COVID-19 vaccine affordability and accessibility.

The need to ensure the affordability of any future COVID-19 vaccine is gaining increasing attention. Although there is support for bulk purchasing, making vaccines affordable is fraught with difficulties, particularly for the so-called missing middle countries that are not eligible for aid from Gavi, The Vaccine Alliance or other aid but lack the resources to produce their own vaccines or afford patent-protected drugs.

For these countries, price controls—regulations that would cap or set prices—provide an effective approach to vaccine affordability and thus accessibility. This has led to the adoption of price controls in Chile and some other low-income and middle-income countries (LMICs). However, if only LMICs impose price controls, vaccine manufacturers might opt to not sell or supply adequate quantities, prioritising high-profit markets instead.

Although price controls only apply to domestic producers, they provide leverage for LMIC governments to negotiate lower prices. Since many of the COVID-19 vaccine developers are in the USA, a US price control would have a big impact. These price controls could enable LMIC governments to purchase the vaccine, ensuring faster access for all those who need it and not just for those who can afford it.

However, the US Government currently prioritises profits, stating “the priority is to get vaccines and therapeutics. Price controls won't get us there”. This stance will hinder efforts to control the pandemic, both within the USA and globally. Multiple approaches, including price controls, are needed to ensure an effective vaccine is widely affordable.