Looking at the vaccine flexes on Instagram and Twitter, you would think nearly everyone has the shot. In the U.S., it's trending that way. This week President Biden said, "Go get a shot. It's never been easier." The CDC reports rapid distribution—some 2 to 3 million doses per day.

Ninety miles south of Miami, vaccinations efforts have failed to launch. An early commitment to a home-grown vaccine has yielded good results but has yet to deliver an approved shot. However, success may be just around the corner.

There are five Cuban vaccine candidates, with two in the final phase of trials. This alone is a national triumph, and has given Cuban leadership opportunities to tout the benefits of a centrally planned medical industry.

But as trials carry on, COVID cases in Cuba are spiking. In response to the uptick, a friend and journalist on the island tells me that the Cuban government is expanding the pool of trial participants. Pairing a trial with a national vaccination effort is highly unorthodox, but it's what the Cuban government believes it must do to bring cases back down to former levels.

Fortunately for those getting jabbed, the vaccine has proved to be safe in early testing. Its efficacy, however, is still in question.

National pride drove Cuba's strategy to develop its vaccine in-house. The island nation has long prided itself on its government medical program, holding it up as a success of the Communist system of government. Throughout 2020, Cuba was able to maintain a low number of COVID-19 cases while exporting doctors and nurses to other countries. Last week Mexican President Lopez Obrador called Cuban President Diaz-Canel to thank him for sending about 1,000 health workers to help Mexico respond to the pandemic.

It's also likely that Cuba turned inward for a vaccine because its rolodex of strategic partners is severely limited by the U.S. embargo. Iran has been available to support trials, but otherwise it's a small group of countries that would be both capable and interested in partnering with the Cubans.

At the current rate of distribution in the U.S., all of Cuba could be vaccinated in under a week. But the Cubans would never ask for help, and I find it unlikely that the U.S. would be willing to share its vaccine supply without first putting some broader diplomatic framework in place.

Cuba's plan to approve and widely distribute a vaccine will likely work, and it will certainly be a national achievement, but the delays come at a cost. On Wednesday Cuban health officials reported a record 18 deaths on a single day.

As the virus remains part of daily life, Cubans continue to suffer. The country was already stumbling under inefficient government policies and a crippling U.S. embargo when the virus wiped out tourism, Cuba's primary economic sector.

On top of these troubles, the Trump administration blocked remittances from the U.S. to Cuba mid-last year, severely limiting access to a major source of income. Sending money to loved ones in Cuba now requires a hand delivery.

A successful vaccine rollout will mean many things for Cubans: cases will go down, tourism will return, and life will get better.