[P1] Two years into the pandemic, vaccine access has refracted pre-existing inequalities. Intercountry gaps remain stark, yet inequities within nations have intensified: school completion among the poorest is reversing; gender disparities are widening amid spikes in gender-based violence; and informal workers absorbed the harshest lockdown losses...

[P2] By early 2022, low-income countries had received a vanishingly small share of global doses... progress is thwarted by supply bottlenecks and limited absorptive capacity: vaccines must arrive on time, in stable cold chains, and meet the staffing and logistics on the ground.

[P3] Financing remains the rub... Case studies warn of a looming debt spiral as countries shoulder new obligations equal to large shares of poverty-reduction and education needs. For many low-income countries, vaccination costs devour fiscal space that could otherwise fund poverty eradication and schooling.

[P4] Solutions are neither mysterious nor effortless... Adequate doses are necessary but insufficient; those doses must be converted into vaccinations through micro-planning, last-mile logistics, and trusted national partners such as Gavi. A “hyperlocal” analytics approach can map vulnerability, steer mobile teams, and target neighborhoods where confidence or access is thin.