Background Vaccination against the coronavirus disease (SARS-CoV-2) is understood to be the key way out of the COVID-19 pandemic. Limited evidence exists on the determinants of vaccine rollouts and their health effects at the country level. Objective Examine the determinants of COVID-19 vaccine rollouts and their effects on health outcomes. Methods Ordinary least squares regressions with standard errors clustered at the country level for Cross-section and Panel daily data of vaccinations and various health outcomes (new COVID-19 cases, fatalities, intensive care unit (ICU) admissions) for an unbalanced sample of about 200 countries during the period 16 December 2020 to 20 June 2021. Results We find evidence that: (i) early vaccine procurement, domestic production of vaccines, the severity of the pandemic, a country’s health infrastructure, and vaccine acceptance are significant determinants of the speed of vaccination rollouts; (ii) vaccine deployment significantly reduces new COVID-19 infections, Intensive Care Unit (ICU) admissions, and fatalities, and is more effective when coupled with stringent containment measures, or when a country is experiencing a large outbreak; and (iii) COVID-19 cases in neighboring countries can lead to an increase in a country’s domestic caseload, and hamper efforts in taming its own local outbreak. Conclusions By providing an early broad overview of the quantitative empirical estimates of the determinants of vaccine rollouts and the effects of COVID-19 vaccines, our paper can help policymakers make informed decisions about local and global distributions of vaccines, as well as related policy tools, such as containment measure.