A secret list was drawn up by former President Trump that decided which countries would receive the vaccine first when it became available early in 2021.
The confidential list gave priority to those nations with whom the U.S. had a good relationship with, ahead of poorer countries with arguably greater needs.
The list, which saw each country being given a score, was drawn up months before the vaccine became a reality, during the second half of 2020.
It saw countries considered allies, including Israel, Taiwan, South Korea, Canada and several European nations, all being placed at the front of the queue.
A confidential vaccine distribution list was developed under former President Trump. Administration prepared a secret list of which nations would get the doses first
Gavi, the Vaccine Alliance, a public–private global health partnership with the goal of increasing access to immunization in poor countries, was third on the list. Pictured, a medical worker in Israel prepares to vaccinate someone. Israel led the world's vaccination efforts
This is despite such nations already having robust healthcare systems of their own and enough financial resources to purchase their own supply, together with the infrastructure to distribute it and store it in giant freezers.
Second on the list were countries that were involved with the development of the pandemic-altering shot.
Gavi, the Vaccine Alliance, a public–private global health partnership with the goal of increasing access to immunization in poor countries was third on the list.
Any nation that didn't fall into the first three categories was then automatically placed at lowest priority level, coming fourth on the list.
The priority list essentially saw the vaccine distributed according to political preferences instead of serving the neediest - ignoring the pleas of global health advocates.
The document which was drawn up under the Trump Administration was passed along to the Biden Administration in January 2021 including officials on the National Security Council, according to Politico, which has seen the information and spoken to five current and former officials.
'We thought that the categories themselves made sense at the time,' said Paul Mango, the former deputy chief of staff for policy at the Department of Health and Human Services, but who was not directly involved in the formation of the list.
'The underserved countries were third on the list,' he said.
'There was a meeting where the-HHS Secretary Alex Azar said: 'My guess is everyone in the world is going to be wanting the vaccine. We need to have a plan,' Mango explained.
The list considered various factors affecting each country including the level of outbreak of the disease and their ability to distribute doses.
But it saw the Trump administration deliberately place those countries with poorer healthcare systems and little in the way of finances to purchase doses in significant numbers, at the back of the line. The countries are those where officials have struggled to contain the spread.
Officials from the State Department, Pentagon, USAID and Department of Homeland Security all weighed into the decision making process.
'We identified categories and we put weights to them and then subject matter experts from each agency came in and informed those categories. From there, we had a panel of experts score each country based on the evidence provided', one former Trump official said.
'We just felt there was no other way to do it,' they added.
Officials who worked during the Trump Administration say the document was only circulated among a small group of people in order to reduce the risk that it might be leaked, likely angering countries around the world and creating some awkward diplomatic discussions.
However, its very existence may shed light as to why still so many countries around the world do not have effective access to the covid vaccines.
'There was a meeting where then-HHS Secretary Alex Azar, right, said 'My guess is everyone in the world is going to be wanting the vaccine. We need to have a plan', said one official
So far, the Biden administration has revealed very little about its decision-making process over how it is decided where to send doses of the vaccine
'The need for transparency is incredibly important and I've been in numerous meetings now where I've asked for that transparency,' said Rep. Raja Krishnamoorthi, a Democrat from Illinois who is attempting to persuade Congress to allocate more resources to low- and middle-income countries.
'I am now concerned that the lack of transparency is related to the confusion that might exist even within administration as to its strategy for how to address the mounting needs around the world. Or it might be related to not wanting to shed light on the deficit between the need and what's been allocated or pledged.'
Although put down on paper, the Trump vaccination priority plan was never put into action because Biden administration came to power before the inoculation effort had been fully established.
'The Biden Administration does not use the previous Administration's policy or the cited list to make vaccine sharing decisions,' read a statement on Thursday.
So far, the Biden administration has revealed very little about its decision-making process over how it decides where to send doses.
A Biden official stated that allocations are 'determined based upon well-defined and articulated principals: no strings attached, free, as well as a country's vaccination coverage and access to vaccines.'
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