Equity in COVID-19 Vaccine Distribution

Piyal Sarkar
Ryerson University, Canada

Effective vaccines to combat COVID-19 pandemic have been developed in record time. However, the virus is still moving with mutated versions at an even faster pace. The main challenge lies in vaccine equity (WHO, 2021). The vaccine equity refers to the fact that vaccines should be distributed equally to all countries, irrespective of economic status, race, or religion. The failure to vaccine equity is affecting the world’s poorest and most vulnerable people. The World Health Organization (WHO) is of the opinion that to stop the pandemic at least 40 percent of people of every country should be vaccinated and closely 70 percent by the first half of 2022. To this end, the equity of distribution in vaccines all over the world is very essential. In order to achieve vaccine equity throughout the globe, we need to understand the challenges first. The distribution of vaccines is guided due to several factors such as political, economic, diplomatic, and social factors. Therefore, in order to develop equity in vaccines, there arises two primary questions:

a. How accessible are vaccines globally?
b. Are these vaccines affordable for all countries?

The problem here is that most of the vaccines are being administered in the high- and middle-income countries of the world. Data reveals that around 61.51 percent people of high-income countries are vaccinated with at least one dose; on the contrary only 3.31 percent of the people have been vaccinated for people with low-income countries as of September 22, 2021.

Fig 1

Source: https://data.undp.org

According to the data from UNICEF, the average cost for one COVID-19 vaccine dose ranges between US$2 -$40. The distribution cost is around US$3.70 per person vaccinated with double doses, considering a percentage of vaccine wastage. This is a significant financial burden for low-income countries, where the average annual per capita health expenditure may be around US$41. Though vaccination programs will increase healthcare costs across all countries, it is especially the case in low-income countries as they would need to increase their health expenditure by around 30-60 percent to reach seventy percent of their population under the current pricing of COVID-19 vaccines. This is quite a challenging task.

Strong action is urgently required to help low-income and middle-income countries to decrease their debt, which is sharply increasing due to the COVID-19 pandemic (NCBI Report, 2021). Vaccine distribution costs are significantly adding to this burden. New scenario analysis suggests that achieving the 70 percent vaccination target in these countries will require US$49.17 billion, assuming a price of US$15.80$15.80 per dose. This accounts to around 0.7 percent of their projected GDP in 2021. The picture is even more challenging when considering only low-income countries. More than US$8$8 billion, or about half of their projected GDP growth in 2021, will be required to vaccinate 70 percent of their populations. The most vulnerable countries are found in Sub-Saharan Africa, including Burundi, Malawi, Mozambique, and South Sudan where less than two out of 100 people have been vaccinated against COVID-19, as of July 2021 (WHO, 2021).

As a solution to these problems, the World Health Organization (WHO) has called for the vaccine equity programs. Following are the call to action for vaccine equity by a) Civil society can rally governments to exercise their power for change, b) Civil society can rally governments to exercise their power for change, c) Manufacturers can share intellectual property so that vaccine production can speed up and scale up, d) Governments can share vaccine doses, help secure funds, and remove any barriers to equitable distribution.

Through this article our aim is to make the ORMS community aware of the COVID-19 vaccine equity fact. For a clear review on the vaccine equity, we encourage readers to refer to the study of Su, Z., et al.(2021). We discussed the challenges, the real statistics, and some feasible solutions to these challenges as the World Health Organizations are undertaking. Accurate and up-to-date data and information are key components in guiding the international community’s understanding of vaccine equity. Developed countries, in accordance with the guidelines of WHO should come up with feasible international strategies to help procuring vaccines to the low-income countries. The earth is a global playground and to fight COVID-19 effectively, vaccine equity is of utmost importance.



  1. https://data.undp.org. Accessed, November, 2021.
  2. https://www.who.int. Accessed, November, 2021.
  3. Summary - Framework for Equitable Allocation of COVID-19 Vaccine - NCBI Bookshelf. Accessed, November, 2021. https://www.ncbi.nlm.nih.gov/books/NBK564086/
  4. Su, Z., McDonnell, D., Li, X., Bennett, B., Šegalo, S., Abbas, J., and, Xiang, Y. T. (2021). COVID-19 Vaccine Donations—Vaccine Empathy or Vaccine Diplomacy? A Narrative Literature Review. Vaccines, 9(9), 1024.