Equitable access to effective vaccination against COVID-19 is now the most effective means to protect older people in low and middle-income countries, both from the health risks of the pandemic and its other social and economic effects.

General progress in national vaccination programmes has been very variable across low and middle-income countries. Some have been able to offer two doses to the majority of their older populations, while many countries have made little headway. In part, this reflects the “vaccine nationalism” of wealthier countries, which are limiting the availability of vaccines in the countries that now need them most. In some countries, it also reflects a low priority given to older people for vaccination, either in policy or in practice. Given the high concentration of COVID-19 mortality at the oldest ages, marginalising older people in this way is unethical, ageist and, in some cases, amounts to gerontocide. We make this point in this Lancet piece:

We call on rich countries to desist from vaccine nationalism.

And we call on countries that do not prioritise older people to desist from vaccine ageism.