Bridging Gaps in Vaccine Access and Equity: A Middle Eastern Perspective
Abstract
1. Introduction
2. Global Overview of Vaccine Equity and Access
2.1. Vaccination Barriers in Developing Countries
2.2. Innovative Solutions for Vaccine Distribution in Developing Countries
2.3. International Organizations and Donor Support as Vaccination Facilitators
3. Overview of the Middle Eastern Region
3.1. Vaccine Landscape in the Middle East
3.2. Innovative Solutions for Vaccine Distribution in the Middle East
4. Challenges and Disparities in Vaccine Access in the Middle East
4.1. Structural and Political Challenges
4.2. Regional and Social Disparities in Access
4.3. Opportunities and Initiatives to Improve Vaccine Equity
4.4. Actionable Strategies and Policy Recommendations
5. Bridging the Gaps for Improving Vaccine Access
6. Study Limitation
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CEPI | Coalition for Epidemic Preparedness Innovations |
DTP3 | Diphtheria-Tetanus-Pertussis (3 doses) |
EPI | Expanded Programme on Immunization |
GCC | Gulf Cooperation Council |
GPEI | Global Polio Eradication Initiative |
GVAP | Global Vaccine Action Plan |
HEPB3 | Hepatitis B (3 doses) |
HPV | Human Papillomavirus |
IA2030 | Immunization Agenda 2030 |
IMD | Invasive Meningococcal Disease |
LICs | Low-Income Countries |
MCV1 | Measles-Containing Vaccine (1st dose) |
MCV2 | Measles-Containing Vaccine (2nd dose) |
MENA | Middle East and North Africa |
MERS-CoV | Middle East Respiratory Syndrome Coronavirus |
MICs | Middle-Income Countries |
NIDs | National Immunization Days |
PCV3 | Pneumococcal Conjugate Vaccine (3 doses) |
ROTA | Rotavirus Vaccine |
VPD | Vaccine-Preventable Disease |
WHA | World Health Assembly |
WUENIC | WHO/UNICEF Estimates of National Immunization Coverage |
YF | Yellow Fever |
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Initiative | Timeline | Countries Involved | Summary | Key Outcomes | Supporting Data/Statistics | Reference |
---|---|---|---|---|---|---|
Vaccine Group Purchasing Program | 1985—present | Bahrain, Kuwait, Oman, Qatar, SA, the United Arab Emirates, and Yemen (since 2004) | In 1978, the Gulf states initiated a joint drug tender, which evolved into a group purchasing system for medical products. The group purchasing of vaccines started in 1985 and required member countries to purchase at least 60% of their vaccine needs through the program. |
|
| [103] |
Meningococcal Vaccination for Hajj and Umrah Pilgrims | 1987—present | SA | Following the 1987 MenA outbreaks, mandatory MenA-C vaccination was implemented for Hajj pilgrims and visitors. Despite this, invasive meningococcal disease (IMD) outbreaks persisted, with notable cases occurring between 1995 and 1999 and 2000 and 2001, mainly due to MenW. From 2002, MenACWY vaccination became mandatory, later switching to a conjugated vaccine. Immunization efforts also expanded to include Saudi residents and infants. |
|
| [104] |
National Immunization Days (NIDs) | 2006—present | Egypt | Since Egypt was declared polio-free in 2006, two National Immunization Days (NIDs) are conducted annually as part of Egypt’s polio program. WHO, UNICEF, and USAID support the Egyptian Ministry of Health and Population (MoHP) to ensure that all children in Egypt, including vulnerable migrant populations, are protected against polio. |
|
| [9] |
Introduction of HPV Vaccine | 2008—present | United Arab Emirates | In 2008, Abu Dhabi introduced the HPV vaccine into its immunization program, offering it free to girls aged 15–17 in public and private schools. By 2013, free immunization had been expanded to Emirati women aged 18–26. In 2019, the HPV vaccine was available to schoolgirls aged 13–14. |
|
| [105] |
Middle East Polio Outbreak Response Plan | 2013–2015 | Egypt, Iran, Iraq, Jordan, Lebanon, Palestine, Syria, and Turkey | Eight national governments partnered with the Global Polio Eradication Initiative (GPEI) to develop a multiphase response plan. Supplementary immunization activities (SIAs) were implemented, including health facility vaccinations, house-to-house visits, transit-point vaccinations, and mobile teams reaching vulnerable and hard-to-reach populations. |
|
| [106] |
MERS-COV Vaccine Development | 2015—present | SA and the UK | SA’s KAIMRC collaborated with the UK’s Oxford University in 2015 to develop the ChAdOX1 vaccine against MERS-COV, which was successful in mice and camels and can potentially protect humans and camels. Human phase 1 trials have begun in both countries. |
|
| [107] |
Routine Childhood Immunizations | 1979—present | Jordan | Supported by UNICEF Jordan, the national immunization program, led by the Ministry of Health, routinely provides vaccinations for children residing in the country. |
|
| [108] |
Inclusive COVID-19 Vaccination Program | 2021—present | Lebanon | In 2021, Lebanon’s COVID-19 vaccination campaign adopted an inclusive approach, covering all residents, including refugees, based on priority categories, such as morbidity and age, regardless of nationality or residency status. The initiative involved the Government of Lebanon, the private sector, the World Bank, UN agencies, and NGOs, with the World Bank reallocating USD 34 million from the Lebanon Health Resilience project and mobilizing additional funds for refugee vaccination. |
|
| [109] |
Hayat Biotech Company | 2021—present | UAE and China | Hayat Biotech is a joint venture between Sinopharm CNBG and G42, a company based in Abu Dhabi. The company focuses on life sciences, biotechnology, and vaccine production, supporting global health security and sustainability. They produced the Hayat-Vax vaccine, the first COVID-19 vaccine in the Middle East, and maintained a strategic stockpile to ensure readiness for future needs. |
|
| [110,111] |
Sadeer City Vaccine and Vital Medicines Factory | 2023—present | SA | The Saudi Authority for Industrial Cities and Technology Zones (Modon) has partnered with the Vaccine Industrial Company to establish a factory in Sadeer City for the manufacture of vaccines and vital medicines, with an investment of USD 133 million. This initiative aims to strengthen pharmaceutical security and localize vaccine production, including those for seasonal flu, COVID-19, chickenpox, pneumococcal, and meningitis. |
|
| [112] |
Country | Income-Level | Global Peace Index (GDI) Ranking | Major Funding source | Gavi Eligibility | Reference |
---|---|---|---|---|---|
Bahrain | High Income | Medium 108 | Fully government-funded | Not Eligible | [69,120,121,122] |
Kuwait | High Income | High 35 | Fully Government-Funded | Not Eligible | [69,120,121,123] |
Oman | High Income | High 48 | Government-Funded | Not Eligible | [69,120,121,124] |
Qatar | High Income | High 21 | Fully Government–Funded | Not Eligible | [69,120,121,125] |
Saudi Arabia | High Income | Medium 119 | fully government-funded | Not Eligible | [69,120,121,126] |
United Arab Emirate | High income | Medium 75 | fully government-funded | Not Eligible | [69,120,121,127] |
Yemen | Low income | Very Low 162 | Gavi, The Vaccine Alliance | Eligible | [69,120,121,128] |
Egypt | Low-Middle Income | Medium 121 | Government-Funded, excluding Campaigns which are funded by WHO, UNICEF and USAID | Not Eligible | [9,69,120,121] |
Iran | High-Middle Income | Low 147 | Government-Funded | Not Eligible | [69,120,121,129] |
Iraq | High-Middle income | Very Low 154 | Ministry of Health supported by the WHO and UNICEF | Not Eligible | [69,120,121,130] |
Jordan | Low-Middle Income | High 62 | Government-Funded | Not Eligible | [69,120,121,131] |
Syria | Low Income | Very Low 161 | Gavi, The Vaccine Alliance | Eligible | [69,120,121,132] |
Lebanon | Low-Middle Income | Low 135 | Government-Funded, Campaign Support Kuwait Fund & humanitarian donors via MOPH + WHO/UNICEF | Not Eligible | [69,120,121,133,134] |
Palestine | Low-Middle Income | Low 134 | Government-Funded, Campaign Support WHO, UNICEF, Gavi. | Not Eligible | [69,120,121,135,136] |
Turkey | High-Middle Income | Low 147 | Government-Funded | Not Eligible | [69,120,121,137] |
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AL-Eitan, L.N.; Almahdawi, D.L.; Abu Khiarah, R.A.; Alghamdi, M.A. Bridging Gaps in Vaccine Access and Equity: A Middle Eastern Perspective. Vaccines 2025, 13, 806. https://doi.org/10.3390/vaccines13080806
AL-Eitan LN, Almahdawi DL, Abu Khiarah RA, Alghamdi MA. Bridging Gaps in Vaccine Access and Equity: A Middle Eastern Perspective. Vaccines. 2025; 13(8):806. https://doi.org/10.3390/vaccines13080806
Chicago/Turabian StyleAL-Eitan, Laith N., Diana L. Almahdawi, Rabi A. Abu Khiarah, and Mansour A. Alghamdi. 2025. "Bridging Gaps in Vaccine Access and Equity: A Middle Eastern Perspective" Vaccines 13, no. 8: 806. https://doi.org/10.3390/vaccines13080806
APA StyleAL-Eitan, L. N., Almahdawi, D. L., Abu Khiarah, R. A., & Alghamdi, M. A. (2025). Bridging Gaps in Vaccine Access and Equity: A Middle Eastern Perspective. Vaccines, 13(8), 806. https://doi.org/10.3390/vaccines13080806