Vaccine diplomacy, a form of
medical diplomacy, is the use of
vaccine
A vaccine is a biological Dosage form, preparation that provides active acquired immunity to a particular infectious disease, infectious or cancer, malignant disease. The safety and effectiveness of vaccines has been widely studied and verifi ...
s to improve a country's
diplomatic relationship
Diplomacy is the communication by representatives of state, intergovernmental, or non-governmental institutions intended to influence events in the international system.Ronald Peter Barston, ''Modern Diplomacy'', Pearson Education, 2006, p. ...
and influence of other countries.
Meanwhile, vaccine diplomacy also "means a set of diplomatic measures taken to ensure access to the best practices in the development of potential vaccines, to enhance bilateral and/or multilateral cooperation between countries in conducting joint R&D, and, in the case of the announcement of production, to ensure the signing of a contract for the purchase of the vaccine at the shortest term."
Although primary discussed in the context of the supply of
COVID-19 vaccine
A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 ( COVID19).
Knowledge about the structure and fun ...
s, it also played a part in the distribution of the
smallpox vaccine
The smallpox vaccine is used to prevent smallpox infection caused by the variola virus. It is the first vaccine to have been developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with th ...
.
Early history of vaccine diplomacy
Commentators have identified vaccine diplomacy occurring as far back as the first vaccine,
Edward Jenner
Edward Jenner (17 May 1749 – 26 January 1823) was an English physician and scientist who pioneered the concept of vaccines and created the smallpox vaccine, the world's first vaccine. The terms ''vaccine'' and ''vaccination'' are derived f ...
's smallpox vaccine. It has also been identified in Soviet involvement with the
Albert Sabin
Albert Bruce Sabin ( ; born Abram Saperstejn; August 26, 1906 – March 3, 1993) was a Polish-American medical researcher, best known for developing the oral polio vaccine, which has played a key role in nearly Poliomyelitis eradication, eradica ...
polio vaccine. The UN has also brokered ceasefires in order to conduct vaccination campaigns such as with talibans in Afghanistan.
During the COVID-19 pandemic
Australia
Australia
Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
promised to ensure early access to a vaccine "for countries in our Pacific family, as well as regional partners in
Southeast Asia
Southeast Asia is the geographical United Nations geoscheme for Asia#South-eastern Asia, southeastern region of Asia, consisting of the regions that are situated south of China, east of the Indian subcontinent, and northwest of the Mainland Au ...
". to help them fight the COVID-19 pandemic.
China
China's infection rates and early success in handling the COVID-19 pandemic were sufficiently low that it could send vaccines abroad without domestic objections.
By August 2021, China had donated 700 million vaccine does abroad, greater than the number from all other countries combined. As academic
Suisheng Zhao
Suisheng Zhao (; born September 17, 1954) is a Chinese-American Political science, political scientist currently serving as professor of Chinese politics and Chinese foreign policy, foreign policy at the University of Denver, University of Denver ...
writes, "Just by showing up and helping plug the colossal gaps in the global supply, China gained ground."
Moreover, the
Center for Strategic and International Studies
The Center for Strategic and International Studies (CSIS) is an American think tank based in Washington, D.C. From its founding in 1962 until 1987, it was an affiliate of Georgetown University, initially named the Center for Strategic and Inte ...
found that its vaccine diplomatic activities earned China goodwill and influence in several middle-income countries, many of which are also notably involved in the
Belt and Road Initiative
The Belt and Road Initiative (BRI or B&R), known in China as the One Belt One Road and sometimes referred to as the New Silk Road, is a global infrastructure development strategy adopted by the government of China in 2013 to invest in more t ...
, indicating that such diplomacy could have improved China's image and strengthened its relationships with countries that wished for, or already took part in, strong relationships with China. However, because most of Chinese distributed vaccines have gone to such middle-income countries, many of the poorest countries are left highly vulnerable, undercutting China's attempts to present itself as a benevolent giver of needed goods and undermining Xi's claim that a Chinese developed vaccine would be treated as a “global public good."
The
Sinopharm BIBP vaccine is used for vaccinations by some countries in Asia, Africa, South America, and Europe. Sinopharm produced one billion doses of the BBIB vaccine in 2021, and supplied 200 million doses by May.
CoronaVac
CoronaVac, also known as the Sinovac COVID-19 vaccine, was a whole inactivated virus COVID-19 vaccine developed by the Chinese company Sinovac Biotech. It was phase III clinically trialled in Brazil, Chile, Indonesia, the Philippines, and ...
is used for vaccinations by some countries in Asia,
South America, North America, and Europe. Sinovac had a production capacity of 2 billion doses a year and had delivered 600 million total doses.
Convidecia is used for vaccination by some countries in Asia,
Europe,
and Latin America. Production capacity for Ad5-NCov should reach 500 million doses in 2021.
China pledged US$2billion to support efforts by
WHO
The World Health Organization (WHO) is a specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has 6 regional offices and 15 ...
for programs against COVID-19, a US$1billion loan to make its vaccine accessible for countries in
Latin America
Latin America is the cultural region of the Americas where Romance languages are predominantly spoken, primarily Spanish language, Spanish and Portuguese language, Portuguese. Latin America is defined according to cultural identity, not geogr ...
and the
Caribbean
The Caribbean ( , ; ; ; ) is a region in the middle of the Americas centered around the Caribbean Sea in the Atlantic Ocean, North Atlantic Ocean, mostly overlapping with the West Indies. Bordered by North America to the north, Central America ...
, and provide five Southeast Asian countries priority access to the vaccine. The
Sinopharm BIBP vaccine and
CoronaVac
CoronaVac, also known as the Sinovac COVID-19 vaccine, was a whole inactivated virus COVID-19 vaccine developed by the Chinese company Sinovac Biotech. It was phase III clinically trialled in Brazil, Chile, Indonesia, the Philippines, and ...
were approved by the WHO as part of
COVAX
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World He ...
.
By July 2021,
GAVI
GAVI, officially Gavi, the Vaccine Alliance (previously the GAVI Alliance, and before that the Global Alliance for Vaccines and Immunization) is a Public–private partnership, public–private global health partnership with the goal of incr ...
had signed advanced purchase agreements for 170 million doses of the Sinopharm BIBP vaccine, 350 million doses of CoronaVac, and 414 million doses of
SCB-2019, another COVID-19 vaccine in Phase III trials.
All of these actions have been a component in enacting China's strategy of enacting mask diplomacy, where the state has distributed medical supplies, including COVID-19 vaccines, and financial support to other European countries, in an effort to restore China's historically maligned and recently ignominious image. While on the other hand, these actions have demonstrated that China is a pragmatic, self-driven problem solver, willing to establish alliances with other nations contrasting the United States' isolationist policies.
In addition, China is utilizing this opportunity to distance, and even shift the narrative regarding the start of COVID-19, as the virus was discovered in the nation. Although China gained some international sympathy, the country was also accosted by “accusations of fanning the pandemic by silencing early reports” and “dogged by international criticisms that trace the origins of the pandemic to a leak from a Wuhan lab.” A 2020 Pew Research poll further suggests a negative narrative surround China; upon polling citizens in 14 economically advanced nations, including East Asian neighbors Japan and South Korea, a median of 61% said China did "a bad job dealing with the
OVID-19outbreak" and 78% said they had no confidence in President Xi. Such a poor global perception could suggest that China's distributed vaccines as a means of repairing or strengthening the country's international image. Providing vaccination doses allowed China to combat negative narratives about its early handling of the crisis and recast itself as a provider of needed goods, while cultivating goodwill and showcasing the nation’s technological strength. Through distributing their vaccines, China clearly took a stride to appear favorable in the eyes of the world, and perhaps reverse the criticism garnered at the early stages of the pandemic.
India

By late March 2021, India had produced 125 million doses of COVID-19 vaccines and had exported 55 million doses. 84 countries had received vaccines from India, either through
COVAX
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World He ...
, grants or regular purchases.
India
India, officially the Republic of India, is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area; the List of countries by population (United Nations), most populous country since ...
sent millions of doses of COVID-19 vaccine to 95 countries including neighboring
Bhutan
Bhutan, officially the Kingdom of Bhutan, is a landlocked country in South Asia, in the Eastern Himalayas between China to the north and northwest and India to the south and southeast. With a population of over 727,145 and a territory of , ...
,
Afghanistan
Afghanistan, officially the Islamic Emirate of Afghanistan, is a landlocked country located at the crossroads of Central Asia and South Asia. It is bordered by Pakistan to the Durand Line, east and south, Iran to the Afghanistan–Iran borde ...
,
Nepal
Nepal, officially the Federal Democratic Republic of Nepal, is a landlocked country in South Asia. It is mainly situated in the Himalayas, but also includes parts of the Indo-Gangetic Plain. It borders the Tibet Autonomous Region of China Ch ...
,
Bangladesh
Bangladesh, officially the People's Republic of Bangladesh, is a country in South Asia. It is the List of countries and dependencies by population, eighth-most populous country in the world and among the List of countries and dependencies by ...
,
Sri Lanka
Sri Lanka, officially the Democratic Socialist Republic of Sri Lanka, also known historically as Ceylon, is an island country in South Asia. It lies in the Indian Ocean, southwest of the Bay of Bengal, separated from the Indian subcontinent, ...
,
Myanmar
Myanmar, officially the Republic of the Union of Myanmar; and also referred to as Burma (the official English name until 1989), is a country in northwest Southeast Asia. It is the largest country by area in Mainland Southeast Asia and has ...
and the
Maldives
The Maldives, officially the Republic of Maldives, and historically known as the Maldive Islands, is an Archipelagic state, archipelagic country in South Asia located in the Indian Ocean. The Maldives is southwest of Sri Lanka and India, abou ...
. India will also supply vaccines to Pakistan through COVAX initiative.
During the second wave of the
COVID-19 pandemic in India
The COVID-19 pandemic in India is a part of the COVID-19 pandemic, worldwide pandemic of COVID-19, coronavirus disease 2019 () caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of , according to Indian government ...
, the Vaccine Maitri program was put on hold until July 2021 due to increased number of COVID cases in India. As of 29 May 2021, India had exported 66.4 million doses including 10.7 million vaccine provided as grant to more than 95 nations.
India's health ministry said the country will resume COVID-19 vaccine exports as a part of
COVAX
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World He ...
and
Vaccine Maitri initiative, by October, promising supply development that comes ahead of high-level talks this week on solving vaccine inequity gaps, while
World Health Organization
The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
chief
Tedros Adhanom Ghebreyesus
Tedros Adhanom Ghebreyesus (, sometimes spelled ; born 3 March 1965) is an Ethiopian public health official, researcher, diplomat, and the DGWHO, Director-General of the World Health Organization since 2017. He is the first African to become W ...
has hailed India's decision to resume COVID-19 vaccine exports as an "important development" in support of the ''goal'' to reach 40 per cent vaccination in all countries by end of the year.
Mexico
Secretary of Foreign Affairs of Mexico Marcelo Ebrard
Marcelo Luis Ebrard Casaubón (; born 10 October 1959) is a Mexicans, Mexican politician who has served as the Secretariat of Economy, secretary of economy since 2024. He previously served as Secretary of Foreign Affairs (Mexico), Secretary of ...
announced agreements with
CanSino Biologics
CanSino Biologics ( zh, s=康希诺生物 , t=康希諾生物 , hp=Kāngxīnuò Shēngwù), often abbreviated as CanSinoBIO, is a Chinese vaccine company.
History
CanSino Biologics was founded in 2009 in Tianjin by Yu Xuefeng, Zhu Tao, Qiu Don ...
and
Walvax to conduct clinical trials for vaccines from China, with the possibility of the manufacturing the vaccines in the country.
Marcelo Ebrard also announced agreements with
Johnson & Johnson
Johnson & Johnson (J&J) is an American multinational pharmaceutical, biotechnology, and medical technologies corporation headquartered in New Brunswick, New Jersey, and publicly traded on the New York Stock Exchange. Its common stock is a c ...
to trial its U.S. developed vaccine in Mexico.
Japan
In July 2020, Japan agreed to provide 11.6 billion
yen
The is the official currency of Japan. It is the third-most traded currency in the foreign exchange market, after the United States dollar and the euro. It is also widely used as a third reserve currency after the US dollar and the euro.
T ...
(US$109million) to five countries along the
Mekong River
The Mekong or Mekong River ( , ) is a transboundary river in East Asia and Southeast Asia. It is the world's List of rivers by length, twelfth-longest river and List of longest rivers of Asia, the third-longest in Asia with an estimated l ...
:
Cambodia
Cambodia, officially the Kingdom of Cambodia, is a country in Southeast Asia on the Mainland Southeast Asia, Indochinese Peninsula. It is bordered by Thailand to the northwest, Laos to the north, and Vietnam to the east, and has a coastline ...
,
Laos
Laos, officially the Lao People's Democratic Republic (LPDR), is the only landlocked country in Southeast Asia. It is bordered by Myanmar and China to the northwest, Vietnam to the east, Cambodia to the southeast, and Thailand to the west and ...
,
Myanmar
Myanmar, officially the Republic of the Union of Myanmar; and also referred to as Burma (the official English name until 1989), is a country in northwest Southeast Asia. It is the largest country by area in Mainland Southeast Asia and has ...
,
Thailand
Thailand, officially the Kingdom of Thailand and historically known as Siam (the official name until 1939), is a country in Southeast Asia on the Mainland Southeast Asia, Indochinese Peninsula. With a population of almost 66 million, it spa ...
and
Vietnam
Vietnam, officially the Socialist Republic of Vietnam (SRV), is a country at the eastern edge of mainland Southeast Asia, with an area of about and a population of over 100 million, making it the world's List of countries and depende ...
over concerns with China's influence on vaccine production and distribution in Asia.
Russia
Russia
Russia, or the Russian Federation, is a country spanning Eastern Europe and North Asia. It is the list of countries and dependencies by area, largest country in the world, and extends across Time in Russia, eleven time zones, sharing Borders ...
, the first country to claim a
COVID-19 vaccine
A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 ( COVID19).
Knowledge about the structure and fun ...
,
Sputnik V
Sputnik V (, the brand name from the Russian Direct Investment Fund or RDIF) or Gam-COVID-Vac (, the name under which it is legally registered and produced) is an adenovirus viral vector vaccine for COVID-19 developed by the Gamaleya Resea ...
, says twenty countries "including Brazil, Indonesia and the United Arab Emirates" have requested access.
Turkey
Turkey
Turkey, officially the Republic of Türkiye, is a country mainly located in Anatolia in West Asia, with a relatively small part called East Thrace in Southeast Europe. It borders the Black Sea to the north; Georgia (country), Georgia, Armen ...
has sent or donated
CoronaVac
CoronaVac, also known as the Sinovac COVID-19 vaccine, was a whole inactivated virus COVID-19 vaccine developed by the Chinese company Sinovac Biotech. It was phase III clinically trialled in Brazil, Chile, Indonesia, the Philippines, and ...
vaccines to
Azerbaijan
Azerbaijan, officially the Republic of Azerbaijan, is a Boundaries between the continents, transcontinental and landlocked country at the boundary of West Asia and Eastern Europe. It is a part of the South Caucasus region and is bounded by ...
,
Bosnia and Herzegovina
Bosnia and Herzegovina, sometimes known as Bosnia-Herzegovina and informally as Bosnia, is a country in Southeast Europe. Situated on the Balkans, Balkan Peninsula, it borders Serbia to the east, Montenegro to the southeast, and Croatia to th ...
,
Northern Cyprus
Northern Cyprus, officially the Turkish Republic of Northern Cyprus (TRNC), is a ''de facto'' state that comprises the northeastern portion of the Geography of Cyprus, island of Cyprus. It is List of states with limited recognition, recognis ...
, and
North Macedonia
North Macedonia, officially the Republic of North Macedonia, is a landlocked country in Southeast Europe. It shares land borders with Greece to the south, Albania to the west, Bulgaria to the east, Kosovo to the northwest and Serbia to the n ...
.
United States
During the
Trump administration Presidency of Donald Trump may refer to:
* First presidency of Donald Trump, the United States presidential administration from 2017 to 2021
* Second presidency of Donald Trump, the United States presidential administration since 2025
See also
* ...
,
Secretary of Health and Human Services
The United States secretary of health and human services is the head of the United States Department of Health and Human Services, and serves as the principal advisor to the president of the United States on all health matters. The secretary is ...
Alex Azar
Alex Michael Azar II (; born June 17, 1967) is an American attorney, businessman, lobbyist, and former pharmaceutical executive who served as the 24th U.S. secretary of health and human services from 2018 to 2021. He was also chairman of the W ...
said the United States will share a vaccine with other countries only after the United States' needs have been met.
The United States has funded and placed multi-billion dollar orders purchasing hundreds of millions of vaccines from the United Kingdom's
AstraZeneca
AstraZeneca plc () (AZ) is a British-Swedish multinational pharmaceutical and biotechnology company with its headquarters at the Cambridge Biomedical Campus in Cambridge, UK. It has a portfolio of products for major diseases in areas includi ...
and Germany's
BioNTech SE in collaboration with American
Pfizer
Pfizer Inc. ( ) is an American Multinational corporation, multinational Pharmaceutical industry, pharmaceutical and biotechnology corporation headquartered at The Spiral (New York City), The Spiral in Manhattan, New York City. Founded in 184 ...
. The United States offered vaccine development to Indonesia in an August 2020 phone call between
Mike Pompeo
Michael Richard Pompeo (; born December 30, 1963) is an American retired politician who served in the First presidency of Donald Trump#Administration, first administration of Donald Trump as director of the Central Intelligence Agency (CIA) fr ...
and
Retno Marsudi
Retno Lestari Priansari Marsudi (born 27 November 1962) is an Indonesian diplomat who formerly served as the Minister for Foreign Affairs in the Cabinet of Joko Widodo between 2014 and 2024. She is the first female minister appointed to the pos ...
.
The
Biden administration
Joe Biden's tenure as the List of presidents of the United States, 46th president of the United States began with Inauguration of Joe Biden, his inauguration on January 20, 2021, and ended on January 20, 2025. Biden, a member of the Democr ...
has promised to finance vaccine manufacturing in various nations with its announcement in the Quad Summit held in March 2021 that it will provide supply of up to one billion coronavirus vaccines across Asia by the end of 2022 along with
India
India, officially the Republic of India, is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area; the List of countries by population (United Nations), most populous country since ...
,
Australia
Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
and
Japan
Japan is an island country in East Asia. Located in the Pacific Ocean off the northeast coast of the Asia, Asian mainland, it is bordered on the west by the Sea of Japan and extends from the Sea of Okhotsk in the north to the East China Sea ...
. The United States vaccine export policies have been criticised as "Vaccine Apartheid" by ''
The Independent
''The Independent'' is a British online newspaper. It was established in 1986 as a national morning printed paper. Nicknamed the ''Indy'', it began as a broadsheet and changed to tabloid format in 2003. The last printed edition was publis ...
''.
European Union
UK-based
AstraZeneca
AstraZeneca plc () (AZ) is a British-Swedish multinational pharmaceutical and biotechnology company with its headquarters at the Cambridge Biomedical Campus in Cambridge, UK. It has a portfolio of products for major diseases in areas includi ...
was accused of prioritizing the UK market and when their EU vaccine production lagged behind the UK. Diplomatic protests from the Irish and UK sides resolved the matter and the threat was withdrawn. In March 2021, the EU planned to suspend vaccine exports once again in order to incentivize the UK to export its domestic vaccine production.
Vaccine nationalism
This led to fears about vaccine nationalism, where developed countries would benefit in producing home-grown vaccine and poorer countries would not get access to the vaccine as soon, ultimately prolonging the pandemic. A similar phenomenon was observed during the
H1N1 Flu and
Ebola
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after in ...
crisis. During the pandemic situation, there is a "diplomatic race ... for potential vaccines."
Another concern has been that wealthier countries would gain prioritized access to vaccines based on their ability to pay. The COVAX program was established with the intention of counteracting this development. In 2021, an unequal distribution of vaccines based on the principle of vaccine nationalism was observed between high, middle, and low income countries. An August 2021 study concluded that this behavior has resulted in increased transmission of COVID-19, especially because it encourages the development of
COVID-19 variants.
Possible collaboration among countries
In early August 2020,
Malaysian Minister of Foreign Affairs Hishammuddin Hussein
Hishammuddin bin Hussein ( Jawi: هشام الدين بن حسين; born 5 August 1961) is a Malaysian politician and lawyer who served as Senior Minister of the Security Cluster and Minister of Defence from 2021 to 2022. A member of the Unite ...
said on
Twitter
Twitter, officially known as X since 2023, is an American microblogging and social networking service. It is one of the world's largest social media platforms and one of the most-visited websites. Users can share short text messages, image ...
that he had spoken with both
Chinese Foreign Minister Wang Yi
Wang Yi ( zh, s=王毅, p=Wáng Yì; born 19 October 1953) is a Chinese diplomat and politician who has been serving as Director of the Chinese Communist Party (CCP) Central Committee Foreign Affairs Commission Office since January 2023, and ...
and
United States Secretary of State
The United States secretary of state (SecState) is a member of the executive branch of the federal government of the United States and the head of the U.S. Department of State.
The secretary of state serves as the principal advisor to the ...
Mike Pompeo
Michael Richard Pompeo (; born December 30, 1963) is an American retired politician who served in the First presidency of Donald Trump#Administration, first administration of Donald Trump as director of the Central Intelligence Agency (CIA) fr ...
on methods to further collaboration on vaccines.
See also
*
Aid
In international relations, aid (also known as international aid, overseas aid, foreign aid, economic aid or foreign assistance) is – from the perspective of governments – a voluntary transfer of resources from one country to another. Th ...
*
Soft power
In politics (and particularly in international politics), soft power is the ability to co-option, co-opt rather than coerce (in contrast with hard power). It involves shaping the preferences of others through appeal and attraction. Soft power is ...
*
Science diplomacy Science diplomacy describes how scientific exchanges and the cross-border collaboration of scientists or scientific organizations can perform diplomatic functions in the context of international relations. Most often this diplomacy happens as part o ...
*
Science diplomacy and pandemics
Further reading
*
References
{{Epidemics
Vaccines
Medical diplomacy