Tracking Global COVID-19 Vaccine Equity

As of July 7, 2021, of the estimated 3.3 billion COVID-19 vaccine doses administered globally, most had been provided in a small number of countries only. For much of the world, particularly for those living in low- and middle-income countries, COVID-19 vaccines remain out of reach. While international efforts, such as COVAX and additional vaccine donations are seeking to increase global vaccine access, several estimates suggest that many countries may not achieve substantial levels of vaccination until at least 2023.

Drawing on and complementing existing efforts that track global vaccine access, such as Our World in Data, the Launch and Scale Speedometer, and Bloomberg’s Vaccine Tracker, we examine several measures of global vaccine equity in an effort to assess where the biggest gaps are and whether they are narrowing or getting worse. Specifically, we group countries by income and by region and look at:

• Share of the total population having received at least one vaccine dose
• Rate of first vaccine doses administered (Using the 7-day rolling average per 1,000,000 people)

Based on the current rate of vaccine doses administered, we also estimate how much the pace would need to increase in order to reach global vaccine coverage goals¹ set by the World Health Organization, World Trade Organization, International Monetary Fund, and World Bank: 40% coverage by the end of 2021 and 60% by mid-2022. We do this at the country-level, and for countries by income group and regional classification.

As we find here, there are wide disparities in access by income and by region (especially where these overlap), with low-income countries (LICs) in particular lagging far behind, followed closely by lower middle-income countries (LMICs), and Africa lagging behind all other regions. If current rates continue, most low-income countries and most countries in Africa are not on track to meet global vaccination targets.

COVID-19 Vaccinations by Country Income

There are large differences in the share of the population that has received at least one vaccine dose by country income, with LMICs lagging significantly behind. As of July 7, whereas more than half of individuals (51%) have received at least one dose in high-income countries (HICs), only 1% of the population in LICs, 14% in LMICs, and 31% in upper middle-income countries (UMICs) have received at least one dose (see Figure 1 and Figure 2).

Three countries (China, India and the United States) account for the majority (57%) of all first doses administered globally. When removed, the difference between HICs and middle-income countries becomes even starker, with HICs still well ahead of other income groups in share of population that has received at least one dose (see Figure 3). See Table 1 for the full list of countries in each income group by share of population that has received at least one dose.

 

Similarly, there is also a large gulf in the rate at which vaccines are being administered by country income. While the daily rate of first doses administered varies by country (see Figure 4), HICs were administering first doses at a rate nearly 2 times the rate in LMICs and in UMICs, and nearly 30 times the rate in LICs. See Table 2 for a breakdown of top countries in each income group by coverage and daily administration rates.

If current trends continue, these disparities are likely to grow, and LICs are unlikely to meet vaccination targets. Based on current vaccination rates (using rates of first doses administered), HICs and UMICs are on track to have 40% or more of their populations having received at least one dose by the end of the year, whereas LMICs would need to increase their daily rate by 1.03 times and LICs would need to increase their daily rate by nearly 19 times in order to meet the same goal. HICs, UMICs, and LMICs are on track to have 60% or more of their populations having received at least one dose by mid-2022, while LICs would need to increase their daily rate by 14 times (see Figure 5). Certain countries, primarily HICs, have already met some of these vaccination targets.

COVID-19 Vaccinations by Region

As with country income, there are large differences in the share of the population that has received at least one vaccine dose among regions, with the highest coverage in Europe and smallest in Africa. As of July 7, the region with the highest coverage is Europe (40%) followed by the Americas (39%) and the Western Pacific (37%); Africa has the lowest coverage (2%) (see Figure 6 and Figure 7).

Similar to income level, China, India and the U.S. are driving trends in vaccination coverage in their respective regions. For instance, China accounts for 87% of first doses administered in Western Pacific, the US accounts for 46% in the Americas, and India accounts for 84% in South-East Asia. When removing these countries, the differences between Europe and the Americas, Western Pacific, and South-East Asia are larger (see Figure 8). See Table 3 for a breakdown of top countries in each region by coverage and daily administration rates.

The rate of vaccine administration is highest in Europe and the Americas and lowest in Africa. While rates of first doses administered vary by country (see Figure 9), Europe and the Americas currently have the highest rate of daily doses administered. These regions are vaccinating at a rate approximately 1.5 times that of South-East Asia, nearly 3 times that of Eastern Mediterranean, 4 times that of the Western Pacific, and more than 13 times higher that of Africa. See Table 4 for a breakdown of top countries in each region by coverage and daily administration rates.

These disparities are likely to grow based on current vaccination trends. Western Pacific, Europe, the Americas, and South-East Asia are all ahead of schedule toward reaching 40% by the end of 2021 while Eastern Mediterranean would need to increase its rate of daily first doses administered by nearly 1.6 times the current rate, and Africa by approximately 11 times the current rate. They are also ahead of schedule to reach 60% by mid-2022, while Eastern Mediterranean would need to increase its rate of daily first doses administered by approximately 1.4 times the current rate, and Africa by approximately 8 times the current rate (see Figure 10). Certain countries, primarily those in Europe, have already met some of these vaccination targets.

Implications

These findings underscore an ongoing equity gap in access to COVID-19 vaccinations around the world, particularly for those living in the poorest countries and in countries in Africa. Furthermore, they suggest that if current rates continue, some of these disparities may grow and many low-income countries will not meet global targets of vaccinating 40% of each countries’ population by end of 2021 and 60% by mid-2022. Increasing vaccine supplies and stepping up the pace of vaccinations in those countries lagging furthest behind can narrow the equity gap and help all countries achieve COVID-19 vaccination coverage goals.

Tables

Methodology

Vaccination Data: We used country-level vaccination data on doses administered, provided by Our World in Data (OWID), to assess global vaccination trends at the income and regional level. Totals for some entities were combined (Taiwan, Hong Kong, and Macao included as part of China, and Jersey and Guernsey were combined and reported as the Channel Islands). Where missing data in the daily doses provided existed between two dates for a country, we estimated the number of doses administered each day between the two reported dates assuming a linear distribution. For countries that have stopped reporting data, we assumed no change in new doses administered. For countries that report total doses administered but not share of population that has received at least one dose, we use OWID’s suggested methodology and calculated a lower-bound estimate. As a result, our estimates are conservative and the actual share of the population receiving one dose is likely higher. For data on daily administration of first doses, we calculated the rolling 7-day average in daily change of the number of people who have received at least one dose. For projecting increased rate needed for groupings to reach certain benchmarks (40% by end of 2021 and 60% by July 1, 2022), we calculated the rate needed to reach these benchmarks for each grouping, based on number of first doses already administered and population, and calculated the percentage change from the current daily rate in first doses being administered to the increased rate needed to reach these targets. Lastly, for all data, to account for any lag in country reporting, we use data up to one week prior (July 7, 2021). Population Data: Population data were obtained from the United Nations World Population Prospects using 2020 estimates for total population (and the CIA World Factbook for Serbia and Kosovo). Totals for some entities were combined (Taiwan, Hong Kong, and Macao included as part of China), while others were separated (separating Kosovo from Serbia). Income Data: Income classifications were obtained using World Bank data. Entities lacking an income classification were excluded from the income-level analysis. Regional Data: Region classifications were obtained using World Health Organization data. Entities lacking a region classification were excluded from the region-level analysis.