A review of global inequities in COVID-19 vaccination access and uptake

The rapid development of safe and effective vaccines against COVID-19 is aptly considered a watershed moment in the course of the pandemic, and one of the greatest collaborative accomplishments of modern medicine. However, the rollout of vaccination campaigns highlighted striking global inequities in the procurement and distribution of vaccine doses. Low- and medium-income countries faced significant struggles hindering both the domestic production of vaccines and their acquisition from global suppliers. The insufficient access to vaccine supplies in developing countries was caused by a combination of external (vaccine nationalism, intellectual property rights, unfair competition) and internal (low economic means, limited manufacturing facilities, gaps in technical expertise) factors. In addition to the procurement and manufacturing hurdles, the administration of the limited available stocks was hindered by both logistical (inadequate supply chain, transportation, and healthcare infrastructure) and sociocultural (vaccine hesitancy, scientific misinformation, religious opposition) issues. Despite the roll-out of multiple international initiatives to facilitate global access to COVID-19 vaccinations, the inequities in vaccine distribution resulted in limited and delayed vaccine coverage—and ultimately immeasurable loss of health and life—in the global South. This chapter discusses the socioeconomic, geopolitical, and cultural causes of COVID-19 vaccine inequity, its impact on the affected populations, and the effectiveness of global initiatives designed to mitigate it.