A public health framework for the equitable global allocation of vaccines: COVID-NEEDS

The equitable global allocation of COVID-19 vaccines has received much attention yet been poorly defined. Understanding equity requires assessing needs for vaccines across countries. Making distinctions is especially challenging when countries perform similarly on traditional epidemiological metrics. This Viewpoint offers a novel conceptual framework (COVID-NEEDS) based on empirical evidence and public health guidance. It encompasses health, social, and economic impacts of COVID-19 and associated non-pharmaceutical interventions. We intend this framework to complement existing needs assessment methods to help identify countries most in need of vaccines. We present factors to consider, but future work will be required to understand how to weight the factors and to determine the practical utility of the framework for supplementing existing COVID-19 vaccine allocation mechanisms.