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The COVID-19 pandemic has led to the rapid development of multiple vaccines, tested in clinical trials located in several countries.1 Low- and middle-income countries have experienced significant delays in vaccine access despite initiatives aiming to ensure fair distribution, such as COVID-19 Vaccines Global Access (COVAX).2 Because pharmaceuticals do not receive consistent and timely authorization for use in lower-income countries where they are tested,3 we examined authorization and delivery of COVID-19 vaccines recommended by the World Health Organization (WHO) in the countries where they were tested.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: September 19, 2021.
Published: November 18, 2021. doi:10.1001/jamanetworkopen.2021.34233
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Ramachandran R et al. JAMA Network Open.
Corresponding Author: Reshma Ramachandran, MD, MPP, National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, SHM IE-61, New Haven, CT 06510 (firstname.lastname@example.org).
Author Contributions: Dr Ramachandran had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: All authors.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Ramachandran, Miller.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Ramachandran.
Administrative, technical, or material support: Ramachandran.
Conflict of Interest Disclosures: Dr Ramachandran reported serving as a board member for Universities Allied for Essential Medicines North America, which is a member organization in the People’s Vaccine Alliance and also cohosts the Free the Vaccine campaign, and being an employee of the Veterans Health Administration. Dr Ross reported receiving grants from the US Food and Drug Administration, Johnson & Johnson, the Medical Devices Innovation Consortium, the Agency for Healthcare Research and Quality, the National Institutes of Health/National Heart, Lung, and Blood Institute, and the Laura and John Arnold Foundation and receiving research support through Yale University from Medtronic Inc and the Food and Drug Administration to develop methods for postmarket surveillance of medical devices and from the Centers for Medicare & Medicaid Services to develop and maintain performance measures that are used for public reporting outside the submitted work. Dr Miller reported receiving grants from the Susan G. Komen Foundation, Arnold Ventures, the National Institutes of Health, and Faster Cures during the conduct of the study; receiving personal fees from Cambria Health and Alexion; and serving as a member of the board of directors for Bioethics International outside the submitted work.
Disclaimer: While Dr Ramachandran is an employee of the Veterans Health Administration, the views expressed in this article are those of the authors and do not necessarily reflect those of the US Department of Veteran Affairs or the US government.
Additional Contributions: We thank Anthony Kamande, BSc, and Max Lawson, MA, of Oxfam International for access to data from the Airfinity COVID-19 platform. No financial compensation was received by Messrs Kamande or Lawson or Oxfam International for these data. Oxfam International also serves as a member organization of the People’s Vaccine Alliance.
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