What Is Vaccine Equity?

Vaccine equity is the equal distribution of vaccines such that everyone, regardless of socioeconomic status, geographic location, or other factors, gets access to vaccines. It entails addressing discrepancies in vaccine access and uptake among various communities, both domestically and globally.

Why is vaccine equity important?
Vaccine equity is crucial for many reasons:
1. Fair access to vaccines is crucial for limiting the infectious disease transmission on a global level. As long as the virus exists anywhere in the world, all countries are at risk. Achieving herd immunity globally requires widespread vaccination coverage, which can only be achieved through equitable distribution.
2. Access to vaccines is a matter of social justice and human rights. Everyone, regardless of country, social status, or geographic location, deserves equal access to life-saving vaccines. The concept of fairness implies that resources be allocated fairly, with priority given to those who are most vulnerable and in need (UN, 2021).

3. The COVID-19 epidemic revealed the global economy’s interconnectivity. Unequal access to vaccines prolongs the pandemic, resulting in more economic disruption and loss. Ensuring vaccination fairness is not just a moral imperative, but also crucial to economic recovery and the restoration of global trade and travel (WHO, 2022).

4. The longer the virus spreads unchecked, the more likely new strains will arise. Some forms may be more transmissible, virulent, or resistant to current vaccines, compromising global efforts to contain the pandemic. By ensuring equal access to vaccines, we can reduce the possibility of new variants emerging and spreading.

5. Investing in vaccination equity can assist low- and middle-income nations improve their healthcare systems. Countries that give resources and infrastructure for vaccine distribution might improve their overall healthcare skills, by boosting not only vaccination efforts but also other aspects of public health.

Factors Affecting Global Vaccine Equity And Access

Vaccine equity and access are influenced by a number of factors, including socioeconomic status, geographical location, political difficulties, healthcare infrastructure, vaccine manufacturing capacity, and international collaboration efforts. Addressing these difficulties requires international organizations, governments, private sectors, civil societies and others to collaborate to ensure equitable access to vaccines for all populations worldwide:
Socioeconomic Status
Income and income inequality can have a significant impact on vaccine availability. People in low and middle-income countries (LMICs) face common obstacles such as poverty, a lack of healthcare infrastructure, and inadequate resources for vaccine procurement and delivery (WHO, 2020).

Geographic Location

remote and rural areas may have limited or no access to healthcare facilities, making vaccination distribution challenging. Furthermore, conflict zones and regions with weak governance may experience additional challenges in vaccine delivery (IFRC, 2021).

Political Factors
Instabilities in politics, corruption, and vaccine nationalism can all impede a fair distribution of vaccines. Nationalistic impulses in vaccine procurement and distribution might lead to hoarding and inequitable allocation.
Healthcare Infrastructure

Insufficient infrastructure for healthcare, such as cold chain storage, transportation networks, and qualified healthcare workers, can stymie vaccination distribution attempts, particularly in resource-constrained settings.

Vaccine Manufacturing Capacity

Limited vaccine production capacity, especially in LMICs (low- and middle-income countries), can exacerbate gaps in access. Building local production capacity and knowledge transfer agreements are crucial for achieving global vaccine equality (Brophy Marcus, 2021).

Global Cooperation Efforts
Multilateral organizations, such as COVAX, aim to provide equitable access to vaccines by pooling resources and coordinating distribution efforts across borders.

Challenges in Ensuring Global Vaccine Equity

Global vaccine equity faces significant challenges due to factors such as inadequate availability, distribution restrictions, logistical constraints, socioeconomic imbalances, and vaccine hesitancy. Here are some key challenges:

1. Limited Vaccine Supply: Global demand for COVID-19 vaccines has outpaced available supply, resulting in disparities between high- and low-income countries.

2. Unequal Distribution and Access: Distribution tactics that favour high-income countries over low-income ones aggravate discrepancies in vaccine availability.

3. Logistical Challenges: Difficulties in maintaining the cold chain, shipping vaccines to remote locations, and assuring proper storage and handling limit equitable distribution.

4. Socioeconomic Inequalities: Vulnerable people, such as those living in poverty or in marginalized groups, face obstacles such as limited access to healthcare and information.

5. Vaccine reluctance: Misinformation, distrust in the government or healthcare systems, and cultural beliefs all contribute to vaccine hesitancy, which lowers immunization rates.
6. Protection of intellectual property and Transfer of Technology: Issues with patents, intellectual property rights, and technology transfer stymie vaccine manufacturing and distribution in low and middle-income countries.

Opportunities To Achieve Vaccine Equity Globally
Ensuring worldwide vaccination equality is crucial for combating the COVID-19 and other infectious diseases. There are several opportunities and actions to achieve vaccine equity.
1. Global Vaccine Distribution Programs: Implementing and supporting global vaccine distribution programs, such as COVAX, which aims to promote equal access to COVID-19 immunizations around the world, with a focus on low- and middle-income countries.
2. Funding Support for LMICs: Providing financial assistance and support to LMICs in order to purchase vaccinations and strengthen their healthcare infrastructure in readiness for vaccination campaigns.
3. Technology Transfer and Intellectual Property Waivers: Encouraging technology transfer and waiving intellectual property rights to facilitate vaccine production in low- and middle-income countries, increasing accessibility and reducing dependency on imports.
4. Community Engagement and Education: Organizing community outreach programs to increase awareness of the necessity of vaccination, alleviate vaccine hesitancy, and build trust in vaccine administration.
5. Fair Allocation Frameworks: Developing and implementing fair vaccine distribution frameworks based on equity principles, with a focus on high-risk groups and healthcare staff, regardless of country or socioeconomic status.
6. Public-Private Partnerships: The initiative involves a joint effort between governments, non-profit organizations, and private sector entities to enhance the efficiency and effectiveness of vaccination delivery.

7. Monitoring and Evaluation: Creating robust monitoring and evaluation systems to analyze vaccination distribution, coverage, and impact, as well as making data publicly available to ensure accountability and inform decision-making.

   Global Vaccine Equity Projects For Preventable Diseases

These equity projects aim to ensure that vaccines are accessible to all individuals worldwide, regardless of socioeconomic status or geographic location. These programs are crucial for achieving health equity and reducing the burden of vaccine-preventable diseases, particularly in low- and middle-income countries with restricted access to vaccines. Here are some key global vaccine equity initiatives:

1. Gavi—the Vaccine Alliance

Gavi is a public-private partnership dedicated to increasing access to vaccines in low-income countries. It funds and supports vaccinations against diseases like as measles, polio, and HPV. Gavi’s mission is to save lives, alleviate poverty, and protect people’s health worldwide.

2. COVAX Facility

COVAX is a global program that promotes equitable access to COVID-19 immunizations. It is co-led by Gavi, CEPI, and the World Health Organization (WHO). COVAX intends to ensure that COVID-19 vaccines are available to people in all countries, regardless of affluence.

3. The Global Polio Eradication Initiative (GPEI).

   GPEI is a joint effort of national governments, the WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), and UNICEF. It aims to eradicate polio worldwide through vaccination campaigns and surveillance. GPEI has been extremely successful in reducing polio cases worldwide.

   4. The Measles and Rubella initiative, a joint effort by the American Red Cross, CDC, UN Foundation, UNICEF, and WHO, aims to eradicate measles and rubella in priority countries through vaccination programs, surveillance, and outbreak response.

4. The WHO’s Expanded Programme on Immunisation (EPI) seeks to protect all children from vaccine-preventable diseases. It provides technical assistance to countries with the introduction and delivery of vaccines, as well as surveillance and monitoring.

These programs, among others, contribute to vaccination equality and lessen the global burden of vaccine-preventable diseases by ensuring vaccine availability to all populations, regardless of socioeconomic status or geographic location.

Example, Global COVID-19 Vaccine Equity Initiatives

Such programs are critical to ensuring equal access to vaccines, especially in low- and middle-income countries. Several projects have been designed to address this issue, with the purpose of bringing vaccines to countries that would otherwise have limited access. Here are some prominent initiatives:

COVAX (Covid-19 Vaccine Global Access)

COVAX, a global initiative by CEPI, Gavi, the Vaccine Alliance, and the World Health Organization, aims to expedite COVID-19 vaccine research and manufacturing while ensuring equitable access for all nations.

Access COVID-19 Tools (ACT) Accelerator

The ACT Accelerator is a global initiative to accelerate the development, manufacturing, and equitable distribution of COVID-19 diagnostics, treatments, and vaccines. It brings together governments, scientists, corporations, and civic organizations.

The Vaccine Alliance (GAVI)
Gavi is a public-private global health initiative aimed at increasing immunization coverage in low-income countries. Gavi is an essential partner in the COVAX initiative, providing financial and logistical support for vaccine supply.

The World Health Organization (WHO) organizes global health programs, such as COVAX, to ensure fair access to COVID-19 vaccines and provide technical assistance to countries.

Africa CDC
It coordinates continental efforts to ensure equal access to COVID-19 vaccines across Africa. It collaborates with a number of partners to facilitate vaccine distribution and deployment.

These initiatives rely on collaboration between governments, international organizations, NGOs, and the private sector to address the challenges of vaccine distribution and ensure that vaccines reach those who need them most, regardless of their income level or geographic location.

Example, Global Vaccination Equity Measures For Polio

These efforts and organizations collaborate to guarantee that all children, regardless of location or socioeconomic level, receive polio vaccines, fostering global vaccine equity in the fight against polio. These have proven essential in efforts to eradicate the illness worldwide. Here are some notable projects and groups working to achieve vaccine equity for polio:

The Global Polio Eradication Initiative (GPEI)

GPEI, a public-private partnership involving national governments, WHO, Rotary International, CDC, and UNICEF, aims to ensure equitable access to polio vaccines and healthcare services for all children, especially those in underserved areas, through organized immunization campaigns and global polio eradication resources.

Polio Vaccination Programs
Vaccination campaigns are carried out all throughout the world, especially in countries where polio is still endemic or at risk of outbreak. To ensure universal immunization coverage, these campaigns usually target isolated and underprivileged populations.
Gavi, the Vaccine Alliance.

Gavi is a global health organization aiming to increasing access to vaccines in the world’s poorest countries. Gavi supports the introduction and administration of polio immunizations, including as inactivated poliovirus vaccine (IPV) and oral polio vaccine (OPV), to ensure equitable access for children in low-income countries.

UNICEF
The United Nations Children’s Fund plays an essential role in obtaining and distributing vaccines, particularly polio vaccines, to countries in need. UNICEF aspires to build health systems and immunization programs that prioritize fairness and reach out to the most vulnerable communities.
WHO Regional Offices

WHO’s regional offices implement strategies tailored to certain geographic regions and populations. They work with governments to remove barriers to vaccine access and equity, providing technical assistance and support to immunization programs.

Global Fund
The Global Fund to Fight AIDS, Tuberculosis, and Malaria assists nations in improving their health-care systems, particularly immunization programs. While the Global Fund does not specifically combat polio, its actions help to enhance vaccine access and equity.
Rotary International

Rotary International has been an important participant on the polio eradication project from its inception in 1988. Rotary clubs worldwide promote immunization efforts, provide funds for polio eradication, and advocate for global vaccine equity.

Coalitions & Alliances
Several coalitions and alliances, such as the Decade of Vaccines Collaboration and the Immunization Agenda 2030, bring together governments, organizations, and stakeholders to work toward vaccine equality goals, including polio.

Final Message
 Making vaccinations available and accessible to everyone, especially those in remote or marginalized communities, through appropriate supply, distribution networks, and outreach initiatives. Making immunizations inexpensive or free for everybody, especially in low- and middle-income countries where people may be unable to afford the cost of vaccination. Increasing vaccination trust and lowering vaccine hesitancy by giving accurate information, engaging communities, and responding to concerns and disinformation.
Finally, attaining vaccine equality is crucial not only for preventing disease spread, but also for addressing larger health and socioeconomic gaps. It calls for collaborative efforts at the local, national, and global levels, as well as continued commitment and investment from governments, healthcare systems, and the international community.

References

Brophy Marcus, M. (2021). Ensuring Everyone in the World Gets a COVID Vaccine. [online] Duke Global Health Institute. Available at: https://globalhealth.duke.edu/news/ensuring-everyone-world-gets-covid-vaccine.

IFRC (2021). World Disasters Report 2020 | IFRC. [online] www.ifrc.org. Available at: https://www.ifrc.org/document/world-disasters-report-2020.

UN (2021). Secretary-General Calls Vaccine Equity Biggest Moral Test for Global Community, as Security Council Considers Equitable Availability of Doses | UN Press. [online] United Nations . Available at: https://press.un.org/en/2021/sc14438.doc.htm#:~:text=Explaining%20that%20investing%20in%20vaccines.

WHO (2020). Fair allocation mechanism for COVID-19 vaccines through the COVAX Facility. [online] www.who.int. Available at: https://www.who.int/publications/m/item/fair-allocation-mechanism-for-covid-19-vaccines-through-the-covax-facility#:~:text=In%20a%20snapshot%2C%20fair%20allocation.

WHO (2022). Vaccine equity. [online] www.who.int. Available at: https://www.who.int/campaigns/vaccine-equity#:~:text=In%202021%2C%20during%20the%20COVID.