Abstract
Objectives: We face the impossibility of having enough COVID-19 vaccines for everyone in the near future. This study aims to contribute to the debate on equitable global access to COVID-19 vaccines, tackling key ethical discussions and policy challenges regarding early phases of COVAX, the global cooperation mechanism for supporting fair vaccine allocation. Methods: We conducted in-depth interviews with twelve experts and a literature research on academic articles, media sources and public statements. We built a data analysis matrix and conducted a thematic analysis. Results: Our findings show, first, that interviewed experts who hold different views on vaccine allocation, including moderate nationalist perspectives, agree on joining a global cooperation mechanism. Second, incentives to join COVAX vary greatly among countries. Third, specific barriers to COVAX emerged in the early implementation phase. And fourth, countries might be trapped in a zero-sum game regarding the global vaccine supply. Conclusion: We present findings that enrich analyses of early phases of COVAX (April 2020–21), we introduce three ethical discussions that provide a common ground for equitable access to COVID-19 vaccines, and we highlight policy challenges.
Highlights
Safe and effective vaccines are being developed to control the coronavirus pandemic
We conclude presenting three ethical discussions that provide a common ground for equitable access to COVID-19 vaccines, and key policy challenges that have emerged so far
This study contributes to the debate on equitable access to COVID-19 vaccines by providing empirical findings that enrich ethical discussions, and highlighting policy challenges regarding the relevance and design of COVAX; the heterogenous incentives to join the scheme; and the implementation issues that have emerged in COVAX’s early phases
Summary
Vaccine production is slow and the current impossibility of having enough vaccine doses for everyone has opened the floor for a discussion on equitable global access to COVID-19 vaccines. This discussion raises ethical and policy issues. We need to discuss the allocation of limited vaccines in a pandemic, knowing that vaccines are an available lifesaving preventive intervention. In this regard, a pressing concern is the availability of vaccines in low and middle-income countries that often lack the means to buy vaccines through bilateral deals with manufacturers. Ensuring equity in global vaccine allocation is a matter of self-interest for high-income countries [2, 3]
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