Bridging Gaps in Vaccine Access and Equity: A Middle Eastern Perspective

Abstract

Vaccine equity and access remain critical challenges in global health, particularly in regions with complex socio-political landscapes, like the Middle East. This review examines disparities in vaccine distribution within the Middle Eastern context, analyzing the unique challenges and opportunities across the region. It provides an overview of the area's diverse finances and its impact on healthcare accessibility. We examine vaccination rates and identify critical barriers to vaccination, which may be particular issues in developing countries, such as vaccine thermostability, logistical hurdles, financial constraints, and socio-cultural factors, or broader problems, like political instability, economic limitations, and deficiencies in healthcare infrastructure. However, we also highlight successful efforts at the regional and national levels to improve vaccine equity, along with their outcomes and impacts. Ultimately, by drawing on the experiences of previous programs and initiatives, we propose strategies to bridge the gaps in vaccine access through sustainable financing, local manufacturing, and the strengthening of health systems. This approach emphasizes the importance of regional collaboration and long-term self-sufficiency in enhancing global health security and achieving more equitable outcomes in the Middle East.

Keywords: Middle East; distribution; economic barriers; equity; global health; vaccine.

Figure 1

Vaccination coverage rates for different vaccines created using GraphPad Prism software version 8.0.2. It includes global rates and rates in high-income, middle-income, and low-income countries from the WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) in 2023 [20,21].

Figure 2

The main challenges that affect vaccination efforts in the Middle East, categorizing the barriers into financial limitations, infrastructure barriers, logistical barriers, human resources shortages, policy hurdles, and vaccine hesitancy and highlighting the multifaceted nature of the problem and the need for comprehensive solutions to improve global vaccine access and equity.

Figure 3

An overview of key global vaccine initiatives from 1974 to 2021, highlighting the launch and progression of critical programs aimed at enhancing immunization coverage, combating vaccine-preventable diseases, and addressing emerging global health challenges.

Figure 4

The map categorizes Middle Eastern countries by income level, using a color-coded system to illustrate regional economic disparities. Low-income countries (red) include Yemen and Syria, both of which are Gavi-eligible for vaccine funding. Lower-middle-income countries (orange) are Egypt, Jordan, and Palestine, while upper-middle-income countries (green) include Iraq, Iran, and Lebanon. Finally, high-income countries (blue) include SA, the UAE, Qatar, Bahrain, Kuwait, and Oman. Additionally, grey shading indicates non-target countries while Gavi-eligible countries are marked with a special symbol, indicating their qualification for global vaccine funding support.

Figure 5

A heat map of vaccine coverage percentages across various vaccine types and countries in the Middle East, utilizing data from the WHO Immunization Data 2024 [20]. The color intensity indicates the level of coverage, with darker green representing higher coverage and lighter colors representing lower coverage.

Figure 6

The chart illustrates the mean vaccination coverage across multiple vaccines for Middle Eastern countries from 2019 to 2024 [20]. Each star represents the average coverage of a specific vaccine in a country, and the dashed vertical line at 95% indicates the WHO-recommended target for vaccine coverage. While several vaccines approach or exceed this threshold, notable gaps exist between them.