Efficiency in COVID-19 Vaccination Campaigns-A Comparison across Germany's Federal States.

Vaccination programs are considered a central pillar of the efforts to stop COVID-19. However, vaccine doses are scarce and several organizational and logistical obstacles, such as the timing of and reserves for second shots and delivery failures, apparently slow down vaccination roll-outs in several countries. Moreover, it is an open question as to where vaccines are administered as efficiently as possible (vaccination centers, hospitals, doctor's offices, pharmacists, etc.). The first aim of our study was to systematically evaluate the efficiency of a country's vaccination campaign. The second aim was to analyze how the integration of doctors' offices into a campaign that formerly relied only on vaccination centers affected the speed of that campaign. Using data on vaccine deliveries and vaccinations given in Germany, we find considerable differences across federal states in terms of efficiency, defined as the ability to administer the most vaccinations out of a given number of available doses. Back-of-the-envelope calculations for January to May 2021 show that vaccinations would have been 3.4-6.9% higher if all federal states had adopted a similar ratio between vaccinations given and vaccines stored, as the most efficient states did. This corresponds to 1.7-3.3% of Germany's total population. In terms of our second research goal, we find evidence that the integration of doctors' offices into the vaccination campaign significantly increased the ratio of vaccinations administered out of a given stock of vaccine doses. On average, there appears to be a structural break in this ratio after doctors' offices were integrated into the vaccination campaign on 5 April 2021. On average, an additional 11.6 out of 100 available doses were administered each week compared to the period prior to that date. We conclude that there are considerable regional differences in the efficiency of the vaccination roll-out. Systematic efficiency analyses are one step to detecting inefficiencies and to identify best practices that can be adopted to eventually speed up the vaccination roll-out in a country.