COVID-19 Vaccines: How Efficient and Equitable Was the Initial Vaccination Process?

Abstract

With nearly 11 billion doses of the COVID-19 vaccine being administered, stark differences in the vaccination rates persist. Vaccine distribution initiatives such as COVAX and African Vaccine Acquisition Trust (AVAT) were formed to ensure equitable vaccine delivery. This review evaluates the initial COVID-19 vaccination efforts and the impact of different vaccine distribution initiatives on equitable vaccination coverage in the early phase. We conducted a descriptive and trend analysis with sub-groups by various context parameters of data on COVID-19 vaccination from December 2020 till February 2022, from four public databases including UNICEF, WHO, COVID-19 Task Force and Our World in Data to examine COVID-19 vaccine distribution progress and the contributions of vaccine procurement initiatives. We found that High Income Countries (HICs) had much higher vaccination rate (78.4%) than Lower-Middle-Income Countries (LMICs) (55.5%) and Low-Income Countries (LICs) (10.9%). Large differentials (>80% to <10%) in the vaccination rates of eligible population of adults in LMICs and LICs existed. Differentials in the total vaccine doses delivered to each country ranged from 355.6% to 4.8% of the total population. In LICs, 53.3% of the total doses were obtained via COVAX, 30.9% by bilateral/multilateral agreements, 6.5% by donations and 3.8% by AVAT. In LMICs, 56.4% of total vaccines procured were via bilateral/multilateral agreements, 21.4% by COVAX, 4.2% by donations and 0.5% by AVAT. COVAX delivered 1 billion doses by January 2022 which constituted 53.2% and 21.4% of procured doses in LICs and LMICs. In LICs and LMICs, 6.5% and 4.2% of total doses were acquired through donations while 30.9% and 56.4% of doses were purchased. Despite global efforts, significant disparities were present in COVID-19 vaccination efforts amongst countries of different income groups. Future efforts should focus on addressing vaccine inequities explicitly and in improving global vaccine distribution.

COVID-19 vaccine inequity in African low-income countries

“…Globally, there is higher coverage of COVID-19 vaccination in high income countries (HICs) than LICs ( 8 ). The disparities within LICs are greater than within the HICs.…”

Equitable Vaccine Access in Light of COVID-19 Vaccine Procurement Strategies in Africa

“…(1) Burkina Faso; (2) This study drew on publicly available data collected by UNICEF regarding the delivery of COVID-19 vaccine doses to respective LMICs in the Africa region [29]. For each country, data from the UNICEF dashboard provided disaggregated quantities of doses delivered to respective countries into the following five categories (The "Unknown" category for each country comprised the number of vaccine doses for which UNICEF was unable to confirm a procurement route: this category was the discrepancy between (a) the total number of administered doses according to Our World in Data plus wastage and (b) the total number of doses confirmed as delivered via four routes: (1) bilateral; (2) donations;…”

“…As one illustration, high-income countries, which hold only 16 percent of world population, had, by the middle of 2021, bought more than half of all available COVID-19 vaccine doses via bilateral purchase procurement agreement (a binding agreement between two parties (one selling party, commonly a vaccine manufacturer or a national government, and one purchasing party, such as a national government), controlling (and generally not sharing) volumes of doses that exceeded their population needs. Low-income and lower middle-income countries (LMICs), meanwhile, had neither the financial means nor the capacity to manufacture vaccines within their borders [2,3]. In Africa, home to 17.4 percent of the world population and composed nearly entirely of LMICs, the number of total vaccine dose administrations in 2021 made up less than 3 percent of the global total [4].…”

COVID-19 Attitudes and Vaccine Hesitancy among an Agricultural Community in Southwest Guatemala: A Cross-Sectional Survey

“…“Vaccine access” and “vaccine hesitancy” are two distinct but overlapping phenomena, which have both been identified as barriers to global vaccination in general and COVID-19 vaccination in particular [ 3 , 4 ]. Many populations in both high-income countries (HICs) and LMICs face ongoing barriers to vaccine access, such as decreased vaccine allocation and poorer public health and logistical infrastructure; these barriers were exacerbated by the COVID-19 pandemic [ 3 , 5 , 6 ].…”