Anyone who was trying to get an appointment for a coronavirus (COVID-19) vaccine in March 2021 will remember what it was like—setting alarms for midnight as pharmacy slots opened, hanging around pharmacies near closing time hoping for an unclaimed dose, and depending on the kindness of strangers to make appointments online.
It was a perfect storm of supply and demand as the pandemic raged and continued to claim thousands of lives. At the beginning of the pandemic, Dr. Rajeev Goel, professor of economics at Illinois State, made some projections on what would happen when a vaccine arrived.
“From an economics perspective, this pandemic was a shock to the economy because it was unprecedented,” Goel said. “This was not the first pandemic, but in recent memory it was. The relevant data on its economic impact was not there.”
Appears InBy the time the vaccine rolled out of warehouses on semitrailers with police escorts, Goel was ready for what would happen next. In his paper “Drivers of COVID-19 Vaccinations: Vaccine Delivery and Delivery Efficiency in the United States,” he examined data from all 50 states. Vaccine delivery was more efficient in states with higher rural populations, more nursing homes per capita, higher COVID-19 deaths per capita, and more health care workers. In January 2021, his earliest data, the top three states for vaccine administration per 100,000 population were West Virginia, South Dakota and North Dakota. (See graphic below.) He published those findings in the journal Netnomics in 2021 with co-author Dr. Michael Nelson, professor emeritus of the University of Akron.
Some results of this research were not surprising: Nursing home residents and health care workers were prioritized for vaccinations, and higher death rates in a state boosted urgency to vaccinate. But other findings were somewhat unexpected. States with a centralized public health agency were not as efficient at distributing vaccines because of delays as information and supplies flowed through channels. And states with a large elderly population were no more efficient than those with high urban populations. Also, political climate, as measured in the study, was found not to be a factor in vaccine delivery. Forty-six percent of states led by Democratic governors were no more efficient at delivering vaccines than states led by Republican governors.
“I would have expected urban populations to be more efficient, and those with more elderly populations and states with Democrats as governors to make a difference,” Goel said.
It’s possible states with more rural residents were better at delivering vaccinations because of a greater sense of community in those areas, he said. Residents may attend the same church, schools, and community centers, and word spreads quickly.
“If I am in a city, I am kind of isolated from my friends,” Goel said. “These rural guys are meeting twice a week maybe. And perhaps because of the small numbers, the supply and availability of the vaccine is better. Even though I may have to travel 20 miles, I am more sure that once I get there (to a vaccination location), the vaccine will be there. In the urban areas, there is maybe congestion, or at least the perception of congestion.”
When Goel looked at gubernatorial party affiliation, he recognized there might be mitigating factors, such as whether the governor’s party held the majority in the state legislature, whether they were facing term limits, and how close the next election was expected to be.
From the time COVID-19 arrived in the U.S. in early 2020 until vaccines were widely available in summer 2021, Goel published six articles in international journals on how the disease impacted economic activity. He has published more than 50 papers on corruption, and leaned on that experience as he looked at the risk of corruption during a pandemic. Recognized internationally for his work on how corruption affects our lives, Goel has researched the economics of corruption for more than three decades.
The potential for corruption existed throughout the vaccine process, from manufacturing through approval, distribution, and administration, even whether boosters were recommended.
“We don’t know whether and to what extent corruption happened, but the potential is there,” he said.
Investigating and understanding the potential for corruption can aid U.S. policymakers and other nations in future pandemics, Goel said. He’s looking into why some states lagged in vaccination rates for no apparent reason and is identifying bottlenecks of the mass vaccination efforts.
“Because of the gravity of the pandemic, and the euphoria over the vaccines’ arrival, some of the challenges of the vaccine delivery are mostly ignored or are not recognized,” he wrote in a paper published in the Journal of Policy Modeling in 2021, co-authored by Nelson and Goel’s son, Viraat Goel, a 2015 University High School graduate and Massachusetts Institute of Technology graduate student.
“We argue that the somewhat unique tension between the speed of vaccine delivery and its scale can create opportunities for corrupt behavior,” he said. “The potential for out-of-turn delivery of vaccines and the stockpiling by unauthorized agents creates incentives for corruption, with the public or bureaucrats initiating corrupt transactions.”
“This was not the first pandemic, but in recent memory it was. The relevant data on its economic impact was not there.”
Dr. Rajeev Goel
Internet access and the digital divide across states did not have a significant impact on vaccination rates, Goel found. Yet among those who did internet searches for more information on vaccine access and reliability, vaccination rates rose, he reported in an article published in the Journal of Economics and Finance in 2021.
“I would have expected internet access to make a significant difference,” he said.
Goel’s daughter, Dr. Srishti Goel ’16, a medical resident with the Southern Illinois University School of Medicine, also co-authored a paper with her father on the pandemic’s impact on the supply chain, forecasting some of the disruption that happened throughout 2021. The pair reviewed pre-COVID data, from 2007–2018, and studied how the supply chain performance effects economic growth and compared that period to how the pandemic challenged the supply chain in 130 countries. The researchers, along with Dr. James Saunoris ’05, M.S. ’07, an Illinois State alum and an associate professor at Eastern Michigan University, published “Supply Chain Performance and Economic Growth: The impact of COVID-19 Disruptions” in the Journal of Policy Modeling in 2021.
In another study, Rajeev Goel researched the demand for surgical masks, showing how prices changed when they were mandated for front-line workers and others, when they were recommended but not required, and when they were mandated for the general public. When masks were universally mandated, the cost rose, and when masks were only recommended, supply increased. The theoretical paper, “Unmasking the Demand for Masks: Analytics of Mandating Coronavirus Masks,” was published in Metroeconomica in 2021, with co-author Dr. Shoji Haruna, of Okayama University in Japan.
Goel is expanding his research on vaccine delivery and administration beyond the U.S. borders, looking at Italy and developing countries, and paying close attention to which vaccines are being promoted.
“One interesting scenario is countries seem to be pushing their own vaccine,” he said. “Not all countries have their own vaccine. Whether a person in a poorer country gets a vaccine from this country or that country doesn’t matter, so long as they’re vaccinated. But we don’t know qualitatively how different those vaccines are.”
Vaccine passports is another topic he and James Jones, director of Illinois State’s Katie School of Insurance and Risk Management, are investigating. They are looking at privacy concerns and how individuals who are unvaccinated because of health concerns or beliefs will be at a disadvantage if governments mandate proof of vaccination to travel or participate in certain activities. The researchers are also studying the potential for corruption in the production of fake passports and the use of bribery to lower or escape penalties for noncompliance.
Before the arrival of COVID-19, Goel never considered researching the possibility of what could go wrong during a pandemic.
“This is new, and it is exciting in that sense,” he said. “It opens a new research frontier.”
And that frontier is one Goel has every intention of exploring as he said corruption continues to be an issue worldwide, with or without a pandemic.
Dr. Rajeev Goel
Dr. Rajeev Goel is an Illinois State University professor of economics who has written two books: the co-authored Global Efforts to Combat Smoking (2008) and Economic Models of Technological Change (1999). He has also published more than 200 scholarly journal articles. Goel has held visiting research positions around the globe and serves on the editorial boards of about a half dozen academic journals.
In 2021 he earned the Janice Witherspoon Neuleib Award for Outstanding Scholarly Achievement of the Year by a Tenured Faculty Member from Illinois State University’s College of Arts and Sciences. He was named Distinguished College Lecturer in 2019 and Outstanding University Researcher in 2011.
The professor has also been recognized internationally, earning the Bergson Prize for the best paper published in the journal Comparative Economic Studies, and since 2018, he has been affiliated as a researcher with the Kiel Institute for the World Economy in Germany.
