Global vaccination equity in the pandemic era, plus research on adverse childhood experiences, e-cigarettes, and more
January 2021
Dear AJPM Reader,
While almost all countries in the Global North now have access to an approved COVID-19 vaccine, those in the Global South face a much longer wait, with estimates that 90% of people living in 67 low-income countries will not receive the COVID-19 vaccine before 2022.
Our January 2021 open access supplement on Global Vaccination Equity speaks directly to the issue of equitable vaccine distribution and receipt in a global context. Research from Mutua and colleagues uncovered substantial disparities in timely vaccination within most Sub-Saharan African countries, the majority of which had coverage of <50%. Low maternal education appeared to be a major driver of these disparities, a finding echoed in Bettampadi and colleagues' study of vaccination in Indian infants over two decades. Also in Sub-Saharan Africa, Janusz et al. found that delayed vaccination in infancy was a key predictor of nonreceipt of later recommended vaccines.
Vaccine hesitancy, long considered a problem of wealthier countries, may also pose a challenge to equitable distribution of a COVID-19 vaccine. A study by Cata-Preta and colleagues indicates signs of increasing vaccine hesitancy in 87 low- and middle-income countries. Research from Harapan and colleagues hints at religious dimensions to emerging vaccine hesitancy in Indonesia, while a study by Wagner et al. shows higher vaccine hesitancy among recent migrants to Shanghai, China, than among longtime urban residents.
These and other barriers will confront low- and middle-income countries as they seek to vaccinate their populations against COVID-19. Less developed countries are at a distinct disadvantage, both when it comes to purchasing the COVID-19 vaccine and in terms of infrastructure for distribution. Meanwhile, global vaccination programs for other diseases such as polio have faced decades of setbacks and will need increased funding and attention as the current crisis ends. Looking ahead, interruptions to the education of girls in these countries may have a knock-on effect on childhood vaccination for the foreseeable future.
The issue of vaccine equity is more important than ever as we go forward. We hope you find the Global Vaccination Equity supplement, as well as our January 2021 articles, to be timely, topical, and informative.
