High-Income Countries Have Secured the Bulk of COVID-19 Vaccines | Global Health | JAMA | JAMA Network
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Global Health
February 16, 2021

High-Income Countries Have Secured the Bulk of COVID-19 Vaccines

JAMA. 2021;325(7):612. doi:10.1001/jama.2021.0189

High-income countries have reserved more than half of the world’s coronavirus disease 2019 (COVID-19) vaccine doses despite representing just 14% of the world’s population, according to an analysis of publicly available data on premarket purchase agreements.

High-income countries that are home to only 14% of the world’s population have secured more than half of the coronavirus disease 2019 vaccine supply.

Paul Sancya/AP Images

The data show that 7.48 billion doses—enough to fully vaccinate about half the world’s population with 2 shots—had been secured as of mid-November 2020. But so far, high-income countries have acquired 51% of the doses, leaving the remainder for low- and middle-income countries where 86% of the global population lives, according to the authors.

For example, the US is home to about 330 million people, or 4% of the world’s population. But it has reserved 800 million doses, enough to vaccinate 400 million people. Although the US had about one-fifth of all cases worldwide at the time of the analysis, other high-income countries with smaller populations and lower COVID-19 case numbers had secured a larger share of reserved vaccines. For example, the authors found that Japan, Canada, and Australia have a combined population of less than 200 million, but they’ve reserved a total of 1 billion doses despite accounting for only 1% of COVID-19 cases worldwide.

The COVAX facility, a global initiative led by the World Health Organization, has agreements with manufacturers to acquire 2 billion doses of COVID-19 vaccines, including 1.3 billion doses earmarked for 92 low- and middle-income countries. That’s enough to vaccinate about 20% of their populations.

“The successful, equitable implementation of COVID-19 vaccination programmes requires unprecedented global coordination and a sustained commitment of resources—financial, logistical, and technical—from high income countries,” Jason Schwartz, PhD, assistant professor of health policy at the Yale School of Public Health, wrote in an editorial accompanying the analysis.

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