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The international community could have learnt lessons from this debacle and put in place a different kind of global vaccine allocation system for COVID-19. In an ideal system, manufacturers would openly share patents and manufacturing technology and adopt transparent, non-profit pricing; manufacturing would be globalised; and countries worldwide would pool funding to buy and allocate vaccines for everyone who needs them, free at the point of care. Unfortunately, we failed to learn from the H1N1 pandemic—rich nations are again flexing their market power by entering into bilateral purchase agreements with COVID-19 vaccine manufacturers (table 1), potentially hoarding the global supply. 3 Such ‘vaccine nationalism’is a major threat to reaching global herd immunity and a return of normal social and economic activity. 4 5