This article assesses the equity of COVID-19 vaccination programmes in three jurisdictions that have historically taken different approaches to the institutionalisation of equity considerations. The Sars-Cov-2 pandemic has thrown into sharp relief persistent societal inequalities and has added novel dimensions to these problems. Certain groups have proved particularly vulnerable, both in terms of infection risk and severity as well as the accompanying social fallout. Against this background the implementation of ‘objective’ vaccination programmes may seem like a great leveller, addressing the disparate risks that are tied to social determinants of health and the pandemic behemoth. However, implementing vaccination programmes in an equitable manner is itself essential for the realisation of such a vision. This article undertakes a comparative analysis of the English, Italian, and American jurisdictions and critically assesses two aspects of their vaccination frameworks: (i) the prioritisation of groups for vaccination and (ii) the nature of public compensation schemes for those who have suffered vaccine-related injuries. It examines whether and to what extent these measures address the inequalities raised by COVID-19 and the role of the law in this pursuit.

From a smartphone ping signifying the start of a fertile window to controlling a breast pump with a few clicks in a mobile app, “femtech” has readily integrated into women's daily lives. Femtech, a term coined to describe the realm of technology catering to female health needs, encompasses a range of digital technology addressing women's health, including fertility tracking, pregnancy and nursing counseling, and online contraception provision. While femtech puts autonomy and information in the hands of its users, access to the technology is not yet equitably distributed. As insurance reimbursement can increase and equitize that access, this research examines what legal duties exist for increasing access to femtech. In analyzing how insurance schemes have integrated femtech, this research compares how select femtech products fare across reimbursement systems, using fertility algorithm, smart breast pump, and pelvic floor trainer case studies in the U.S, U.K, and Sweden. Insights reveal a duty to promote access to femtech, as well as varying degrees of integration in respective health systems. Insights also reveal which elements of the female life course are overlooked in reimbursement schemes. Key messages Femtech has the power to put agency and information in the hands of millions of women. Yet, access is not equitable given significant financial and regulatory barriers. Comparative studies of fertility algorithms, smart breast pumps, and pelvic floor trainers in international health systems demand increased advocacy to realize the duty to enable femtech access.

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Governance is a critical upstream tool in public health emergency preparedness, for it provides structure to emergency response. Pandemics, singular public health emergencies, pose challenges to inherently fragmented federal governance systems. Understanding and utilizing the facilitators of response embedded within the system is critical. In its examination of how contemporary federal systems addressed fragmentation in the face of the Covid-19 pandemic, this article uses two mitigation measures, community masking and vaccination administration to compare elements of federal system mechanics in the United States and Germany’s respective pursuits of public health goals. With particular focus on federal-state power-sharing, it analyzes the division and application of federal-state authority, therein examining mechanisms of executive expediency, as well as the cooperation of multilevel actors. Comparing the jurisdictions identifies inter-federal coordination, availability of exigency mechanisms, and federal guidance as facilitators of public health goal achievement.

The United States has one of the worst maternal mortality rates among developed nations. American mothers are three times more likely than Canadian mothers and six times more likely than Scandinavian mothers to die from pregnancy-related deaths. Currently, for every 100,000 live births, 26.4 mothers are dying in the U.S, with significant disparities between White mothers and mothers of color. Projections indicate that by 2030, the maternal mortality rate will rise to 45 maternal deaths out of 100,000 live births. In direct contrast, most other similarly situated high-income nations have decreased their maternal mortality rates in recent years, evidencing only single-digit mortality per 100,000 mothers. This research examines how social protection measures afforded by the law can facilitate differences in these rates. Specifically, this presentation compares legal interventions enshrined in social law that impact maternal health in the United States, Germany, and the Netherlands, including mandated access to prenatal care, midwifery reimbursement, and obligatory duration of postnatal care. Compared to the United States, both Germany and the Netherlands enshrine more comprehensively midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes. Evidence accumulated by comparing these interventions with maternal mortality statistics suggests that legal interventions that spur extra attention to mothers during and after birth may help prevent pregnancy-related deaths. It also opens a discussion about how policymakers can use legal interventions to help eliminate racial disparities in maternity practice. Key messages Codified legal interventions that mandate extra attention to mothers during and after birth may help prevent pregnancy-related deaths. Compared to the U.S., both Germany and the Netherlands better enshrine midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes.