RT Journal Article SR Electronic T1 Vaccine equity in COVID-19: a meta-narrative review JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e009876 DO 10.1136/bmjgh-2022-009876 VO 7 IS 12 A1 Borowicz, Julia A1 Zhang, Zheting A1 Day, Giskin A1 Pinto da Costa, Mariana YR 2022 UL http://gh.bmj.com/content/7/12/e009876.abstract AB The topic of inequitable vaccine distribution has been widely discussed by academics, journalists and policy-makers in the context of the COVID-19 pandemic. However, research into perceptions of vaccine equity has been particularly neglected, resulting in a lack of universal understanding of vaccine equity. To address this, we conducted a meta-narrative review on COVID-19 vaccine equity according to the Realist And MEta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standard. The review included articles published between January 2020 and September 2021. It aims to (1) identify research traditions that have considered this topic and investigate how it has been conceptualised; (2) explore any potential differences in understandings of the concept of vaccine equity adopted by distinct research groups; and (3) investigate the angles from which authors based their recommendations on how vaccine equity can be achieved. Five meta-narratives from the literature across various research traditions are identified, contextualised and discussed: frameworks and mechanisms for vaccine allocation, global health law, vaccine nationalism, ethics and morality, and reparative justice. Our findings indicate the need for a comparative review of existing global COVID-19 allocation frameworks, with a focus on explicating understandings of vaccine equity. COVID-19 will not be the last health crisis the world confronts. Heterogeneity in the academic literature is part of the way concepts are debated and legitimised, but in the interests of global public health policy-making, it is desirable to reach a consensus on what constitutes progress on equitable development, production, distribution and research.All data relevant to the study are included in the article or uploaded as online supplemental information.