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Equitable COVID-19 Vaccine Distribution (Part 1): Global Efforts vs. the U.S

Updated: Oct 10, 2020

The World Health Organization (WHO) announced 5 days ago their mechanism to allocate vaccines and “end the acute phase of the pandemic by the end of 2021. In the months leading up to this, there has been intense discussion over equitable Covid-19 vaccine distribution: prioritizing healthcare or minority groups such as Black and Latinx people who the pandemic disproportionately affect.

WHO’s “fair allocation mechanism” proposes the distribution of vaccines in two phases. Considering the limits of vaccines initially, in phase 1 countries would receive vaccines proportional to their population( initially enough to immunize 3 percent of their population and then until 20% of a nation is covered.). WHO also envisages that these doses would be used to immunize those at the highest risk from COVID-19: elderly people and those with comorbidities. For phase 2, vaccines would be delivered based on the urgency of immunization, factoring priority based on the effective reproduction number of viruses as well as the vulnerability of a country’s health system.

Opposers to this plan argue that the priority of who the most vulnerable should be factored in initially rather than in the second phase. For example, low-income countries that already experience socio-economic challenges will face even more devastating consequences if not prioritized during vaccine distribution. The World Bank back in April predicted the pandemic could push over 40-60 million people into extreme poverty; now, it can be as many as 71 million with areas such as sub-Saharan Africa most affected.

Global Alliance for Covid-19 Distribution: COVAX

COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO and coordinates a global risk-sharing mechanism for pooled procurement and equitable distribution of COVID-19 vaccines. 64 members from higher-income countries- not including the USA- as well as 92 low- and middle-income economies have committed support to the procurement of vaccines through COVAX which means that 156 economies, 64% of the global population, will be united in the effort of developing and distributing 200 billion vaccines by end of 2021. The joint effort ensures that no participating economy will be left behind in receiving vaccines.

The Trump Administration has said that it will not participate in COVAX or global efforts because of WHO’s involvement. As a result, the USA plans to go solo. COVAX was created to unite globally in the fight against COVID, discouraging hoarding and vaccinating high-risk people in every country first. As Suerie Moon, co-director of the Global Health Center at the Graduate Institute of International and Development Studies in Geneva said “[if] the U.S. says it is not going to participate in any sort of multilateral effort to secure vaccines, it’s a real blow.” U.S’s none participation is a huge risk on a global scheme as well as for the US alone; it could mean all other parts of the world receiving vaccines, leaving the U.S with no options, or the U.S providing vaccines for all Americans including low-risk people, leaving none for vulnerable countries.

What is the USA’s Distribution Plan?

Advisory Committee on Immunization Practices’s (ACIP) recommendation plan includes a “jumpstart phase” where high-risk workers in healthcare facilities or first responders will have priority in the vaccine. Phase 1b also prioritizes the elderly living in overcrowded spaces and people with underlying conditions. Phase 2 will include critical risk workers, teachers and school staff, other elderly not included in phase 1, people in homeless shelters or physical and mental disability recovery centers, people in prisons, jails, and detention centers. Phase 3 will include young adults, children, and other essential workers in society. Phase 4 will include everyone else residing in the United States.

ACIP in conjunction with CDC and OWS runs the important task of the final determination of who will get the vaccine first. Evolving vaccine development will lend its take on a recommendation because groups of people the vaccine may be more effective for( elderly, a certain race, etc.).

So What?

It's concerning when the US does not take a stance in the united global effort against the Covid-19 virus. In my next installment, I'll be looking specifically at USA's distribution- what are the barriers to equity in the COVID-19 vaccine distribution in the USA.


  1. https://www.gavi.org/news/media-room/boost-global-response-covid-19-economies-worldwide-formally-sign-covax-facility

  2. https://www.sciencemag.org/news/2020/09/who-unveils-global-plan-fairly-distribute-covid-19-vaccine-challenges-await

  3. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-09/COVID-07-Dooling.pdf

  4. https://www.statnews.com/2020/09/01/u-s-advisory-group-lays-out-detailed-recommendations-on-how-to-prioritize-covid-19-vaccine/

  5. https://www.washingtonpost.com/world/coronavirus-vaccine-trump/2020/09/01/b44b42be-e965-11ea-bf44-0d31c85838a5_story.html

  6. https://www.worldbank.org/en/news/factsheet/2020/06/02/world-banks-response-to-covid-19-coronavirus-in-africa

  7. https://www.weforum.org/agenda/2020/06/world-bank-coronavirus-covid19-extreme-poverty/

  8. https://www.hhs.gov/sites/default/files/strategy-for-distributing-covid-19-vaccine.pdf

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