A matter of priority: equitable access to COVID-19 vaccines

Over past months, several effective COVID-19 vaccine candidates have been developed in different countries around the world, with some of them still being in the approval phase. At the same time, the impossibility of having enough vaccines for everyone in the near future has opened the floor for a debate about the priority of values and ethical principles that should guide vaccine allocation. There are, most notably, two main opposing ideas, with several views in between. Some argue that vaccines should be allocated equitably at the global level, and others claim that it is right and proper for governments to prioritise populations at the national level. What we currently see is that some high-income countries (HICs) have launched massive COVID-19 vaccination campaigns, whereas many low- and middle-income countries (LMICs) will have to wait considerably before immunisation can be started because of limited access to vaccines. As current data suggest, vaccination has barely started and progressed in many LMICS, which means that the most vulnerable groups and healthcare workers remain unprotected (figures 1 and 2). In view of the current situation, it is crucial to address if (at all) and why wealthier countries should support less affluent populations