COVID-19 vaccines became the flagship political artifact to address the health crisis. Despite a fragmented health system, political polarization, depleted federal reserves, and a peripheral position in global value chains, Argentina’s newly elected government coordinated state capacities to respond to the pandemic. This paper analyzes the state’s role in acquiring, producing, developing, and administering COVID-19 vaccines, drawing on qualitative methods from political science, Science, Technology and Society, and innovation studies on capabilities. We examine coalitions of key actors and the cognitive, symbolic, and material elements coordinated around vaccines. The COVID-19 vaccine saga in Argentina highlights the state’s critical role, its capacities, and key actors in redefining access. In a context that renewed the value of state intervention to address complex challenges, we argue that traditional analyses of state capacity must be expanded to include how policy direction and preferences are shaped. We focus on the symbolic representations and narratives of sovereignty promoted by the governing coalition as drivers of coordination across fragmented bureaucracies. These narratives redefined the state’s role, aligning actors and capacities amid a context of institutional weakness, political division, and global dependency, becoming instruments of policy direction and state activation during the COVID-19 vaccine rollout.