Vaccine Innovation, Ethics, and Global Equity: Lessons from COVID-19 for Future Public Health Governance

Abstract

Vaccines constitute a vital bulwark of global public health. From eradicating smallpox to controlling the COVID-19 pandemic, technological advances have profoundly reshaped immunisation strategies. Over the past two decades, novel platforms such as mRNA and adenovirus vectors have dramatically shortened development cycles. Accelerated approval processes have not only fuelled ethical debates but also revealed deeper tensions in how societies balance urgency with accountability. Questions surrounding long-term safety, the adequacy of informed consent, and the transparency of regulatory decisions have persisted, often resurfacing in public discussions and scholarly critiques. These issues became especially prominent during the COVID-19 pandemic, a period that laid bare severe inequities in global vaccine distribution and made visible the uneven capacity of health systems to respond to crisis. High-income nations were able to secure, stockpile, and administer doses rapidly, while many lowincome countries endured chronic shortages and delayed coverage, resulting in disproportionately high mortality rates and heightened risks of viral mutations that ultimately threatened the health security of all populations.