A little over a year into the pandemic, just about 27 percent of the population of the United States has been fully vaccinated. This is a feat that once seemed impossibly distant. Yet, despite some scrambling as Americans figure out exactly when and where they can be vaccinated, the Biden administration has made it clear that, within weeks, any American adult who wants a vaccine will be able to get one. Unfortunately, this is not the case in much of the world.Disparities in vaccine distribution both within and between countries became an issue almost as soon as vaccine distribution started in late 2020. An equitable global approach would have seen health care workers and high-risk populations in all countries vaccinated before younger and healthier populations were vaccinated anywhere. This is not what happened. Instead, high-income countries bought up more than 75 percent of the vaccines in a rush to vaccinate their entire populations. While the United States has just agreed to release up to 60 million doses of the AstraZeneca vaccine to other countries, it took massive pressure to get the Biden administration to budge and critics say the amount provided is not nearly enough. Some estimate that many of the world’s poorest countries won’t see significant vaccination campaigns at all until 2022 or later.
Moreover, even within the countries that stockpiled the vaccine, significant disparities persist. In the United States, for example, Black Americans are getting vaccinated at nearly half the rate of white Americans. The disparity for Hispanic Americans was even more pronounced. Americans in rural parts of the country, unhoused populations, and low-income populations of all races saw slower vaccination rates as well. And the same is true around the world: The most marginalized—the poor, migrants and refugees, racial and religious minorities—will likely be the last to get vaccinated.

The cost of these disparities is not theoretical. People are being denied life-saving medicine based solely because of where they were born or some other arbitrary characteristic. That’s exactly what makes vaccination such a potent rallying cry for health equity for the marginalized, including refugees, migrantsIndigenous communitiesunhoused people, and incarcerated populations. It’s also being used as a new tool in advocating for the health rights of Palestinians.