Data insight

Vaccine equity has not improved much

The international distribution of primary vaccines and boosters remains glaringly unequal

Vaccine equity across borders can be usefully assessed by comparing vaccination progress across the World Bank income classification of countries. In the four charts that follow we look at inequalities across income groups (high-income, upper-middle-income, lower-middle-income and low-income countries: HICs, UMICs, LMICs and LICs) focusing on the progress made with respect to administering vaccines to the total population. 

Four trends stand out:

Low vaccine coverage in LMICs and LICs

Average vaccine coverage in the poorer developing countries is currently just a fraction of what we observe in the rest of the world. 

We show the vaccine coverage ratio, which simply measures total doses administered divided by the total population. For full coverage we need a ratio of 200% (or 2). To make sure that this threshold applies also for countries that use single-dose protocols (like J&J or CanSino), we convert doses under such protocols into double-dose equivalents (multiplying them by 2). That way a 200% ratio means full vaccination for everyone.

Look in the chart above at the values for LMICs and LICs, which together represent 52% of the global population. Their vaccine coverage ratios are much lower than those of HICs and UMICs.

Rapid catch-up over time for UMICs, but not so for LMICs and LICs

We can also look at the above over time. The chart above shows the evolution of coverage by income group. It’s clear that the richer part of the developing world (UMICs)  has been catching up. This is not the case for LMICs and LICs. The values for LICs have been virtually stagnant and the progress among LMICs has been very slow.

Poorer countries have been hit on both the extensive and intensive margins of vaccine equity

The extensive margin measures whether have started vaccinating. The intensive one captures the extent of vaccine coverage once they have started inoculating their populations.

The dynamic visualizations above shows the vaccination progress for each country in the world grouped by World Bank income group. The countries are sorted not only by income but also by the intensive margin (the coverage ratio). 

The visualization shows over time the intensive margin: the circular inner bar which measures the share of countries in each country group that have started vaccinating. The extensive margin is captured by the blue bars within the circle. The idea here is the provide a global snapshot of vaccine equity in these two dimensions. The country codes may be a little hard to read, but that’s not the focus here. The purpose is to give a general global impression. 

Universal global coverage would occur when this donut turns completely blue. Alas, we continue to see huge gaps caused by the considerable lag in vaccination participation among poor countries (extensive margin) and their persistently poor vaccine coverage (intensive margin).

UMICs are in worse shape than the group average suggests

The chart above is a beeswarm chart that displays all individual country values for the vaccine coverage ratio and groups them by income group. The size of the bubble grows with population size. 

The previous dynamic chart simply listed all countries next to each other – India next to Seychelles for example. This chart accounts for population differences.

We can immediately derive from this that China is pulling up the UMIC average in a considerable way. Excluding China, the UMICs are actually in a worse place. 

Bottom line

  • The world’s revealed capacity to vaccinate its population is blatantly regressive (poorer countries fare much worse).
  • Vaccine equity across borders hasn’t improved much for LMICs and LICs.
  • The poorer countries have been hit by vaccine inequity on both the extensive and intensive margins.
  • UMICs look better but are actually worse off once we take out China from the UMIC averages.