The Dark Side of the Moon: Global challenges in the distribution of vaccines and implementation of vaccination plans against COVID-19

Concomitantly with the start of the pandemic, the pursuit of effective vaccines began and developed with great success, and mass vaccination campaigns commenced by the end of 2020. The first quarter of 2021 saw countries such as Israel, the United Kingdom and the United States advancing at great pace in the vaccination programs, while other countries, mainly in the southern hemisphere, were just starting. By the beginning of April, 30 countries had not received a single dose and only 0.57% of the African population was vaccinated [1]. The lag in the introduction of new immunization strategies between countries is not new. For example, in 2016, only 14% of the low- and middle-income countries (LMICs) had introduced the HPV vaccine in their national immunization plans, while 55% of high-income countries (HICs) had done so already [2]. Indeed, some vaccines have been introduced in LMICs years later than in HICs [3]. Despite the challenges posed by the unequal impact and the long duration of the pandemic, the introduction of a vaccine for the prevention of COVID-19 has awakened feelings of hope in the global population. In this context, the Vaccine Global Access (COVAX) agreement was born as an initiative to ensure equitable global distribution of vaccines [4]. But even with this mechanism, there are multiple risks for unequal administration of the vaccines, so the greatest challenge now will be closing the gaps and mitigating the inequities in access to healthcare that have arisen [3,5,6]. Here we describe some of the barriers that contribute to unequal distribution of vaccines in LMICs (see Fig. 1 ). Open in a separate window Fig. 1 Global challenges in the distribution of vaccines and implementation of vaccination plans against COVID-19.