The Asia-Pacific region has been severely affected by the COVID-19 pandemic. The economic and health recovery from the pandemic of countries in the region hinges on the rapid and equitable deployment of safe and effective COVID-19 vaccines. At present, 60 per cent of the population in the region has been fully vaccinated, and there is a large variation across and within countries. As of March 2022, vaccination coverage in highincome countries in the region was 80 per cent compared to 10 per cent in low-income countries. As of March 2022, booster shots are being administered in some countries, while poorer countries have yet to achieve their coverage targets for the primary series. For example, Singapore and the Republic of Korea have already vaccinated 68 per cent and 62 per cent of their population, respectively.
Equitable distribution of COVID-19 vaccines means that all countries should have access regardless of economic development (WHO, 2020). Vaccine inequity is a serious threat to public health and to the global economy. Allowing the populations of certain countries to remain unprotected increases the risk of continuous viral transmission and mutation, leading to a patchy economic recovery (Asundi, O’Leary and Bhadelia, 2021). The problem of accessing life-saving vaccines and drugs in developing countries has been observed in previous public health emergencies and epidemics (e.g. influenza outbreaks in 2004 and 2009) (Fidler, 2010). With the COVID-19 pandemic, there has been a concerted effort to address the problem through the creation of the COVID-19 Vaccine Global Access (COVAX) facility (WHO, 2020; Emanuel and others, 2021). Despite this effort, vaccine inequity remains a challenge in many countries the region (Stein, 2021). In general, poor subnational states and disadvantaged populations have lower vaccination coverage (Thankur and others, 2020; Marmot and others, 2020).
The unequal distribution of COVID-19 vaccines across and within countries in the region during the initial year of vaccine roll-out could be attributed to vaccine nationalism, characterized by competition between countries for the procurement of vaccines (Katz and others, 2021). However, as COVID-19 vaccines become part of the disease prevention programmes of each country and as global supply stabilizes, the readiness of the national health systems becomes even more critical (Haldane and others, 2021). This paper has three objectives: to examine vaccine inequities across and within countries in the Asia-Pacific region; to identify health system barriers that might impede equitable access; and to provide specific recommendations for countries in the region in ensuring vaccine access.