Kokusai Hoken Iryo (Journal of International Health)
Online ISSN : 2436-7559
Print ISSN : 0917-6543
Review Article
COVID-19 vaccine in the Pacific Islands related to COVAX Facility and bilateral assistance
Mami WakabayashiMana TakahashiHiroyasu Iso
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2022 Volume 37 Issue 2 Pages 51-68


  Vaccines were developed at an unprecedented speed in response to the COVID-19 pandemic. High-income countries, including Japan, recorded high vaccination rates in 2021. However, many low-income countries still recorded low vaccination rates, highlighting a global vaccine disparity.

  The COVID-19 Vaccines Global Access Facility (COVAX Facility) is a global risk-sharing framework established to ensure the equitable distribution of COVID-19 vaccines. This paper explains the mechanism of the COVAX Facility and discusses the following aspects: (1) issues related to vaccine supply through the COVAX Facility, and vaccine donation or provision as a means of bilateral assistance; (2) case studies of vaccine supply and the number of vaccines administered in the Pacific Islands; and (3) the state of vaccine support in terms of the island nations’ vulnerability to COVID-19.

  COVAX Facility was established in May 2020 and started to supply vaccines to low-income countries in February 2021. The framework also played a significant role as a means of vaccine donation from developed countries having had surplus COVID-19 vaccines to low-income countries when COVAX Facility experienced a shortage of vaccines. However, despite these efforts, COVAX Facility was unable to achieve “equal access” to COVID-19 vaccines.

  For instance, vaccine disparities persist among the 14 Pacific Island countries, which continue to face challenges pertaining to land dispersal, narrowness, and remoteness from global markets. On some of these islands, received bilateral assistance and vaccine donations through COVAX Facility have provided the necessary and sufficient vaccines and achieved high vaccination rates. However, in some island countries such as Kiribati, Solomon Islands, and Vanuatu, the vaccine supply is sufficient, but it does not translate into vaccinations being administered actively. Such places are particularly susceptible to vaccine wastage. Furthermore, in Papua New Guinea, a country with low basic health care standards, improving vaccination coverage may be a challenge even if large-scale support of the health care system for COVID-19 would be provided in the short term.

  It has been over two years since the detected outbreak of COVID-19. To improve vaccination rates globally, it is necessary to not only provide support in terms of vaccine supply but also to offer mid- to long-term assistance, including support for the establishment of vaccination systems and basic health care services.

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