With the number of global infections reaching 123 million as of March 24, 2021 according to the World Health Organization (WHO), the coronavirus disease (COVID-19) could be considered one of the most impactful diseases in human history. This pandemic has had unique consequences for everyone on the planet, including changes in our daily lives. To counter this threat, a range of public health strategies and vaccines have been developed. These proposed solutions, however, have not been without their controversies. For example, there is intense debate over which social and age groups should be prioritized for vaccinations and how vaccines should be distributed.

Being reported as a new infectious disease to the World Health Organization (WHO) on December 31, 2019, COVID-19 has since then negatively affected all sectors of societies all over the world. Of the countless recent problems associated with COVID-19, one that stands out is its many mutations, which are leading to an increasingly faster spread of the virus. Professor Kim Woo-joo (College of Medicine) stated that these mutations could lead to a reset in the development of COVID-19 vaccines because new strains of the virus may require a new vaccine. If so, the vaccines developed to this point could be rendered unusable.

Moreover, the toxicity of COVID-19 has even reached the international political sphere; some countries have been risking harming relations with other countries to gain medical supplies. For example, according to BBC, the United States (U.S.) has redirected 200,000 masks that were en route to Germany. On April 3, 2020, former U.S. President Donald Trump stated that 200,000 N-95 respirators, 130,000 surgical masks, and 600,000 gloves had been procured, but the source was never mentioned. The local government in Berlin claimed that their shipment of U.S.-made masks was “confiscated” in Bangkok by the U.S., serving to harm relations between Berlin and Washington.

COVID-19 and Related International Politics

One method some countries have been using to increase their soft power across the globe during the COVID-19 era is donating vaccines and medical supplies to their allies. This so-called vaccine diplomacy is being implemented by countries such as China, India, and Russia. South Korea adopted a similar but different foreign policy by donating some medical supplies to countries such as Ethiopia and the U.S. during the early phases of COVID-19. However, vaccine diplomacy comes at a cost — countries that utilize this tactic inevitably give away supply that could be used for their own citizens, risking their own public health. Nonetheless, Professor Woo Jungmoo (Department of Political Science and Diplomacy, Dongguk University) believes that further economic and technological support will follow, as it is in the interest of many countries to end the spread of COVID-19 in all countries. 

Some nations may practice vaccine diplomacy for these reasons but other agendas exist as well. According to Professor Jo Sung-Hwan (Graduate School of Political Studies, Kyonggi University), China has been catastrophically affected diplomatically since it cultivated a national image of being the epicenter of COVID-19 and failed to stop the spread of the disease early on in the pandemic. China may, therefore, use this opportunity to improve their national image in the global sphere. For instance, China’s Ministry of Foreign Affairs has stated that China has sent its vaccines to 69 countries among which Hungary, a member of the European Union (EU), approved its use. 

Vaccine diplomacy carried out by countries such as China may challenge the global hegemony of the U.S. and weaken the international influence of both the EU and the U.S. Desire for diplomatic gains can, however, backfire, according to Professor Woo; for instance, vaccine diplomacy once resulted in the deterioration of China’s image in Brazil due to the given vaccine’s lack of effectiveness. Hence, efficient use of vaccine diplomacy will be required in order to gain from its adoption.

As such, vaccines are being used as a geopolitical tool to advance national interests, which may serve to further complicate post-COVID-19 geopolitics. Professor Jo views this as a serious concern as China’s economic warfare against the U.S. and its allies is growing increasingly larger with an emphasis on developing countries, eroding the U.S.’s influence significantly. The U.S. and the EU may have to consider adopting measures if they do not wish to see their global power and influence decrease post-COVID-19.

COVID-19 Public Health Strategies

In contrast to the vision statement of WHO Director-General Tedros Adhanom, who stated that he wishes to reaffirm WHO’s role in creating a “healthier and safer world,” COVID-19 seems to have reduced people’s trust in the organization. WHO has been criticized for its handling of the virus, and when the Trump administration notified the UN of its withdrawal from the WHO on May 29, 2020, the public image of the WHO received a significant blow. 

Despite the WHO having lost so much authority, experts such as Professor Lee believe that the WHO can restore some of its lost authority as the U.S. President Joe Biden brought the U.S. back in the WHO. Professor Lee believes that if the U.S. participates actively in the WHO it could restore its lost authority. WHO takes a leading role in programs such as the COVAX initiative so it is highly likely that the WHO’s influence will remain even after the pandemics end. Professor Woo however, believes that the need for the organisation's internal reforms will be necessary due to its failures during the COVID-19 pandemic.

To compensate for a lack of an effective public health strategy recommended by credible organizations such as WHO, many countries have pursued their own unique approach to a COVID-19 related plan. One of the most famous cases is Sweden’s short-lived test of herd immunity. The Swedish government’s plan was to naturally immunize the entire population against COVID-19, which meant leaving the virus to spread naturally between people. It was a bold strategy, but it ultimately received criticism for failing to protect vulnerable groups such as the elderly from the disease.

Another approach has been to completely lock down population centers. This is what China did early on in order to stop people from coming into contact with each other and reduce the risk of the virus spreading. This strategy seems to have been highly successful judging from China's said reduction in COVID-19 cases, but many have argued that it infringes upon the civil rights of citizens, and that it was only possible due to the Chinese government’s strong central control of the country.

South Korea pursued yet another strategy; it has relied on its citizens to follow strict social distancing in order to weaken the spread of COVID-19. The Korean government has also prioritized testing as many people as possible and tracing anyone who could be potentially infected since the early stages of the COVID-19 pandemic. Although the number of daily confirmed cases remains around 300 and 400, Korea remains one of few countries to have avoided any form of lockdown, which many people view as a testament to the effectiveness of their public health strategies.

Vaccines, Herd Immunity, and Societal Obstructions

All three countries – South Korea, China, and Sweden – have pursued different public health strategies and achieved different results. However, public health strategies may be insufficient to combat COVID-19, which is mutating at an incredible speed. The most important element required to return to normalcy, in fact, would be to ensure that as many people as possible are immune to SARS-COV-2, the virus responsible for the COVID-19 pandemic. According to Professor Kim, 70 percent of the population would need to have immunity against the disease in order to stop the pandemic. In other words, vaccines and treatments for COVID-19 seem to be the only apparent resolution at this point. Consequently, various countries and pharmaceutical companies have exerted their energies on developing an effective vaccine — none of which have helped a country reach herd immunity yet, due to a yet low number of actual vaccinations. 

Along the same lines, another important requirement in the fight against COVID-19 is reliable logistics hubs and infrastructure to support the transportation of vaccines. Some vaccines, such as Pfizer’s COVID-19 vaccine, require storage at ultra-cold temperatures of between –80 and –60 degrees Celsius while others such as Moderna’s vaccine require storage at -20 degrees Celsius. As a result, cold chain storage systems, essentially for ultra-low temperature storage, is necessary for any country that wishes to distribute vaccines to its population. Vaccines that are not stored under optimal conditions will not have the desired effects against SARS-COV-2 when administered.

Despite this, vaccines are becoming an increasingly politicized topic. According to Prime Minister Chung Sye-kyun, this is because some people have actively sought to politicize vaccines when science should be the only standard for decision-making. Various issues, such as the question of who should be vaccinated first in Korea, raised tensions in domestic Korean politics, with some politicians demanding that President Moon Jae-in be vaccinated first. Remarks such as “The president is not a test subject” increased unease about the current situation and reduced the population’s confidence in the vaccines. Another issue has been the concern that Korea had a late start with its vaccination program. According to *Kookmin Ilbo*,South Korea’s vaccination program was the last to begin among the Organisation for Economic Co-operation and Development (OECD) countries, and this relatively slow start raised concerns that returning to normal life may also be slow to occur. 

To escape the coronavirus pandemic, achieving herd immunity against COVID-19 is crucial and the politicization of vaccines will only hamper this effort as fewer people will be willing to cooperate, putting more people at risk of contracting the disease. Another issue will be controlling the pandemic in Less Economically Developed Countries (LEDC) as a true end to COVID-19 can only be seen once all countries are free from the disease.  Many are reluctant to get vaccinated because of misinformation regarding the vaccines in general and because of negative news stories about people who have taken it. 

For example, a U.S. survey done by the Pew Research Center found that those who were definitely or probably going to be vaccinated rose to 60 percent as of November of 2020. Nonetheless, 39 percent of the population stated that they would definitely not get the vaccine – although 18 percent of U.S. adults stated that they might change their minds once more information regarding the vaccines becomes available. However, that still leaves 21 percent of the population that are set on not being vaccinated, regardless of information availability. 

While these numbers are specific to the U.S., this is a case where major problems may arise because of a small proportion of the population. Herd immunity against COVID-19 can only be achieved when 70 percent of the surrounding community is immune, thus protecting the remaining individuals who are not. However, the numbers reported in the survey indicate that this target may not be achieved, due to people who are against the idea of getting vaccinated. Herd immunity is necessary: to protect those that cannot protect themselves. Those who are anti-vaccine make it difficult for society to reach that level quickly, leaving many people vulnerable. Therefore, it is necessary to raise awareness and endorse the current efforts to create a cheap, worldwide solution to ensure the equal safety of all citizens.

Rush-Order Vaccines

Most of the developed COVID-19 vaccines have been revealed to be using the quite novel technology of mRNA vaccines. In the long history of vaccine development, mRNA vaccines differ significantly from their predecessors. mRNA vaccines act by first teaching cells how to create a protein with natural antibodies against the targeted virus. These are called spike proteins, and they occupy empty cell space. These proteins are then sacrificed for the body to develop resistance to the targeted virus, which is, in this case, the COVID-19 virus. mRNA vaccines do not affect the DNA makeup of the body because mRNA never enters the nucleus of the cell. The cell, after breaking down the instructions provided by the mRNA vaccine, removes them from inside itself. 

However, there are some associated issues. Given that this is a new technology, mRNA vaccine’s world-changing benefits are accompanied by some flaws. In particular, there is the potential risk of local, systemic inflammatory responses to the vaccine, which, in serious cases, can lead to autoimmune conditions. A more serious issue may be the disinformation distributed online. Social media reinforces the false belief that mRNA vaccines alter the DNA and render women infertile or cause autism due to toxins in the vaccine. However, the current vaccines may not be what the world needs. Traditionally, new vaccines take ten years to create and test because tests are necessary to determine whether a vaccine is safe for human use. However, the COVID-19 vaccines did not have the luxury of time – instead, the ones that are being administered currently spent only a single year in testing. This rushed schedule has inevitably resulted in dangerous outcomes. The process was so rushed that the vaccines simply could not achieve their purpose; for example, Chinese workers in Serbia were infected despite being administered the vaccine.

On the domestic front, two people with underlying health conditions died in Gyeonggi Province after receiving a shot of the AstraZeneca vaccine on March 4. While it cannot be proven that these deaths are due to the vaccine they received, the perceived association between their deaths and the vaccine has many people doubting whether they should receive them or not, and this is clearly amplified by the rushed nature of the vaccines. These examples mean that vaccine skepticism has become more common, even as the opportunity to receive a vaccine rises. Trust in the newly developed vaccines is hitting new lows and is hindering efforts to achieve herd immunity.

Countries Compete to Vaccinate

While the effectiveness of these vaccines is not fully verified, countries continue to compete for the limited supply because it remains the best solution available.  South Korea, Japan, and the U.S. are among those that have ordered a bulk supply of available vaccines. The U.S. has already been distributing vaccines for emergency use. The federal and state governments have been distributing it to targeted groups since December 11, 2020. Priority has been geared towards healthcare personnel and long-term care patients, with the Acting Secretary also ruling that teachers, school staff, and childcare workers should be eligible for prioritized COVID-19 vaccinations. Other decisions regarding priority are made at the state level. Japan has also established a schedule for its vaccine rollout, with 10,000 to 20,000 frontline healthcare workers at state hospitals to be vaccinated first, followed by 3.7 million healthcare workers. Those aged 65 and older are the next priority for March and April afterward. Vaccinations for the general public are to start from July and onwards, with 314 million doses available. 

Supplies are low, and many countries have found that, even though they have the money, there are no COVID-19 vaccines available to buy. Countries on the African continent and in the Middle East are among those that have yet to receive doses. According to Professor Lee Wang Hwi (Department of Political Science, Ajou University), countries are too focused on inoculating their own citizens first before turning their attention to international matters. Despite the recurring calls for the fair distribution of vaccines by the WHO, it is clear that no country is paying special attention to these demands. COVID-19 vaccines are being used for political profit and are acting as diplomatic currency. Wealthier countries are buying supplies from pharmaceutical companies, while China and Russia, whose vaccines are shrouded in controversy, are selling their shots to poorer nations. 

South Korea has started vaccinating citizens as of 3/25, starting the country’s attempt to vaccinate almost everyone in the country and has gained sufficient doses for approximately 44 million people from various sources, including AstraZeneca, Pfizer/BioNTech, Moderna, and Johnson & Johnson. The COVID-19 Vaccines Global Access (COVAX) facility has been contracted to supply around 10 million doses and other agreements have been set for the remaining 34 million. The priority is to vaccinate the elderly and the ill first, before establishing rankings for who should be vaccinated next. The government has also stated that, due to issues with storage and maintenance, mRNA vaccines will be provided through stations created specifically for vaccinations. 

Are Mandatory Vaccinations a Viable Solution? 

Indonesia announced in February that it would *require* those who were eligible to receive a vaccine in an effort to curb the number of infected. As in Indonesia, it seems that other countries will make receiving a COVID-19 vaccine mandatory as more supplies become available. More than 100 nations of the 193 in the United Nations (UN) have some form of legal mandate that imposes penalties for noncompliance. These penalties include fines and not allowing unvaccinated children to attend school. However, other nations are disinclined towards making vaccinations a requirement. President Joe Biden of the U.S. stated that he is not supportive of mandatory vaccinations, and the federal government cannot enforce it nationwide anyway. States can, however, and some bills have already been passed to make it happen. New York has had a lawmaker propose a bill for this purpose, although there is no suggested penalty for noncompliance. 

In Korea, there are a few outspoken groups who are resistant to vaccinations in general, and some people are reluctant to receive a vaccination while they are still untested. However, with countries already rolling out vaccinations, up to 500,000 people have already received the vaccine, with the Korea Disease Control and Prevention Agency (KDCA) deputy chief stating that Koreans’ willingness to receive a vaccine is quite high. For example, more than 90 percent of Korean medical staff are reported to be willing to be vaccinated. However, there are people who believe that mandatory vaccination will only increase resistance to being vaccinated in the first place. Forcing vaccinations may represent an ethical violation from a humanitarian perspective because it subsumes free will in favor of the government’s desires. 

Overall, COVID-19 vaccines are making headlines around the world. While there are still many issues surrounding them, the simple fact that they exist brings great hope that the end of the pandemic is near. As individuals, we should continue to stay informed about this situation and to remain safe from the potential spread of COVID-19. However, to eradicate COVID-19 worldwide, a number of political hurdles need to be overcome, and these will require governments to remain alert and aware and to cooperate on an international scale.