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Vaccine Inequity Among the Stateless

Vaccine Inequity
At the height of the pandemic, the critical global message was “no one is safe until everyone is safe.” It referred to the common-sense view that vaccinating everyone was the only way to control COVID-19. However, vaccine inequity among the stateless presented a barrier to raising global vaccination rates.

In countries such as Montenegro, Lebanon and the Dominican Republic, vaccine inequity among the stateless was characteristic of the exclusion and marginalization that stateless people typically experience for reasons ranging from politics to discrimination. Other major reasons include administrative issues stemming from affected individuals lacking specific documentation.

Stateless people have historically suffered unequal access to health care due to systems that provide services based on nationality and faced disproportionate impacts of the COVID-19 pandemic. Vaccine inequity among the stateless presented a further devastating blow for some of the world’s most vulnerable people.

Vaccine Inequity in the Dominican Republic

Vaccine inequity among the stateless in the Dominican Republic existed due to a policy decision to exclude the affected individuals. In 2021, the president announced that only Dominicans would be included in the COVID-19 vaccination rollout, thus excluding illegal migrants or stateless people. The problem of discrimination and anti-Haitianism directed toward those born Dominican has been historically rife in the country. In fact, an overnight and discriminatory court decision in 2013 revoked the citizenship of Dominicans of Haitian descent. The court ruling stood as another example of furthering discrimination, even if it ran counter to the public health imperative.

However, several community responses echoed in unison to drive positive change. A community-based organization in the south of the country held persuasive talks with local government officials to convince the officials to consider residency status, name and age as sufficient for vaccination. Eventually, the localized vaccination distribution meant that some Dominicans without documentation could receive their shots.

Moreover, the Caribbean Migrants Observatory, a body set up in 2009 to facilitate migration and social development, also stepped in. Apart from developing the first migratory profile of the Dominican Republic, its advocacy talks with government officials led to a reversal in discriminatory vaccine policy and a subsequent commitment to universal vaccine access in the country.

Vaccine Inequity in Montenegro

Vaccine inequity has also affected the Roma community in Montenegro. A population at risk of statelessness, members of the Roma community face high fees for health care access during non-pandemic times. This is because Roma people are not on the official records for government health programs as they lack the required documentation.

The directive in the first stages of the vaccination rollout held that stateless people would be last in line to receive vaccines despite living in densely populated areas with significantly high risks of contracting the virus. Fortunately, following advocacy by the community-based organization Phiren Amenca, which emerged in 2012 to advocate for the rights of the Roma community, the new government changed the policy.

The government placed community members in a priority group, adding that all residents, regardless of citizenship status and health insurance, could receive the vaccine. Further clarifications revealed that this new development also included those in the process of resolving their legal status and those without legal documents. Phiren Amenca has also succeeded in extending the deadline for the registration of Roma people. A Roma doctor also visited a settlement to educate the community on the importance of vaccination and to deliver vaccine shots.

Vaccine Inequity in Lebanon

Vaccine inequity among stateless people in Lebanon existed primarily due to administrative issues. Oummal, a community-based organization set up in 2010 to provide universal health coverage that includes stateless people, had an eye-opening discovery. It found out, through community interviews, that stateless people could not register to receive the vaccination as no category existed for ‘no nationality’ on the registration portal. Furthermore, a lack of awareness about the importance of vaccination alongside fears of hospitalization and its associated costs stood as issues.

Oummal advocated for the inclusion of a ‘no nationality’ category on the registration platform. The organization set up a vaccination hotline for inquiries on documentation and vaccination. It also accompanied people to get their documents and receive vaccinations. Lastly, another resolution came about by waiving hospitalization costs for stateless people after meetings with the Ministry of Health. Oummal supported about 1,500 people, 1,068 of whom registered for vaccinations. The dedicated hotline for stateless people received 134 calls and the organization recorded 63 cases to follow up on regarding documentation and vaccination.

Advocacy and Community Work

Stateless people suffer from exclusion and discrimination, but the costs of exclusion during a global pandemic are far higher. Several countries excluded stateless people from accessing vaccines due to discrimination, lack of documentation and administrative issues. However, the influence of community work and advocacy resulted in the vaccination of many stateless people.

– Ottoline Spearman
Photo: Flickr

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About the Philippines’ Vaccination Drive


From November 29 to December 1, 2021, the Philippines vaccinated 7.6 million people in three days. This was part of a mass vaccination campaign called “Bayanihan, Bakunahan.” The intense Philippines vaccination drive exceeded expectations by about 200,000 vaccines. A second wave of the “Bayanihan Bakunahan” campaign ran later in December.

According to Our World in Data, the Philippines lags behind the global average for the vaccinated population. However, the Philippines vaccination drive shows a stark improvement from the beginning of the year.  At that time, vaccines were scarcely available. The government hopes to have 77 million fully vaccinated. Filipinos by the end of the first quarter of 2022. Here are some facts about the Philippine’s mass vaccination program.

The Philippine’s Mass Vaccination Program

  1. COVID-19 Vaccines: The Philippines has approved eight COVID-19 vaccines for usage. The vaccines include Pfizer, Moderna and Johnson & Johnson. Vaccines from other countries include China’s Sinovac and Sinopharm, Russia’s Sputnik V, the United Kingdom’s AstraZeneca and India’s Bharat BioTech. The vaccines range in efficacy from 51% to 95%, but the Philippine government encourages vaccination by any brand despite variance in efficacy. The vaccine variety helps ensure there is vaccine availability in the case of delayed shipments or shortages. The Philippine government purchased most of these doses from their respective producers. It also received more than 53 million doses through the COVAX initiative.
  2. Vaccine Access: There was easy access to vaccination due to 8,000 vaccination centers being open across the Philippines. Even during Typhoon Odette, which hit during the Philippines vaccination drive, the Department of Health vaccinated millions of people. To hit the government target of fully vaccinating 77 million Filipinos by the end of March 2022,  local vaccination centers have extended their hours to remain open on weekends.
  3. Vaccine Hesitancy: Vaccine hesitancy has been decreasing in the Philippines. During the COVID-19 pandemic, many Filipinos have been concerned about the safety of the vaccine due to a controversy over the government rollout of a dengue vaccine in 2017. With time, seeing that adverse reactions to the COVID-19 vaccine are very rare, people are becoming willing to get vaccinated.

Lagging Vaccination During Philippines Vaccination Drive

Vaccination rates in the Philippines still lag behind the rest of the world. The pandemic pushed millions of Filipinos into poverty. The Philippines Statistics Authority reported 3.9 million more people living in poverty since 2018. Some blame the pandemic lockdowns. These reduced economic demands and therefore jobs. However, as a result of the Philippines vaccination drive, cases have been dropping so the government has been able to ease restrictions. While the Omicron variant may disrupt this progress, Philippine President Rodrigo Duterte has encouraged vaccination as the best protection against illness and death from COVID-19.

Expanding Vaccination Access

One next step for the Philippines is to expand vaccination across all population groups.  Another step is to begin providing booster shots to the fully vaccinated. On December 22, the Philippines approved the Pfizer vaccine to vaccinate children aged 5-11. The government also recently shortened the interval between the second and third doses, which will allow people to receive a booster dose after three months.

The Philippines vaccination drive has increased interest in vaccination. This interest has kept many temporary vaccination sites opened during the drive stay open. With President Duterte’s adamant pleas for Filipinos to get vaccinated, similar vaccination drives will likely take place again and inch the country closer to herd immunity.

– Emma Tkacz
Photo: Flickr

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COVID-19 Vaccine Equity


As the COVID-19 pandemic continues to surge, global calls for achieving COVID-19 vaccine equity are increasing. Vaccine equity is a simple concept: it is the belief that all people should have equal access to vaccines. Inequitable access to COVID-19 vaccines leaves developing nations helpless against the virus. Moreover, inequitable access has allowed new deadlier variants of the virus to emerge and spread globally.

According to the World Bank Group, as of November 15, 2021, 72.8% of the population in high-income countries received a COVID-19 vaccine. This is a harsh difference from the mere 4.2% of the population in low-income countries. Luckily, several global organizations have initiated various efforts to help make COVID-19 vaccine equity a reality.

The World Health Organization (WHO)

The World Health Organization (WHO) is a leader in global health initiatives. Its COVID-19 vaccine equity campaign is a roadmap to achieve vaccine equity. This roadmap sets the goal to administer a COVID-19 vaccine to at least 40% of the residents in every country by the end of 2021. It sets a second goal to vaccinate 70% of the global population by mid-2022. WHO is calling for countries and companies that control vaccine supplies to donate and contract with COVAX and The African Vaccine Acquisition Trust (AVAT) to get the vaccines where they are most needed.

WHO also believes that individual efforts matter. It launched its GoGiveOne fundraising initiative to allow individual efforts to directly aid the vaccine equity campaign through crowdfunding. A donation of $6 amounts to one vaccine.

Global Dashboard for Vaccine Equity

The Global Dashboard for Vaccine Equity is a collaborative effort that the World Health Organization, the United Nations Development Programme (UNDP) and the University of Oxford launched with support across the U.N. It is a part of the SDG 3 Global Action Plan for Healthy Lives and Well-being for All.

This initiative works towards global COVID-19 vaccine equity by sharing the latest data on the COVID-19 vaccine rollout. It also provides socioeconomic data to demonstrate why the acceleration of global vaccination is critical. The Dashboard shows how a faster rollout not only saves more lives but also supports a speedier pandemic recovery. Moreover, it presents and highlights important vaccine equity policies and uses these to help guide legislative change. Finally, the Dashboard aids in educating the public about COVID-19 vaccine equity through free resources and statistics.

Only organizations can directly participate in the Dashboard. Nevertheless, individuals have a significant part to play. Raising awareness and increasing knowledge about COVID-19 vaccine equity is the Dashboard’s primary goal.

African Vaccine Acquisition Trust

The African Vaccine Acquisition Trust (AVAT) is a global effort that strives for equitable access to COVID-19 vaccines across the African continent. To combat the looming vaccine inequality, in August 2020, a group of 10 people from throughout Africa gathered and became the African Vaccine Acquisition Task Team. This team went on to found the African Vaccine Acquisition Trust and gain the endorsement of the African Union. Moreover, AVAT became an integral part of the Africa Vaccine Strategy. AVAT’s primary goal is ensuring the vaccination of at least 60% of the African population against COVID-19. Individuals can help through advocating for increased COVID-19 vaccine donations from their governments and through educating themselves about COVID-19 vaccine equity in Africa.

Realizing COVID-19 Vaccine Equity

As the COVID-19 pandemic continues to affect the world, vaccine equity should remain at the forefront of global efforts. Many developed countries are increasingly pledging to donate COVID-19 vaccines due to pressure from the global initiatives mentioned above. Therefore, it remains important for individuals to support the global COVID-19 vaccine equity initiatives to help make vaccine equity a reality.

– Nohad Awada
Photo: Unsplash