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May 20, 2021
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Will equity issues persist for boosters or variant-specific doses of COVID-19 vaccine?

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Many parts of the world have begun vaccinating large groups of people against COVID-19, whereas others have not because of issues related to vaccine equity.

We asked William Schaffner, MD, Infectious Disease News Editorial Board Member, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center and medical director for the National Foundation for Infectious Diseases, if these issues also will impact boosters or variant-specific doses of COVID-19 vaccine.

Domestically, before COVID-19 and before the COVID-19 vaccine, people of color availed themselves less frequently of routine vaccinations. So, there were differences and disparities, and this always has to do with two things. First, do those people have the same kind of access to the vaccines? Of course, that is often not the case, so we have to reach out and make sure that the vaccine is available to everybody, minority groups of all kinds. However, the other side of that coin is that even when vaccinations are available, people of color do not accept vaccination as often or as frequently as white people in the United States. With that understanding, I would anticipate that going forward, with boosters or anything else, those two issues will continue.

William Schaffner, MD
William Schaffner

Currently, in many parts of the country, vaccine supply exceeds demand — we have vaccine, it is in the refrigerator, and it is waiting for arms. In other words, we have vaccinated many of the eager beavers and the early acceptors, but now we are running into hesitant populations and some people who tell us they will not, under any circumstances, get a vaccine. That is very, very troublesome because they make up a substantial proportion of the population, and if we wish to achieve some semblance of herd immunity and community protection, we need many of them to volunteer to be vaccinated.

Internationally, the short answer is that of course equity issues will persist, because we as a global society still have not worked out a way to provide advances in medical care and prevention to the world’s citizens. We’re still struggling to figure out ways to provide COVID-19 vaccines to many developing countries, and, sure, if boosters are required, those challenges will remain. They will continue.

We have to make sure that the vaccines are accessible to everybody, but the other thing is that we have to educate and encourage, comfort and reassure the entire population so that when the vaccine is available, they actually take advantage of it.

Click here to read the Cover Story, "‘Shocking imbalance’ of COVID-19 vaccine distribution underscores inequity."