Since the start of the global COVID-19 pandemic, vaccines have been promoted as an important tool for ending the global health emergency. Even while controlled clinical trials were measuring the medical efficacy of vaccine innovation, anthropologists were calling for increased focus on social efficacy of novel vaccines. The fact is that vaccination campaigns have always been a project of public cooperation. A vaccine can only be as effective as public willingness to participate and the community’s ability to access the resource. The technological breakthrough that COVID-19 vaccines represent, however, has tended to garner more attention and resources than has the social enterprise of vaccination. Anthropologists have been studying vaccine confidence for decades. This research has demonstrated that multiple factors influence a person’s perspectives on, and acceptance of vaccines (i.e. individual and group influences; contextual influences • historical, political, and institutional; and vaccine development and safety). Just as contagious as the pathogens that vaccines are trying to stop, are the personal perceptions, emotions, and beliefs that transmit within the social environment. Contextual influences • from historical maltreatment from the medical industry to issues of systematic racism • affect issues of trust vs mistrust, as well as material access in a vaccination campaign. Transparency in the vaccine development process , including safety monitoring systems and personal experience with adverse effects, has major effects on the credibility of vaccination efforts. Both within countries and across the world, the pandemic has had disproportionate adverse impacts. It is critical that COVID vaccines be delivered in a fair and equitable fashion to remedy these disparities. While each country has been leading its own vaccination delivery efforts, the reality is such that in order to stop the pandemic, we must reach community immunity among the global population. Rich countries have received reasonable pressure to waive intellectual property rights over COVID vaccine, and to prioritize vaccination of vulnerable adults worldwide over that of their own less-vulnerable children, to ensure an equitable distribution of the resource across the globe. This round table brings together anthropologists who have been working closely in local communities, nations, and the world on the COVID-19 vaccine roll out from a social efficacy and equity perspective. The roundtable aims to have all participants engage actively in a conversation about appropriate response efforts. This round table discussion will be conducted in an open forum fashion in order to encourage as much dialogue with the audience as possible.