COVID‐19 pandemic, vaccine nationalism and counterfeit products: Discourse and emerging research themes

Abstract Although “vaccine nationalism” and vaccine diplomacy have thus far typified the COVID‐19 vaccine rollouts around the globe, there remain limited scholarly insights on global vaccine distribution strategies. This research note (RN) examines the global vaccine distribution strategies and implications for public policy and governments. In conceptualizing the global vaccine distribution strategies into three competing perspectives (i.e., “vaccine nationalism,” vaccine diplomacy, and global initiative), this article highlights the divergent effects of different approaches in terms of ushering elements of nationalism and ethnocentrism. By contextualizing the discourse on the COVID‐19 pandemic into the three competing perspectives and highlighting the role of pharmaceutical companies and COVID‐19 vaccine passport, the study also offers pathways for further examination of the subject incorporating the contextual conditions.

restrictions to trade and investments. Indeed, some commentators have suggested that the nationalism force could erode much of the progress made in ushering in deregulation and liberalized markets (The Economist, 2020). As suggested by The Economist (2020, p. 7), "even before the pandemic, globalization was in trouble" with America's tariff rate on imports reverting to 1993 levels.
Although advancements in global deregulation and trade liberalization efforts have been crucial in ushering in 20th century globalization (Doganis, 2005;Ocampo & Taylor, 1998), these forces have come under sustained pressure in the 21st century not only from the pandemic but also from some global leaders who championed the notion of "nationalism" in their responses to it. According to the International Chamber of Commerce (2021), the global economy could lose up to US$9.2 trillion due to "vaccine nationalism" as governments have failed to ensure that developing economies gain equitable and timely access to COVID-19 vaccines. Indeed, by late February 2021, the World Health Organization (WHO) observed that around 75% of the available vaccine doses were dispensed in around 10 wealthy nations (Blanchfield, 2021). Thus, for effective global economic recovery to occur, reliance on vaccines to mainly advanced economies pandemic (e.g., Fernandes, Veiga, Lobo & Raposo, 2022;Santos, Oliveira, Ratten, Tavares & Tavares, 2021), this study conceptualizes global vaccine distribution strategies into three competing perspectives (i.e., "vaccine nationalism," vaccine diplomacy, and global initiative), which provide not only deeper understanding of the current approaches but offer clarity in the current discourse on vaccines in the wake of COVID-19. Moreover, this study further contributes to current discourse on the COVID-19 pandemic (Callaghan et al., 2021;Durizzo, Asiedu, Van der Merwe, Van Niekerk, & Günther, 2021;Dhanani & Franz, 2021;Park & Chung, 2021;Latkin, Dayton, Yi, Konstantopoulos, & Boodram, 2021;Sheng et al., 2021) by integrating COVID-19 insights to advance a novel business and public policy research agenda with the aim of meeting some of the new global challenges. In addition, although past studies on the COVID-19 pandemic have illuminated understanding of governments' responses (e.g., Mintrom & O'Connor, 2020), there is a paucity of research on "vaccine nationalism" and its implication for international business research. This study examines this issue and outlines avenues for future research.
In the remainder of this article, a brief overview of the COVID-19 pandemic and vaccine distribution strategies is presented. This is followed by the development of a conceptual framework and then an outlining of a new agenda for future research is presented.

| COVID-19 AND VACCINE DISTRIBUTION STRATEGIES: AN OVERVIEW AND CONCEPTUALIZATION
In the past few years of COVID-19 pandemic, healthcare systems in many developed and emerging nations have been teetering toward collapse and unable to handle the growing hospitalizations (Drexler, 2021). The financial and economic shock has cascaded into many firms fighting for survival (Amankwah-Amoah et al., 2020a).
Indeed, countries' financial resources have been severely depleted as a result of having to divert funding to combatting the disease and helping small businesses stay buoyant (Bartik, Bertrand, Cullen, Glaeser, Luca, & Stanton, 2020).
Following the dislocation of voluminous small businesses across the globe, governments have increasingly been called upon to shore up such firms to be able to transition to the future. For instance, in the US, the government partly achieved this objective via the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) (Bartik et al., 2020). Although some resource-constrained nations have better weathered the coronavirus pandemic such as Bhutan and Vietnam (Drexler, 2021), developed nations continue to struggle to maintain effective handling of the crisis.

| Businesses and COVID-19 vaccine development
Owing to the native effects of lockdown measures, border closures, and cessation of businesses, governments and donor/philanthropic organizations such as the Gates Foundation sought to boost investment in developing vaccines to help find solutions and support national economies to recover in a speedy manner (Hooker & Palumbo, 2020). Indeed, governments around the globe have provided over £6bn and £1bn from donor/philanthropic organizations toward vaccine development (Hooker & Palumbo, 2020). Accompanying the pandemic has been a massive investment by pharmaceutical companies into vaccine development activities. For instance, the US firm Johnson & Johnson worked in collaboration with the UK's AstraZeneca/University of Oxford-based biotech company to develop one of the vaccines (Hooker & Palumbo, 2020). In a similar vein, Moderna, a biotechnology firm, has also worked with not-for-profit organizations in bringing its vaccine to market. At the core, the pharmaceutical industry has responded to the crisis by prioritizing research and development activities related to COVID-19 and new technology adoption to underpin drug development (Association of the British Pharmaceutical Industry, 2021). It is worth noting that some of the pharmaceutical companies have also charged different amounts in different countries, which might benefit developing nations (Hooker & Palumbo, 2020). Despite substantial resource investment, the pharmaceutical company Merck shelved its two COVID-19 vaccine candidates-known as V590 and V591-due to unfavorable results from clinical trials (Chappell, 2021b).
Pharmaceutical companies have also mobilized a range of new technologies to disseminate not only information but also to minimize faceto-face interaction to curtail contagion mechanisms for the virus. This also means the increasing use of virtual teams as a means of managing their activities. Indeed, modern ICT offers ample opportunities for R&D activities, at any global location of the firms, to forge international partnerships and disseminate knowledge (Castellano, Chandavimol, Khelladi, & Orhan, 2021). Virtual research and development (R&D) teams help to maintain a virtual presence to foster an effective functioning of the team (Castellano et al., 2021). A major challenge stemming from COVID-19 is the obligations imposed on businesses regarding health and safety (Manuel & Herron, 2020). Indeed, numerous organizations have not only instituted new cleaning regimes but also offer personal protective equipment (PPE) at work, encompassing items, such as gloves, eye protection, face shields, clothing, and safety wear.
Although facilitating knowledge diffusion can be challenging in virtual teams due to potential misinterpretation of signals, the cost of transmitting information and communication has shrunk (see Klitmøller & Lauring, 2013). One possible explanation is that technologies, such as video conferencing, Zoom and Teams offer opportunities to minimize face-to-face interactions. By avoiding face-to-face meetings and requiring limited office space to work and organize firms' activities, organizations are able to conserve financial resources. During the COVID-19 pandemic, environmental sustainability issues and practices have also been elevated to the forefront of businesses' agenda (Amankwah-Amoah, 2020a, 2020b), focusing on the reduction in greenhouse gas emissions, air pollution, carbon emission footprints, and energy consumption (Chowdhury, Paul, Kaisar, & Moktadir, 2021).

| GLOBAL VACCINE DISTRIBUTION STRATEGIES
To deduce the patterns related to global COVID-19 vaccine distribution strategies, the study relied mainly on secondary/archival sources.
To mobilize information for the conceptualizations, this article utilized insights from COVID-19-related press releases and reports from international organizations data such as the European Commission, OECD, US Food and Drug Administration and World Health Organization. In addition, industry/business periodicals (e.g., The Economist and Airline Business) alongside news reports (e.g., BBC, CNN and The New York Times Company) were also consulted.
Globally, governments including US, UK, and China have played a vital role in providing financial resources to pharmaceutical companies not only for COVID-19 vaccine development but also its distribution. For instance, in the US, the government has used the Defense Production Act, a wartime power to obtain equipment and accelerate vaccine manufacturing (Lupkin, 2021a). By invoking the Defense Production Act 2021, the US government was able to leverage its powers and resources to get pharmaceutical giant Merck to help manufacture Johnson & Johnson's COVID-19 vaccine (Lupkin, 2021b). This was a major step given that the two companies are rivals and historically opted to compete rather than collaborate. Although the development of COVID-19 vaccines in record time is regarded as one of the greatest achievements of scientists in modern times (Ghebreyesus, 2021), the distribution of vaccines has been marked by divergent approaches. The research note (RN) conceptualizes the global vaccine distribution strategies into broadly three perspectives (i.e., "vaccine nationalism," vaccine diplomacy, and global vaccine initiative), as demonstrated in Figure 1.

| Vaccine nationalism
The first of the global vaccine distribution strategies is "vaccine nationalism." According to Evenett et al. (2021, p. 1), "vaccine nationalism can take the form of overt export bans or limits-that aim at increasing domestic availability of vaccines at the expense of foreign supply-or they can take less transparent but often equally effective forms." This is rooted in weak or lack of cooperation and collaboration between nations to facilitate timely and equal access to vaccines. A defining characteristic of this perspective is its inward/domestic focus on vaccine distribution permanently or temporarily and also in terms of producing nations creating trade barriers or even delays in shipments.
As previously noted, the global economy is set to lose around $9.2 trillion if "vaccine nationalism" persists, thereby leaving the developing world behind in inoculating their citizens (Busari & Cheung, 2021). Even if all citizens of developed economies are vaccinated, the potential for a new version of the virus to re-merge could linger. Although around 85% of developing nations are yet to have effective vaccination programs and "there is a growing realization that the virus is likely to find a permanent home in humans," developed nations have accelerated their programs (The Economist, 2021a, p. 9-10). Indeed, prior to an effective vaccine emerging, the World Health Organization Director-General Tedros Adhanom Ghebreyesus urged nations to focus on global access to mitigate "hoarding" by some leading nations' "vaccine nationalism" (Neuman, 2020a;. Another feature of vaccine nationalism is a tendency among governments to seek to secure vaccine doses to the detriment of others (Evenett, Hoekman, Rocha, & Ruta, 2021  However, the notion of "vaccine nationalism" is a recipe for greater ethnocentrism on the global stage where more and more consumers/citizens develop a hostile attitude toward foreignmade products. The term ethnocentrism is used in a sense that it can act as a "self-defense reflex of local economies, governments, organizations, and individuals against the threat of imports and foreign competition" (Siamagka & Balabanis, 2015, p. 66). Besides just government encouragement to buy homemade products, the elevation of domestic priorities over all concerns is worrying. The forces of globalization face a headwind due to some countries becoming more inward looking and nationalistic. The "vaccine nationalism" approach was adopted by many western nations including the US and European nations. The necessity of vaccines in re-starting national economies after lockdowns around the globe appears to have created an incentive for some governments to initiate and implement some forms of protectionist measures.

| Vaccine diplomacy
In contrast to the above approach, vaccine diplomacy refers to a "branch of global health diplomacy that relies on the use or delivery of vaccines" (Hotez, 2014, p. 1). A distinctive characteristic of this perspective is its focus on humanitarian intervention as a means of enhancing a country's standing. Under the umbrella of vaccine diplomacy, is vaccine science diplomacy, which refers "to the joint development of life-saving vaccines and related technologies, with the major actors typically scientists" (Hotez, 2014, p. 2). For instance, China, India, and Russia have championed the so-called "vaccine diplomacy" as means of amassing goodwill in the developing world and developing "soft power" (Myre, 2020). To further elucidate, Russia has made its Sputnik V COVID-19 vaccine, which offered a robust protective effect, widely available to developing nations and this has helped in this direction (Jones & Roy, 2021). In the meantime, China has also spent around $2 billion to help developing nations as well as making its vaccine widely available (Myre, 2020). By February 2021, around a million doses of China's Sinopharm COVID-19 vaccine had been exported to countries, such as Nepal, Pakistan, Cambodia, Sierra Leone, and Zimbabwe as a key pillar of its "vaccine diplomacy" strategy (Jennings, 2021).
At another level, India has donated some supplies of the AstraZeneca/Oxford vaccine, which is made in the country, to neighboring countries such as Bangladesh, Myanmar, and Nepal (Jennings, 2021).

| Global vaccine initiative
The final perspective is the global initiative with multilateral collabora- • Inward attitude to vaccine distribution.
• Can foment intense quest for resources between nations. • Largely designed to focus on vaccination requirements in the "motherland" for a period. • Ignites the spirit of "patriotism" in either vaccine development or distribution, or both. • Seen to counter the growing tide of globalization around the globe.
• Nationalism can lead to ethnocentrism, which can manifest in citizens and consumers' behavior. • Hoarding by some countries can undermine harmony and trust between nations. • Potential to undercut international collaboration between countries. • Forces weaker and resource-poor nations to become wearier of rich and developed nations. • Potential to exacerbate nationalism tendencies.

Vaccine diplomacy
• Leveraging vaccine distribution to gain goodwill and improve a country's standing around the globe. • Home-and allied-countries' first approach.
• It has potential to elevate less democratic nations, such as Russia and China on the global stage. • Vaccine diplomacy could encourage developing nations to reduce their dependence on developed nations for vital suppliers beyond vaccines.

Global vaccine initiative
• Recognized the globalization realities and benefits of global access to vaccines. • A vital ingredient for effective multilateral cooperation and all-countries first approaches.
• Domestic citizens may resent the notion of elevating other countries' citizens' concerns and access to vaccines to the top of global priority.
included 600,000 doses of the AstraZeneca vaccine, thereby taking a giant step in meeting COVAX's objective of helping to bridge the gap between advanced countries and developing nations in accessing the vaccines (BBC, 2021b). This was to be followed by delivering to other countries in the region and beyond. By focusing on international effort geared toward helping low-and middle-income countries vaccinate their citizens and cope with the pandemic (Chappell, 2021a), the COVAX global program represents some kind of mid-point between the "vaccine nationalism" and vaccine diplomacy approaches adopted on the global stage. Rooted in the above analysis, Table 2 summarizes the merits and demerits of the three competing perspectives.  (Ozawa et al., 2018). This preexisting trend has been further amplified by the global unequal access to vaccines.

| COVID-19 AND COUNTERFEIT VACCINES
Following the preceding analysis, one of the outcomes of the unequal distribution of vaccines has been the spread of counterfeits COVID vaccines (see Amankwah-Amoah, 2022). Some contend that vaccine "hoarding" by advanced nations has not only created conditions for "vaccine nationalism" (Neuman, 2020a;, but also created the conditions forcing many developing nations and citizens to explore other means of accessing the vaccines. According to World Health Organization (2022), equitable access to safe and effective vaccines is sine qua non in countries' ability to combat and return the world to greater degree of normalcy. Despite this important recognition, "vaccine nationalism" remains a major issue.
In the vacuum of lack of access to vaccines and prevalence of fake information, many questionable products have also emerged in the "marketplace" in both developed and developing nations purporting to help diagnose, remedy, treat, and even prevent COVID-19 dis-

| Vaccine passport
There is anecdotal evidence suggesting that vaccine passports offer an effective pathway to return industries and the world back to normalcy (see Boon, 2021;European Commission, 2021;IATA, 2022). Broadly speaking, the vaccine passports is some kind of "immunization certificates" encompassing not vaccination status of the holder, but also results from infection tests, proof that the individual possess a "completed a period of quarantine, or exemptions from vaccination for health reasons" (The Economist, 2021c, p. 75-77). For instance, the European Union, the European Commission' plan has been put in motion for the so-called "Digital Green Certificate" and thereby offering verifiable vaccination status of individuals (European Commission, 2021; The Economist, 2021c).
The certificate seeks to create conditions that help to allow free intra-EU

| Theoretical and practical contributions
The analysis yielded several important contributions to theory and practice. Theoretically, prior scholarly efforts neither theoretically nor empirically have sought to elucidate and differentiate the divergent global vaccine distribution strategies during the pandemic (e.g., Fernandes et al., 2022;Santos et al., 2021). Viewing quality and attentive leadership as essential ingredients in not only identifying and responding to the crisis (Drexler, 2021), it is contended that global leadership would be crucial in the postpandemic phase. The analysis also suggests a need for global organizations, such as WHO and UN to move toward de-escalating the forces driving "vaccine nationalism" and move toward a more global solidarity approach that fosters harmony. This would go a long way in ushering in a post-pandemic global economic recovery rather than regional recovery. The potential for heightening nationalism and ethnocentrism is real with regard to the "vaccine nationalism" approach which must be borne in mind. Thus, more resources need to be geared toward COVAX to quell this. Given that vaccine distribution is seen as the best chance of ushering in global economic recovery, it is incumbent on governments and policymakers to ensure that they do not succumb to nationalism and vaccine nationalism tendencies. By encouraging nations to join forces in scaling-up of COVID-19 vaccine production and distribution has the potential of reducing tension and potential global conflicts between countries.

| Limitations and future research directions
There are several limitations which culminate in the direction for future research. First of all, a limitation is that the analysis provides a snapshot on an unfolding event with consequences for years to come.
Thus, future study could seek to extend our insights into the effects of COVID-19 in the post-pandemic business landscape. Future research could build on prior efforts by investigating how global variation in access to COVID-19 vaccine can be traced to the quality of a country's informal and formal institutions, such as legal system, culture, and beliefs. Pertaining to this, the specific questions for future research are illustrated in Table 3. The empirical and practitioner literature has been contradictory with regard to long-term effects of vaccine diplomacy. Thus, a more robust analysis of the long-term implications for governments and how businesses formulate their strategies in response to vaccine nationalization and diplomacy is needed.
In this study, we conceptualized three perspectives around the globe (i.e., "vaccine nationalism," vaccine diplomacy, and global Home-country first approach.
What firms organize their activities in the wake of COVID-19-induced disruptions to reduce reliance on some countries? How do geographically dispersed co-workers or teams benefit from "vaccine nationalism"? To what extent does the "home-country first approach" lead to limited international engagement by businesses?
Vaccine diplomacy Leveraging vaccine distribution to win. Home-and alliedcountries first approach.
To what extent can "vaccine diplomacy" undermine the "rules of the game" governing developed and developing nations' firms on the global stage? Can "vaccine diplomacy" be turned into a source of market competitiveness for emerging market firms from countries such as China and Russia? Can "vaccine diplomacy" have a knock-on effect in fostering greater technology transfer to developing economies?

Global vaccine initiative
Multilateral cooperation and all-countries first approaches. Global access to vaccines.
How do businesses organize their global activities to provide pandemic security? Would the pandemic make firms and governments more environmentally aware of future challenges?
To what extent can the variations in access to COVID-19 vaccine be traced to the quality of a country's informal and formal institutions such as legal system, norm, culture, and beliefs? What would be the effects of COVID-19 in nurturing and creating cross-border and supply-chain partnerships? To what extent do governments and other stakeholders capitalize on the COVID-19 pandemic to champion stringent sustainable practices for MNEs and SMEs? What are the opportunities and potent incentive measures to usher in a greater green revolution in this new era?
Note: Data sources: synthesized by the authors from multiple sources including Callaghan et al., 2021;Amankwah-Amoah et al., 2022;Dhanani & Franz, 2021;Amankwah-Amoah, 2021;Latkin et al., 2021. initiative) and their rationale. Future research could explore which of these approaches offer a more conducive environment for startup domestic business' development. One possible line of thinking is that "vaccine nationalism" might be effective for the development and scaling-up of new domestic businesses, given the "protection" offered to such organizations. Unlike firms forged under vaccine diplomacy, and global initiative it has the potential of creating conditions for development of businesses that are unlikely to be competitive in a global environment. Although the global supply of COVID-19 vaccine doses is surging, the initial roots of nationalism and diplomacy have been planted, which can have effects on nations beyond the pandemic.