Vaccine Equity And Access: Overcoming Barriers To Immunization For Vulnerable Populations

  • Shannon Reed BSc (Hons) Biology With a Year in Industry, University of York
  • Antonina Swierkowska MSc Translational Neuroscience, The University of Sheffield

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Imagine a world where not everyone has the same chance to recover from a global pandemic, sounds scary, right? Yet, this is an all-too-familiar scenario, that somewhat mirrors our reality. There is a great disparity in the global distribution of vaccines, highlighting the social and economic division between countries and thus creating ethical challenges.3 Vaccine equity is essential to save lives, bring about a fair recovery, and create effective public health management for all, irrespective of the economic condition of their country. 1-3 For example, despite global efforts, the disparity in COVID-19 vaccine intake remains significant. As of late 2023, nearly 80% of the population in wealthier countries have received at least one vaccine dose, compared to just about 33% in poorer countries.1-3 When it comes to vaccine inequity, the most vulnerable people such as those living in extreme poverty, isolated rural areas, or with inadequate health systems are the hardest hit, facing logistical challenges, prohibitive costs, misinformation, and vaccine hesitancy. 

This article will explore the barriers that vulnerable groups face, advocate for intensified global efforts to bridge these gaps and propose actionable solutions to ensure equitable vaccine access for all to promote a healthier, more just global future. 

Understanding vaccine equity and access

What is vaccine equity and access?

Vaccine equity ensures that every individual, no matter where they are in the world, has fair access to vaccines. This involves more than just distribution, it's about ensuring that vaccines are available, affordable, and accepted across all segments of society. 4,5 Vaccine equity includes: 

  • Availability: Vaccinations should be as accessible in each community as local medical facilities, ensuring no one is left out due to their location
  • Affordability: Vaccines must be priced such that they do not place a financial burden on individuals or families, making it feasible for everyone to obtain them
  • Acceptance: Effective public health campaigns are crucial in helping communities understand and trust the efficacy and safety of vaccines, overcoming scepticism and misinformation
  • Logistical Capability: Healthcare systems need to be equipped to deliver vaccines efficiently, navigating geographical, economic, and societal barriers.4,5

What does fair access to vaccines mean?

Fair access ensures that vaccines reach all corners of the global community, playing a pivotal role in:

  • Controlling Disease Transmission: Like a net that catches the fish, immunization prevents diseases from finding vulnerable hosts and spreading unchecked.4,5
  • Maintaining Global Economic Stability: Widespread vaccination helps prevent the kind of outbreaks that disrupt economies through halted trade, restricted travel, or reduced workforce productivity.4,5

The impact of unequal vaccine distribution

The consequences of unequal vaccine distribution are significant and multifaceted:

  • Health Risks: When vaccines aren't available to everyone, pandemics can linger longer, illnesses can spread further, and new, resistant virus strains may even evolve as a result.4,5
  • Economic Disruption: A lack of vaccine access can cause ripple effects in the global supply chain, resulting in economic instability. An outbreak in one part of the world can impact markets and travel globally.4,5
  • Social Inequality: Vaccine inequity can deepen socio-economic divides and weaken the solidarity needed for global health initiatives, making it more challenging to coordinate efforts during health emergencies.4,5

Barriers to immunization for vulnerable populations 

Vulnerable populations may face various socioeconomic, geographic, informational and social barriers to immunisation. This section will provide a breakdown of these barriers to immunisation and their impacts on vulnerable populations.

Socio-economic barriers

Socio-economic barriers relate to a person’s social or economic status and how they impact their daily lives. Two examples of socio-economic barriers to immunisation include financial limitations to healthcare access and inadequate healthcare infrastructure. Vulnerable groups may face financial struggles that impact their ability to afford vaccinations or healthcare in general. The cost of vaccines and other healthcare services can be prohibitively expensive.6,7 Furthermore, the lack of sufficient clinics and hospitals compounds these financial barriers, significantly hindering access to necessary immunizations.6,7

Geographic barriers

Geographic limitations can delay or prevent the effective distribution of vaccines to vulnerable populations.6 Individuals in remote or rural areas may encounter challenges in accessing healthcare services due to limited transportation options and few medical facilities nearby.

Informational barriers

Misinformation and low health literacy are significant informational barriers to immunisation and were particularly prevalent during the COVID-19 pandemic. Misinformation provides false information about vaccines without malicious intent but may still cause fear and doubt among communities, and is often worsened by social media and other communication platforms.6 Disinformation describes the provision of false information intended to mislead others and is also harmful to the cause of vaccine equity.7 Additionally, having a limited understanding of health information complicates public health efforts to promote vaccination.6

Cultural and social barriers

  • Mistrust and cultural beliefs: Some communities have deep-seated mistrust towards the healthcare system due to historical grievances, scepticism about pharmaceutical practices, or political influences.6,8
  • Cultural norms and social influences: Deeply ingrained beliefs and norms about health and prevention significantly impact individual decisions regarding vaccinations.6,8

Overcoming barriers to immunization

Ensuring vaccination accessibility for all

It is possible to overcome barriers to immunisation by implementing initiatives and funding that aim to improve the socio-economic, informational, geographical or social limitations that are preventing equitable access.

Improving systems at healthcare facilities

  • Efficient practices: It's beneficial to administer vaccines during regular doctor visits, especially for children during check-ups or patients visiting for minor ailments. This approach helps ensure that opportunities for vaccination are not missed.9,10.11,12

Bringing vaccines closer to people

  • Mobile vaccination clinics: Deploying mobile clinics to remote and rural areas brings vaccines directly to those who are far from hospitals and clinics, eliminating travel as a barrier to access.9,10.11,12

Making vaccines affordable for everyone

  • Removing costs: Eliminating the costs associated with vaccinations, such as travel expenses and government taxes, makes it easier for individuals to access necessary vaccines.9,10.11,12
  • Financial support: Implementing policy changes to provide financial support for vaccinations in economically disadvantaged areas ensures that vaccines are affordable and accessible to all.9,10.11,12

Helping everyone get to a vaccination site

  • More access in the country: Establishing more vaccination sites in rural areas and improving transportation options are effective ways to make reaching vaccination services easier.9,10.11,12

Teaching people about vaccines

  • Education campaigns: Conducting comprehensive education campaigns to dispel myths and provide accurate information helps individuals make informed decisions about getting vaccinated.9,10.11,12
  • Better technology: Enhancing technology to simplify the scheduling and tracking of vaccinations, particularly in areas with limited internet, supports smoother vaccination processes.9,10.11,12

Building trust within communities

  • Working with local leaders: Collaborating with trusted community leaders and influencers is crucial for disseminating clear and culturally sensitive information about vaccine safety and benefits.9,10.11,12
  • Addressing concerns: Targeted outreach programs that address specific community concerns, especially where scepticism is rooted in political, cultural, or historical factors, can significantly reduce vaccine hesitancy.9,10.11,12

Success stories

Local community programs boosting vaccine reach

Community action partnerships

The Centers for Disease Control and Prevention (CDC) has teamed up with local groups across the U.S. to make vaccines more available to everyone. In places like Berkeley County, South Carolina, community gatherings and convenient vaccination stations have helped more people get vaccinated. This approach works well because it uses trusted local figures like church leaders and community health workers who people feel comfortable with, making it easier to overcome doubts and misinformation about vaccines.13

Cultural respect in vaccination efforts

White earth nation's tailored approach

In the White Earth Nation, respecting cultural values has been key to their vaccination success. Supported by a CDC grant, they used elements of Anishinaabe tradition, like the Medicine Wheel, to help explain health risks and protection measures. This culturally rich approach led to many community members, especially elders, choosing to get vaccinated, showing how important it is to align health campaigns with local beliefs and practices.13

Global efforts for fair vaccine distribution

WHO's COVAX Initiative

The World Health Organization (WHO) is leading global efforts to make sure COVID-19 vaccines reach all corners of the world fairly, especially in poorer countries. Through COVAX, millions of vaccine doses are being sent to these countries, aiming to protect at least 20% of their populations. This helps ensure that less wealthy nations aren't left behind in the fight against the pandemic, tackling what's known as 'vaccine nationalism' where richer countries might hoard vaccines.14


This article has examined the critical issues of vaccine equity and access, underscoring the disparities in vaccine distribution that significantly affect socio-economic recovery worldwide, particularly in low- and lower-middle-income countries. We've highlighted successful strategies to overcome barriers to vaccination, such as enhancing office procedures to ensure vaccines are administered during routine visits, deploying mobile clinics to remote areas, and implementing policies to make vaccines more affordable. The success stories from the CDC and WHO demonstrate how global the commitment is to make sure each person has access to life-saving vaccines, no matter where they live or their financial reach. 


How can I help support vaccine equity?

Supporting vaccine equity can be achieved through a variety of practical actions. You can advocate for fair vaccine policies and support initiatives that promote the global distribution of vaccines, ensuring that everyone, regardless of their location, has access to these life-saving resources. Consider donating to organizations like Gavi, the Vaccine Alliance, or the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which are instrumental in distributing vaccines to underserved areas. Additionally, by educating your community with accurate, scientifically-backed information, you help combat the spread of misinformation about vaccines. Volunteering with local health campaigns or community outreach programs can also make a significant impact by increasing vaccine awareness and uptake, thus contributing to broader vaccine equity.

How does vaccine inequity affect global health?

Vaccine inequity has profound impacts on global health, leading to prolonged pandemics as unequal access allows viruses more time to spread and mutate. Such inequity can also trigger a resurgence of diseases that were previously controlled or nearing elimination. Without widespread immunity, infectious diseases can easily cross borders, posing a threat even to countries with high vaccination rates. The economic repercussions are also significant; persistent outbreaks can disrupt global trade and travel, severely impacting economies worldwide and exacerbating poverty, especially in vulnerable regions. This complex web of health and economic challenges underscores the critical need for equitable vaccine distribution to ensure global health security and economic stability.

What impact does misinformation have on vaccine equity?

Misinformation severely undermines vaccine equity by fueling vaccine hesitancy, especially among vulnerable populations, which leads to lower vaccination rates. It spreads doubt and fear about the safety and efficacy of vaccines, thus discouraging their uptake. Moreover, false information can erode trust in health authorities and the medical community, complicating the implementation of successful vaccination programs. In some cases, misinformation fosters complacency about the risks of diseases, resulting in individuals choosing to forego vaccinations. Often, this misinformation is strategically targeted at specific groups, exploiting fears and historical grievances, and thereby intensifying health disparities.


  1. Global dashboard for vaccine equity | Data Futures Exchange. UNDP [Internet]. [cited 2024 May 4]. Available from:
  2. Vaccine Equity Declaration [Internet]. [cited 2024 May 4]. Available from:
  3. Vaccine equity [Internet]. [cited 2024 May 4]. Available from:
  4. Graaf R van der, Browne JL, Baidjoe AY. Vaccine equity: Past, present, and future. Cell Rep Med [Internet]. 2022 [cited 2024 May 4]; 3(3):100551. Available from:
  5. Ali HA, Hartner A-M, Echeverria-Londono S, Roth J, Li X, Abbas K, et al. Vaccine equity in low and middle income countries: a systematic review and meta-analysis. International Journal for Equity in Health [Internet]. 2022 [cited 2024 May 4]; 21(1):82. Available from:
  6. Robinson R, Nguyen E, Wright M, Holmes J, Oliphant C, Cleveland K, et al. Factors contributing to vaccine hesitancy and reduced vaccine confidence in rural underserved populations. Humanit Soc Sci Commun [Internet]. 2022 [cited 2024 May 4]; 9(1):1–8. Available from:
  7. EuropeanCommission. European Commission - Tackling coronavirus disinformation. [cited 2024 May 24]. Tackling coronavirus disinformation. Available from:
  8. Anderson EL. Recommended Solutions to the Barriers to Immunization in Children and Adults. Mo Med [Internet]. 2014 [cited 2024 May 4]; 111(4):344–8. Available from:
  9. Banza Mpiongo P, Kibanza J, Kambol Yav F, Nyombo D, Mwepu L, Basame D, et al. Strengthening immunization programs through innovative sub-national public-private partnerships in selected provinces in the Democratic Republic of the Congo. Vaccine [Internet]. 2023 [cited 2024 May 4]; 41(51):7598–607. Available from:
  10. Zhu J, Cole CB, Fihman J, Adjagba A, Dasic M, Cernuschi T. Opportunities to accelerate immunization progress in middle-income countries. Vaccine [Internet]. 2023 [cited 2024 May 4]. Available from:
  11. Jecker NS. Achieving Global Vaccine Equity: The Case for an International Pandemic Treaty. Yale J Biol Med [Internet]. 2022 [cited 2024 May 4]; 95(2):271–80. Available from:
  12. A New Commitment for Vaccine Equity and Defeating the Pandemic [Internet]. [cited 2024 May 4]. Available from:
  13. EU and WHO collaborate to protect vulnerable populations from vaccine-preventable diseases by ensuring immunization equity [Internet]. [cited 2024 May 4]. Available from:
  14. Partnering for Vaccine Equity: Stories from the Field| CDC [Internet]. 2024 [cited 2024 May 4]. Available from:

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Falguni Chakravarthy

Master of Public Health – University of Aberdeen

I am a recent graduate with a Master of Public Health from the University of Aberdeen and a strong foundation in biomedical sciences. My expertise lies in developing and implementing public health strategies to promote sustainable health outcomes. Actively engaged with current trends in health science, I am dedicated to improving community health practices through my academic and research pursuits. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
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