Making sure people have access to a COVID-19 vaccine is critical to fighting the COVID-19 pandemic. Equitable vaccine distribution prioritizes vulnerable populations and areas and helps protect those who have not had the shot.

As of November 2021, less than half of the world’s population has received a vaccination. In some cases, this is because people have chosen not to get the shot. But many individuals have not been vaccinated because they simply do not have access to the vaccine, putting both themselves and their communities at risk.

When thinking about distributing the vaccine, there are two strategies to consider: equal distribution and equitable distribution. Equal distribution focuses on giving everyone the same level of access to the vaccine.

However, equitable distribution focuses on fairness and overcoming access barriers.

This includes tailoring vaccine messaging to specific communities, identifying common access barriers, and prioritizing the needs of those for whom the vaccine is most likely life saving. Equitable distribution ensures that the people most vulnerable to the virus –– and those most likely to spread it –– have access to the vaccine.

Additionally, it prevents new, vaccine-resistant COVID-19 variants from emerging.

Read more to learn about what equitable distribution is, why it matters, and how we can help overcome current barriers to equitable allocation.

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Michael Ciaglo/Getty Images

Equitable allocation is the fair distribution of the COVID-19 vaccine. This means people who need the vaccine the most get access to it –– not just those with the most money or resources.

Sometimes, individuals use the terms “equal” and “equitable” interchangeably when discussing vaccine allocation. However, they actually mean two different things.

Equal distribution means all people have the same access — or an equal proportion of all groups have access — to the vaccine.

Equitable distribution prioritizes needs and fairness, ensuring that the most vulnerable individuals have access to the vaccine.

Equitable distribution is more complex, and it can be hard to visualize what it actually means in practice. Different agencies, governments, and individuals also have varying understandings of what “equitable” means.

However, in general, the goal is to make vaccine access fairer.

Some questions an organization or government might ask to ensure equitable distribution include:

  • How can we reduce barriers according to socioeconomic class and status?
  • How can we address physical and logistical obstacles, such as being unable to drive to a vaccination location?
  • How can we make registering for and getting the vaccination easier?
  • How can we eliminate bureaucratic barriers, such as requiring a license or identification for the shot?
  • Who needs the vaccine the most due to their exposure and medical vulnerability?
  • What strategies work best for convincing people, especially the most vulnerable, to get the shot?
  • Does vaccinating certain groups, such as healthcare workers, protect the larger community?

Fair and equitable distribution of the COVID-19 vaccine is crucial for global health. This is because it can control the spread of the virus, reduce the chances of new variants emerging, and prevent hospitalizations and deaths worldwide.

Some benefits of equitable distribution include the below.

Protecting vulnerable individuals and communities

Vulnerable groups, such as those from low income households, may encounter further difficulties if they develop COVID-19. They may not have paid time off from work, forcing them to choose between going to work sick and spreading the virus or staying home and losing income.

Vaccine access also affects vulnerable communities. In countries and neighborhoods with denser populations and close contact, the virus will spread more readily.

Increasing the chances of herd immunity

When more people choose vaccination, and more vulnerable individuals have access to the shot, the chances of herd immunity increase. This protects people who are unable to get vaccinated, such as individuals with compromised immune systems.

Slowing the spread of COVID-19

Making the vaccine more accessible encourages more people to get vaccinated, which will slow the spread of the virus.

Reducing the emergence of new variants

When fewer people contract the SAR-CoV-2 virus — the virus that causes COVID-19 — it has fewer opportunities to mutate. This slows the development of more contagious and harmful variants, including those that may be vaccine-resistant.

This can protect individuals who will not or cannot choose vaccination.

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Infographic by Diego Sabogal

While nearly half of the global population has received at least one COVID-19 vaccine dose, the vaccination rate in the world’s low income countries is just 2.5%.

In the United States, Black and Latinx people are less likely to have had the vaccine than white individuals. However, recent vaccine efforts have reached a larger share of the Black population, which may narrow this gap.

People from low income households also have lower vaccination rates. According to June 2021 U.S. Census data, individuals from households earning under $50,000 per year were less likely to receive a COVID-19 vaccine.

People reported distrust of the government and the vaccine as the most common reasons for not getting it.

Therefore, tailoring vaccine messaging to specific populations is a key part of equitable distribution. Research on vaccine acceptance suggests most individuals with concerns about vaccine safety are willing to change their minds, meaning it is up to local governments, leaders, and advocacy groups to connect with them empathetically and honestly.

For example, people from low income households have concerns about the cost of the shot. With this in mind, individuals should know that everyone living in the U.S. –– regardless of insurance or immigration status –– can receive the COVID-19 vaccine for free.

Click here to find a free COVID-19 vaccination provider near you.

There are numerous barriers to equitable vaccine access. The specific obstacles vary from country to country and person to person, but include:

  • Lack of vaccine access in a country: Low income countries have few or no vaccines available.
  • Logistical barriers: This can comprise transportation issues, lack of time off work, or trouble finding vaccine sites. For example, older adults may not have transportation or be able to drive.
  • Vaccine hesitancy: People who do not trust vaccines can reduce equitable distribution by either choosing not to get the vaccine or convincing others to avoid it. This hesitancy can result from ongoing oppression, such as distrust of vaccines among those exposed to medical racism.
  • Financial concerns: Some people think they will have to pay for a vaccine, but other financial factors can also play a role. For example, a person who works long hours or lacks childcare may not be able to get a vaccine appointment easily. Additionally, an individual who does not have paid leave from work may not be able to get time off to go to an appointment.

There is no single solution to equitable vaccine distribution and access — it takes a variety of solutions. These may include:

  • Funding: Increased funding for vaccines in low income countries and communities can help more people get vaccinated. For example, the COVID-19 Vaccines Global Access fund distributes money from high income countries to low income countries to promote vaccination.
  • Addressing vaccine hesitancy: Providing educational and tailored messaging, especially in low income communities, may encourage vulnerable people to get vaccinated.
  • Overcoming practical barriers: Many vulnerable groups face logistical barriers, such as the lack of transportation, time off work, or childcare. Transportation programs, vaccine outreach, and greater access to vaccines in local clinics may help.
  • Priority access: Prioritizing vaccine access according to need can equitably distribute immunizations. For example, in the U.S., the earliest recipients of vaccines were medically vulnerable groups, those living in nursing homes, and those over the age of 65 years.

Equitable allocation of COVID-19 vaccines affects everyone, not just vulnerable populations with limited vaccine access. The actions of people across the globe stand to impact everyone in the global community.

A combination of strategies, including improving vaccine access, providing vaccine education, and increasing vaccination funding, can boost vaccine uptake rates. This can both slow the spread of the disease and reduce the chances of new variants emerging.

Widespread access to vaccines depends on funding, government policy, and good public health strategies. Lobbying government and health agencies to improve equitable access is one way to help fight the COVID-19 pandemic.