Brand inequity in access to COVID-19 vaccines

In anticipation of a safe and effective COVID-19 vaccine being available in 2021, COVAX was launched as a mechanism to ensure equitable supply of and access to COVID-19 vaccines to all countries in the world. Despite the initial commitment and global enthusiasm, there has been global inequity in access to vaccine doses in low- and middle-income countries (LMICs). Many high-income countries (HICs) and wealthy economies signed bilateral agreements with vaccine manufacturers to ensure doses were available to their citizens.2 This has resulted in health workers and at-risk populations in LMICs largely being unvaccinated, with approximately <5% of eligible population in LICs being vaccinated.3 Complex reasons are driving inequities in vaccine supply and access including purchasing power, intellectual property for vaccine development, exports bans on vaccine ingredients, cold-chain and distribution logistics and have been discussed elsewhere.