Vaccine equity in COVID-19: a meta-narrative review

Abstract

The topic of inequitable vaccine distribution has been widely discussed by academics, journalists and policy-makers in the context of the COVID-19 pandemic. However, research into perceptions of vaccine equity has been particularly neglected, resulting in a lack of universal understanding of vaccine equity. To address this, we conducted a meta-narrative review on COVID-19 vaccine equity according to the Realist And MEta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standard. The review included articles published between January 2020 and September 2021. It aims to (1) identify research traditions that have considered this topic and investigate how it has been conceptualised; (2) explore any potential differences in understandings of the concept of vaccine equity adopted by distinct research groups; and (3) investigate the angles from which authors based their recommendations on how vaccine equity can be achieved. Five meta-narratives from the literature across various research traditions are identified, contextualised and discussed: frameworks and mechanisms for vaccine allocation, global health law, vaccine nationalism, ethics and morality, and reparative justice. Our findings indicate the need for a comparative review of existing global COVID-19 allocation frameworks, with a focus on explicating understandings of vaccine equity. COVID-19 will not be the last health crisis the world confronts. Heterogeneity in the academic literature is part of the way concepts are debated and legitimised, but in the interests of global public health policy-making, it is desirable to reach a consensus on what constitutes progress on equitable development, production, distribution and research.

Vaccine Effectiveness against SARS-CoV-2 Infection during the Circulation of Alpha, Delta, or Omicron Variants: A Retrospective Cohort Study in a Tertiary Hospital in Serbia

“…A cohort study of US hospitals found that higher hospital-onset infection rates were associated with increases in community-onset SARS-CoV-2 infection rates according to the period of the COVID-19 pandemic, the admission testing rate, Census region, and the number of beds in hospital [ 22 ]. Vaccination as a measure of prevention for COVID-19 is still insufficiently researched in hospitalized patients, especially in countries with limited resources [ 23 ]. Our objective was to assess the VE of four different vaccine types and their combinations after full vaccination with two doses or after booster vaccines against SARS-CoV-2 infection in a population of hospitalized patients in a tertiary healthcare centre in Serbia during the Alpha, Delta, and Omicron waves.…”

Lessons learnt from COVID-19 to reduce mortality and morbidity in the Global South: addressing global vaccine equity for future pandemics

“…Also, within a country, vaccines have often been distributed unequally, with the most vulnerable in the Global South last 18. Inequities in access to vaccines have been noted in all countries.…”

“…Also, within a country, vaccines have often been distributed unequally, with the most vulnerable in the Global South last. 18 Inequities in access to vaccines have been noted in all countries. Examples include people with disabilities, homeless populations, refugees, as well as those in prisons, crowded living conditions and with precarious work conditions.…”