Vaccine inequity is the ignominy of our times

This visualization illustrates the glaring inequality through three different lenses (extreme poverty, average income and population size) and correlates that with the full vaccination rate.

• Extreme poverty is measured here by the $1.90 extreme poverty headcount ratio, which is the percentage of the population living on less than $1.90 a day at 2011 international prices.
• Average income is captured by the World Bank income group the country belongs to (high, upper-middle, lower-middle, or low income).
• Population size measures the full population (i.e. including children) in millions.
• These variables are correlated with the full vaccination rate, which measures the share of people who have completed a full vaccination cycle as per the underlying protocol (1 shot as in CanSino and J&J, 3 shots as in Abdala and 2 shots as in most other vaccines).

The following results are striking:

• The first thing to note is that, despite the considerable progress in reducing extreme poverty, in so many countries in this world very large shares of the population continue to be extremely poor. This includes many large countries, so also in the absolute the headcount is large. As of 2017 – the last reference year for which we have globally comprehensive information –  the world counted just under 700 million extremely poor people.
• Among countries that have all but eliminated extreme poverty, there is a huge variation in full vaccination rates (check the vertically stacked countries at the 0% value for the X-axis).  Among them, the top observations for full vaccination are almost all data points of high-income countries, with China – which is an upper-middle-income  country – being the notable exception.
• Conversely, among the countries that have nonzero extreme poverty rates, virtually all of them have very low vaccination rates. This includes most lower-middle-income and all low-income countries. Notice how again some of these countries are very large – the largest one of course being India.

Global vaccination has been highly regressive. The huge inequality we currently observe is an inequity that may eventually backfire epidemiologically, socially and economically. The regressive pattern of vaccination enhances the risk of the development of more dangerous variants and by doing that it risks exacerbating the direct and indirect effects of the health emergency on social and economic outcomes either through domestic or cross-border channels.