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. 2021 Sep 30;11(9):e049505.
doi: 10.1136/bmjopen-2021-049505.

Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries

Elizabeth F Peacocke  1 , Lieke Fleur Heupink  2 , Katrine Frønsdal  2 , Elin Hoffmann Dahl  3 , Lumbwe Chola  2
Affiliations

Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries

Elizabeth F Peacocke et al. BMJ Open. .

Abstract

Objective: To identify the factors contributing to equitable access to COVID-19 vaccines for low and middle-income countries (LMIC).

Methods: We conducted a scoping review following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and a five-stage framework for scoping studies. We performed systematic searches for published peer-reviewed literature in five databases: Medline, Embase, Web of Science, Global Index Medicus and COVID-19 Evidence Epistemonikos (August 2020, updated May 2021).

Results: Systematic selection according to predefined criteria resulted in the final inclusion of 45 peer-reviewed articles, with no limitations on study design or publication type. We derived four key factors that potentially influence equitable access to COVID-19 vaccines in LMICs: (1) collectively agreed global mechanisms or frameworks; (2) bilateral purchasing, contracting, and vaccine prices; (3) vaccine manufacturing that is supported by sharing know-how; and (4) countries' strength in implementing vaccination programmes.

Conclusions: This scoping review highlights the ongoing challenges for the international community in ensuring equitable access to COVID-19 vaccines for LMICs. The literature suggests that vaccine manufacturing can influence the supply of vaccines, as can the role of patent holders who can influence global governance through their role in the distribution of COVID-19 vaccines. Our findings indicate that including the principles of equitable access throughout vaccine research and development, procurement, scale-up and distribution processes can support equitable access for LMICs. Advances made with mRNA vaccines may have additional benefits in relation to expanding the manufacturing of other vaccine. Finally, the exploration and scale-up of such capacities of LMICs are likely to prove to be a valuable investment, even after the pandemic.

Keywords: COVID-19; health policy; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Timeline of events and relevant initiatives. ACT, Access to COVID-19 Tools; GAP, Global Pandemic Influenza Action Plan.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart for selection of articles.
See this image and copyright information in PMC

References

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