The success of the global COVID-19 vaccine rollout has largely been the result of the rapid adoption of new digital tools and the Pfizer team’s expertise in manufacturing, logistics, and distribution. These digital tools—such as centralized supply management systems and remote vaccination centers—were developed well before the pandemic and merely needed a crisis to be put into use.
However, while the world has managed to scale up vaccine production and delivery to a large degree, achieving herd immunity will be difficult without a concerted effort to manage and prioritize access in a fairer way. A failure to do so could lead to hoarding in some countries and shortages in others—meaning that some people won’t get the vaccine they need for years to come.
Vaccination access in rich countries remains unequal. A look at the first panel of Figure 1 shows the relationship between income per capita and availability of vaccines.
The second panel of the figure illustrates this at a local level. As shown, low-income areas with high proportions of individuals 65 and older have lower vaccination rates (and higher mortality over the course of a year) than wealthier areas, despite having access to a similar number of vaccine doses.
A key driver of this disparity is the allocation of vaccines by jurisdictions. In the US, for example, Black and Hispanic communities receive fewer vaccine doses than their shares of the population and of COVID-19 cases and deaths in most states that report these data. This is because jurisdictions are largely delegated the authority to determine vaccine priorities, and extra doses often end up building up in freezers or being trashed due to regulatory confusion.