Covid vaccine hoarding by wealthy countries may be responsible for the death of 1.3 million people in 2021, according to recent mathematical models (7). Inequitable vaccine distribution globally has posed a critical problem during the COVID-19 pandemic. High-income countries have been hoarding hundreds of millions of excess doses while low-income countries struggled to vaccinate their vulnerable populations (7). In the wake of this stark estimate, some experts are pointing to Covid vaccine hoarding and failed equitable vaccine distribution as an issue that must be addressed both within the current pandemic and to set a stronger foundation for future global health emergencies.
Covid vaccine hoarding took place within a larger framework of vaccine nationalism during the COVID-19 pandemic. Wealthier countries competed for earlier access to vaccine supplies and withheld information about vaccine production from other manufacturers (6). Indeed, 15 million doses were wasted between March and September of 2021 in the United States alone (3). William Moss, a vaccine expert at Johns Hopkins University, emphasized that there would be 500 million excess doses in the United States in 2021–after all eligible residents had received a booster (3). Comparatively, only 550 million doses were needed to aid 82 other countries in reaching their goal of vaccinating 40% of their populations by the end of the year (3).
Early on in the pandemic, the World Health Organization and other international governmental bodies began a global vaccine procurement mechanism named COVAX. COVAX’s goal was to distribute Covid-19 vaccines equitably throughout the world once effective vaccines became available, streamlining distribution and reducing the problem of vaccine hoarding. Gavi, a private-public global health partnership, was responsible for managing and overseeing COVAX operations (4). Vaccines would be rolled out in two phases. All participating countries would be eligible to receive vaccines for 20% of their population in the first phase so that they could prioritize vaccinating frontline workers and high-risk individuals. Thereafter, additional doses would be made available depending on funding. However, wealthy countries who were participating as self-financiers could request doses for up to 50% of their populations in this second phase (1).
Over time, it has become evident that COVAX failed in delivering its promises to middle and low-income countries. By early 2022, only 10% of people living in low-income countries had received at least one dose of the Covid-19 vaccine (4). High-income countries competed with the COVAX initiative to procure vaccine doses from pharmaceutical companies, raising demand. Indeed, wealthy countries who participated in COVAX as self-financiers pre-ordered large supplies of Covid-19 vaccines, already buying out 2 million doses through bilateral deals not part of COVAX by August 2020 (8). Adding insult to injury, vaccine manufacturers who had received large amounts of funding from the United States refused to share information about vaccine production to manufacturers in low and middle-income countries, preventing other countries from adding to the global supply of vaccines.
Covid vaccine hoarding by wealthy countries demonstrated how prioritizing profit and national interests over global public health may result in a devastating loss of human lives. At a national scale, these power dynamics have been reproduced along racial and class lines, with Black, Hispanic, and Indigenous Americans dying due to Covid-19 at three times the rate of White Americans (1). Ultimately, data suggests that some of the tragic losses experienced in the past few years may have been prevented with equitable vaccine distribution.
- “COVAX: A Broken Promise to the World.” Medicines San Frontieres, 21 Dec 2021, msfaccess.org/covax-broken-promise-world
- Binagwaho, Agnes et al. “Equitable and Effective Distribution of the COVID-19 Vaccines—A Scientific and Moral Obligation.” International Journal of Health Policy and Management, 26 April 2021, doi: 10.34172/ijhpm.2021.49
- Donovan, Doug. “As Africa Goes Unvaccinated, U.S. Remains Awash in Shots.” Johns Hopkins University, 2 Nov 2021, hub.jhu.edu/2021/11/02/covid-vaccine-inequality-africa/
- Elder, Kate and Jessica Malter. “COVAX: A broken promise for vaccine equity.” Medicines Sans Frontieres, 21 Feb 2022, msfaccess.org/covax-broken-promise-world
- Goldhill, Olivia. “We have enough Covid vaccines for most of the world. But rich countries are stockpiling more than they need for boosters.” STAT, 13 Dec 2021, www.statnews.com/2021/12/13/we-have-enough-covid-vaccines-for-most-of-world-but-rich-countries-stockpiling-more-than-they-need/
- Hefner, Marco et al. “COVID-19 and the Cost of Vaccine Nationalism.” Rand Health Quarterly, 2022 Aug; 9(4): 1.
- Ledford, Heidi. “COVID vaccine hoarding might have cost more than a million lives.” Nature, 02 Nov 22,doi.org/10.1038/d41586-03529-3.
- “US must stop hoarding excess COVID-19 vaccine doses.” Medicines Sans Frontieres, 11 October 2021, www.doctorswithoutborders.org/latest/us-must-stop-hoarding-excess-covid-19-vaccine-doses