Vaccine equity as good as it sounds, study suggests

In a study published in Nature Communications in March 2023, researchers investigate the socioeconomic benefits of a set of “idealised” vaccine distribution scenarios in relation to COVID-19 vaccination programmes. Their results suggest that an equitable vaccine distribution could increase global economic benefits by $950 billion each year, compared to a scenario that ‘fully’ vaccinates vaccine-producing countries first. Lessons that should have been taken on from early pandemic vaccination strategies are emphasised in their evaluation of the multiple benefits of a more equitable approach.

COVID-19 vaccination

The authors note that the “recurrent waves” of SARS-CoV-2 variants have enabled the COVID-19 pandemic to threaten public and economic health across the globe for three years.

“Though vaccination has regionally mitigated the pandemic toll in certain areas, global inequities in vaccine distribution is an important issue which presently weakens the effectiveness of vaccines in lowering transmission globally.”

Despite efforts of many organisations to promote accessibility, such as the ACT Accelerator, the current levels of vaccination demonstrate that there are “still many disincentives for equitable vaccine distribution”.

“It is clear that nobody wins the race until everyone wins.”

Thus, the authors were motivated to consider the role of collaboration between countries that produce vaccines and other countries. To address the issues of disincentives and individual benefits, a “framework” to link epidemiological and socioeconomic modelling is required, to “probe the potential gains of global vaccine allocation strategies from the socioeconomic perspective”.

Benefits and consequences

The authors acknowledge that “local shortages of many commodities” across the world illustrate the importance of our “highly connected global supply chains”. This was demonstrated in the trickle down of negative economic effects from a country in lockdown to other countries along supply chains. The opposite is also true: “vaccination decisions in one country may be beneficial to the economic recovery of other countries, which is often referred to as one type of externality of vaccination”.

The study

In the study, the authors link epidemiological and socioeconomic modelling frameworks to “quantify the socioeconomic benefits of a set of idealised COVID-19 vaccine-distribution scenarios”. The evaluation considered three main outcomes:

The health gains
The lockdown-easing effect
The supply-chain rebuilding benefit

The researchers modelled three sets of scenarios into a tiered structure. “Tier Global” addresses the issue of the “cooperative attitude” of countries, while “Tier Domestic” address the issue of “how received vaccines are allocated within each destination country”. This approach provides “new information” to enable us to understand the “game” of vaccine distribution and facilitate global vaccine cooperation.

Equitable distribution brings benefits

The analysis conducted not only demonstrates the “potentially significant differences” in benefits achieved by each mode of distribution, but also reveals why equitable vaccine distribution, and the consequent global economic benefits, have “not been achieved”.

“The ‘equitable distribution’, in this study, is not a simple appeal, but a solution that makes economic sense.”

The authors emphasise that it is not a sacrificial approach, but a mutually beneficial mechanism. Despite this, they believe that a “bias” in the “player’s decision-making” is created by poorly quantified and considered benefits of economic recovery in comparison with health gains. The conclusion, however, is that a “multilateral benefit-sharing instrument should be developed” in time for “future pandemics”, in order to remove the disincentives for early and equitable vaccine distribution.