Hasan Mahmud Reza and colleagues argue that access to vaccines enabled by predictable supply of vaccine doses and delivery to remote areas are critical for vaccine uptake in low and middle income countriesCovid-19 vaccine distribution has brought global inequities in healthcare access into sharp relief. In the first six months of vaccine distribution, over 90% of all doses were given to residents of high and upper middle income nations. Many other countries are now catching up, but less than 21.5% of Africans were vaccinated 18 months after vaccine development.