Preserve, Pressure, Protect, and Peel: The US-China Rivalry and the Politics of Vaccine Provision

Lead states compete for influence and followers and the provision of health aid is a crucial foreign policy tool. Yet, there is variation in the means and patterns of provision. How and to which countries do providing states distribute vaccines amidst global crisis and rivalry? This article posits a novel typology of strategies: preserving existing partnerships, pressuring opponents, protecting recipients based on need, and peeling off countries from geopolitical rivals. It then analyzes US and Chinese vaccine distribution throughout the COVID-19 pandemic with respect to such strategies. Regression results and Bayesian process tracing suggest the US approach is characterized by protecting and peeling, while the Chinese approach is a combination of pressuring, preserving, and protecting. As for why certain provision strategies are pursued over others, evidence from original interviews and case studies of Nicaragua and Paraguay suggest grand strategic considerations take precedent over dyadic geopolitical calculations or domestic special interests.