International collaboration and diplomacy in Denmark's Covid-19 vaccine strategy: A SCANVAX case study

This working paper examines Denmark's Covid-19 vaccine procurement and distribution strategy within the framework of the SCANVAX project on Nordic vaccine diplomacy. Through document review, media analysis and interviews, the study analyses how Denmark navigated tensions between national health security and international solidarity during the pandemic. Denmark pursued multiple procurement channels including attempted domestic production, bilateral agreements, and primarily EU joint procurement mechanisms. Denmark became the first country worldwide to permanently exclude AstraZeneca and Johnson & Johnson vaccines from its national programme due to safety concerns, despite European Medicines Agency approval. This precautionary approach reflected the government's assessment that Denmark's stable epidemiological situation allowed for heightened safety standards but created vaccine surpluses that formed the basis for international vaccine diplomacy. Denmark donated 10.78 million Covid-19 vaccines globally, including 7.27 million through COVAX and 3.5 million through bilateral agreements to countries including Kenya, Ukraine, Bhutan, Lebanon, and Bosnia and Herzegovina. Denmark also sold vaccines, including to Australia and New Zealand at cost price to recover procurement expenses, implementing what officials described as a "two-legged strategy" of donations and sales. Vaccine donations showed significant geopolitical dimensions, with contributions strategically earmarked for specific regions including North Africa, Small Island Developing States, and selected African countries. The attempted donation of 250,000 Johnson & Johnson vaccines to Rwanda, later withdrawn due to legal delays, illustrated connections between vaccine diplomacy and Denmark's broader foreign policy objectives, particularly regarding asylum arrangements. Political debates centered on intellectual property rights, with Denmark opposing the TRIPS waiver, and the ethics of donating vaccines deemed unsuitable for Danish citizens to developing countries. These discussions extended to the collaboration with Israel and Austria. Opposition parties criticised the government's bilateral initiatives as undermining EU cooperation, while the government defended these approaches as necessary supplements to multilateral frameworks. The Danish case shows the complexities of how a small European state managed pandemic responses through multilateral frameworks while pursuing national interests, highlighting persistent tensions between vaccine nationalism and global health solidarity during health crises. Denmark's experience illustrates the multifaceted realities of vaccine diplomacy, where even countries with strong international development commitments prioritise domestic health security when faced with uncertain vaccine supplies, while simultaneously using surplus vaccines as tools for broader foreign policy objectives.