In a recent article in JAMA Psychiatry, Warren et al1 propose that people with severe mental disorders (SMD) should be prioritized for the COVID-19 vaccine. They indicate that people with SMD are at higher risk of being infected by SARS-CoV-2, have increased COVID-19–associated morbidity and mortality rates, and face individual and structural barriers to participation in vaccination programs. From a global mental health perspective, we underscore that across the globe, people with SMD were typically poor, socially excluded, and in poor health even before the pandemic struck. Indeed, within almost all countries, people with SMD are among the most disadvantaged groups of all. They have been recognized by the United Nations as a vulnerable population entitled to special consideration to ensure that they benefit from socioeconomic and health development, including vaccines.2 As vaccines for COVID-19 roll out, however, most countries have not yet prioritized this group. Furthermore, the pandemic has reduced mental health services for this population in the face of increasing demand, especially in low- and middle-income countries (LMICs), where services are already minimal relative to need (eg, Latin America).3 Although we focus here on people with SMD, including those with psychotic disorders as well as bipolar disorder and major depression without psychosis, we believe that a similar argument could be made for people with other psychosocial disabilities (eg, developmental disabilities).