Global inequity creates local insufficiency: A qualitative study of COVID-19 vaccine implementation challenges in low-and-middle-income countries

The COVID-19 pandemic has amplified pre-existing challenges to health promotion and care across the world, and particularly in low- and middle-income countries (LMICs). This qualitative study draws on data from a panel of immunisation experts and uses a novel framework of vaccine delivery domains to...

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Published in:PloS one Vol. 18; no. 2; p. e0281358
Main Authors: Haldane, Victoria, Ariyarajah, Archchun, Berry, Isha, Loutet, Miranda, Salamanca-Buentello, Fabio, Upshur, Ross E. G.
Format: Journal Article
Language:English
Published: United States Public Library of Science 13.02.2023
Public Library of Science (PLoS)
Subjects:
Biology and Life Sciences
Content analysis
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - prevention & control
COVID-19 Vaccines
Decision making
Developing Countries
Disease transmission
Earth Sciences
Economic aspects
Economic recovery
Epidemics
Health aspects
Health care disparities
Health promotion
Humans
Immunization
Income
Infectious diseases
International aspects
Latin America
Medical research
Medicine and Health Sciences
Medicine, Experimental
Nominations
Pandemics
People and Places
Physical fitness
Public health
Qualitative analysis
Qualitative research
Social aspects
Social Sciences
South Asia
Vaccination
Vaccines
Viral diseases
Canada
South Asia
Latin America
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary:The COVID-19 pandemic has amplified pre-existing challenges to health promotion and care across the world, and particularly in low- and middle-income countries (LMICs). This qualitative study draws on data from a panel of immunisation experts and uses a novel framework of vaccine delivery domains to explore perspectives from those who live and work in these settings on the challenges to implementing COVID-19 vaccine programs in LMICs. We conducted a thematic content analysis of 96 participant free text replies to questions from Round I of a three-round Delphi consensus study amongst global experts on COVID-19 vaccine implementation. Participant responses highlighted challenges to vaccine program implementation including issues related to equity; governance, decision-making, and financing; regulatory structures, planning, and coordination; prioritisation, demand generation, and communication; vaccine, cold chain, logistics, and infrastructure; service delivery, human resources, and supplies; and surveillance, monitoring, and evaluation. We reflect on our findings in light of global efforts to address vaccine inequity and emphasise three key areas salient to improving vaccination efforts during novel infectious disease outbreaks: 1) Ensuring safe and sustainable service delivery in communities and at points of care; 2) Strengthening systems for end-to-end delivery of vaccines, therapeutics, diagnostics, and essential supplies; 3) Transforming structural paradigms towards vaccine equity.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0281358