Cost analysis should therefore encompass logistical and distribution issues, which are likely to be significant drivers of affordability and influenced by, for example, the requirement for vaccine storage at very low temperatures. 6 Vaccine costs and cost-effectiveness should be considered in the wider context of equity of access and outcome, and fair allocation of resources within and across populations. 7 8 Though COVID-19 vaccines may initially be funded by donors, all countries will need long-term, mass COVID-19 vaccination strategies to ensure equitable and sustainable practices.
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