?

As we have seen, one of the requirements for something to be a public good is non-rejectability. Yet in the case of Covid vaccination, there was a significant rejection by a sector of the world’s population – the “anti-vaxxers”.

In some countries, there were strong feelings between those in favour of vaccination and those against it. In some cases, mandates required that people needed proof of being vaccinated to keep their jobs, with anti-vaxxers made unemployed.

A study in Nature found that many vaccinated people expressed discriminatory attitudes towards unvaccinated individuals, at a level as high as discriminatory attitudes commonly aimed at immigrant and minority populations. They perceived the unvaccinated as free riders, who might endanger their peers and society at large. The study covered people from 21 countries and found that people held these views across all countries except for Hungary and Romania.