Vaccine equity

Vaccine equity means ensuring that everyone in the world has equal access to vaccines.^[1][2] The importance of vaccine equity has been emphasized by researchers and public health experts during the COVID-19 pandemic^[3] but is relevant to other illnesses and vaccines as well. Historically, world-wide immunization campaigns have led to the eradication of smallpox and significantly reduced polio, measles, tuberculosis, diphtheria, whooping cough, and tetanus.^[4]

There are important reasons to establish mechanisms for global vaccine equity.^[4] Multiple factors support the development and spread of pandemics, not least the ability of people to travel long distances and widely transmit viruses.^[5][6] A virus that remains in circulation somewhere in the world is likely to spread and recur in other areas. The more widespread a virus is, and the larger and more varied the population it affects, the more likely it is to evolve more transmissible, more virulent,^[4] and more vaccine resistant variants.^[1] Vaccine equity can be essential to stop both the spread and the evolution of a disease. Ensuring that all populations receive access to vaccines is a pragmatic means towards achieving global public health. Failing to do so increases the likelihood of further waves of a disease.^[4][7]

Infectious diseases are disproportionately likely to affect those in low and middle-income neighborhoods and countries (LMICs), making vaccine equity an issue for local and national public health and for foreign policy. Ethically and morally, access for all to essential medicines such as vaccines is fundamentally related to the human right to health, which is well founded in international law.^[4][7][8][9] Economically, vaccine inequity damages the global economy. Supply chains cross borders: areas with very high vaccination rates still depend on areas with lower vaccination rates for goods and services.^[10]

Achieving vaccine equity requires addressing inequalities and roadblocks in the production, trade, and health care delivery of vaccines.^[11] Challenges include scaling-up of technology transfer and production, costs of production, safety profiles of vaccines, and anti vaccine disinformation and aggression.^[12]