Abstract

Any guidance on vaccine use prioritization, including booster dose policies, cannot ignore the current, ongoing profound inequities in global COVID-19 vaccine access and coverage. While higher-income countries expand their vaccination programs to children as young as 6 months old, and in some countries, multiple booster doses to a large proportion of their populations, many lower-income countries still struggle to get access and coverage of a primary vaccination series for their highest priority-use groups, including older adults and healthcare workers who comprise only a small proportion of their populations.According to the updated WHO Roadmap, averting severe disease and deaths and protecting health systems remain the primary objectives of vaccine use in the context of the global COVID-19 response [1]. The WHO Roadmap, however, also considers vaccine use for resuming socioeconomic recovery, particularly the priority of maintaining uninterrupted education to keep children connected and learning. Here, we examine the rationale for vaccinating children based on consideration of those objectives, together with a potential surplus of currently available vaccines.

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