COVID-19 Vaccination and Public Health: Addressing Global, Regional, and Within-Country Inequalities

Author:

Santangelo Omar Enzo12ORCID,Provenzano Sandro3ORCID,Di Martino Giuseppe45ORCID,Ferrara Pietro67ORCID

Affiliation:

1. Regional Health Care and Social Agency of Lodi, ASST Lodi, 26900 Lodi, Italy

2. School of Medicine and Surgery, University of Milan, 20122 Milan, Italy

3. Local Health Unit of Trapani, ASP Trapani, 91100 Trapani, Italy

4. Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy

5. Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy

6. Center for Public Health Research, University of Milan–Bicocca, 20900 Monza, Italy

7. Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy

Abstract

The COVID-19 pandemic, with over 775 million cases and 7 million deaths by May 2024, has drastically impacted global public health and exacerbated existing healthcare inequalities. The swift development and distribution of COVID-19 vaccines have been critical in combating the virus, yet disparities in access to and administration of the vaccine have highlighted deep-seated inequities at global, regional, and national levels. Wealthier nations have benefited from early access to vaccines, while low- and middle-income countries (LMICs) have faced persistent shortages. Initiatives such as COVAX aimed to address these disparities, but challenges persist. Socioeconomic factors, education, ethnic identity, and the healthcare infrastructure play crucial roles in vaccine equity. For example, lower-income individuals often face barriers such as poor access to healthcare, misinformation, and logistical challenges, particularly in rural areas. Addressing these inequities requires a multifaceted approach, integrating national policies with local strategies to enhance vaccines’ accessibility, counter misinformation, and ensure equitable distribution. Collaborative efforts at all levels are essential to promote vaccine equity and effectively control the pandemic, ensuring that all populations have fair access to life-saving vaccines. This review explores these complex issues, offering insights into the barriers and facilitators of vaccine equity and providing recommendations to promote more equitable and effective vaccination programs. With a focus on the different levels at which vaccination policies are planned and implemented, the text provides guidelines to steer vaccination strategies, emphasizing the role of international cooperation and local policy frameworks as keys to achieving equitable vaccination coverage.

Publisher

MDPI AG

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